Communication Accommodation Theory as an Intervention Tool to Improve Interprofessional Practice in Healthcare

  • Bernadette M. WatsonEmail author
Part of the Communicating in Professions and Organizations book series (PSPOD)


Leonard et al. (The Human Factor: The Critical Importance of Effective Teamwork and Communication in Providing Safe Care. Quality and Safety in Health Care, 13(Suppl 1), i85–i90, 2004) stated that 70% of patient adverse events were caused by communication failure. To date, interventions to improve communication have not reduced adverse events (Zegers et al., Evidence-Based Interventions to Reduce Adverse Events in Hospitals: A Systematic Review of Systematic Reviews. BMJ Open, 6(9), e012555, 2016). This chapter examines why communication competence skills training interventions have not led to effective communication between different health professions. It argues that, while communication skills interventions are critical to establishing quality patient care, by themselves they are insufficient. An applied theoretical approach is required, which takes account of intergroup dynamics and socio-technical structures in health settings. These factors are most often ignored in communication competence training interventions. By linking practical interventions with a robust theory of communication such as communication accommodation theory, it is possible to bring theory and practice together. This will enable health professionals to recognise how the health context influences their day-to-day interactions with other health professionals and patients.


  1. Anderson, E. S., & Lennox, A. (2009). The Leicester Model of Interprofessional Education: Developing, Delivering and Learning from Student Voices for 10 Years. Journal of Interprofessional Care, 23(6), 557–573.CrossRefGoogle Scholar
  2. Ashforth, B. E., & Mael, F. (1989). Social Identity Theory and the Organization. Academy of Management Review, 14, 20–39.CrossRefGoogle Scholar
  3. Auraaen, A., Klazinga, N. S., & Slawormiski, L. (2017). The Economics of Patient Safety. OECD Health Working Papers, 106, 1–57. Scholar
  4. Barnes, M. (2011). Findings of the Inquest into the Death of Ryan Charles Saunders (Rockhampton Coroner’s Court, Ed.). Brisbane, QLD: Office of the State Coroner.Google Scholar
  5. Chevalier, B. A. M., Watson, B., Barras, M., & Cottrell, W. N. (2017). Investigating Strategies Used by Hospital Pharmacists to Effectively Communicate with Patients During Medication Counselling. Health Expectations, 20(5), 1121–1132. Scholar
  6. Chevalier, B. A. M., Watson, B. M., Barras, M. A., & Cottrell, W. N. (2018). Hospital Pharmacists’ and Patients’ Views About What Constitutes Effective Communication Between Pharmacists and Patients. International Journal of Pharmacy Practice, 26(5), 450–457. Scholar
  7. Chevalier, B. A. M., Watson, B., Barras, M., Cottrell, W., & Angus, D. (2019). Using Discursis to Enhance the Qualitative Analysis of Hospital Pharmacist–Patient Interactions. PLoS ONE, 13(5), e0197288. Scholar
  8. Coupland, N., Wiemann, J. M., & Giles, H. (1991). Talk as “problem” and Communication As “miscommunication”: An Integrative Analysis. In N. Coupland, H. Giles, & J. M. Wiemann (Eds.), “Miscommunication” and Problematic Talk (pp. 1–17). Newbury Park, CA: Sage.Google Scholar
  9. Dragojevic, M., & Giles, H. (2014). Language and Interpersonal Communication: Their Intergroup Dynamics. In C. R. Berger (Ed.), Handbook of Interpersonal Communication (pp. 29–51). Berlin: De Gruyter Mouton.Google Scholar
  10. Emry, R., & Wiseman, R. L. (1987). An Intercultural Understanding of Ablebodied and Disabled Persons’ Communication. International Journal of Intercultural Relations, 11(1), 7–27. Scholar
  11. Fiol, C. M., Pratt, M. G., & O’Connor, E. J. (2009). Managing Intractable Identity Conflicts. Academy of Management Review, 34, 32–35.CrossRefGoogle Scholar
  12. Foronda, C., MacWilliams, B., & McArthur, E. (2016). Interprofessional Communication in Healthcare: An Integrative Review. Nurse Education in Practice, 19, 36–40.CrossRefGoogle Scholar
  13. Frenk, J., Chen, L., Bhutta, Z. A., Cohen, J., Crisp, N., Evans, T., Fineberg, H., Garcia, P., Ke, Y., Kelley, P., Kistnasamy, B., Meleis, A., Naylor, D., Pablos-Mendez, A., Reddy, S., Scrimshaw, S., Sepulveda, J., Serwadda, D., & Zurayk, H. (2010). Health Professionals for a New Century: Transforming Education to Strengthen Health Systems in an Interdependent World. The Lancet, 376(9756), 1923–1958.CrossRefGoogle Scholar
  14. Gallois, C., Ogay, T., & Giles, H. (2005). Communication Accommodation Theory: A Look Back and a Look Ahead. In W. Gudykunst (Ed.), Theorizing about Intercultural Communication (pp. 121–148). Thousand Oaks, CA: Sage.Google Scholar
  15. Gallois, C., Watson, B. M., & Giles, H. (2018). Intergroup Communication: Identities and Effective Interactions. Journal of Communication, 68(2), 309–317.CrossRefGoogle Scholar
  16. Giles, H. (2016). The Social Origins of CAT. In H. Giles (Ed.), Communication Accommodation Theory: Negotiating Personal Relationships and Social Identities across Contexts (pp. 1–12). Cambridge, USA: Cambridge University Press.Google Scholar
  17. Grice, A., Gallois, C., Jones, E., Paulsen, N., & Callan, V. J. (2006). “We Do It, but They Don’t”: Multiple Categorizations and Work Team Communication. Journal of Applied Communication Research, 34(4), 331–348.CrossRefGoogle Scholar
  18. Hewett, D. G., Watson, B. M., & Gallois, C. (2015). Communication Between Hospital Doctors: Underaccommodation and Interpretability. Language & Communication, 41, 71–83.CrossRefGoogle Scholar
  19. Hewett, D. G., Watson, B. M., Gallois, C., Ward, M., & Leggett, B. A. (2009a). Communication in Medical Records: Intergroup Language and Patient Care. Journal of Language and Social Psychology, 28(2), 119–138.CrossRefGoogle Scholar
  20. Hewett, D. G., Watson, B. M., Gallois, C., Ward, M., & Leggett, B. A. (2009b). Intergroup Communication Between Hospital Doctors: Implications for Quality of Patient Care. Social Science and Medicine, 69(12), 1732–1740.CrossRefGoogle Scholar
  21. Jones, L., Woodhouse, D., & Rowe, J. (2007). Effective Nurse Parent Communication: A Study of Parents’ Perceptions in the NICU Environment. Patient Education and Counseling, 69(1–3), 6.Google Scholar
  22. Kish-Gephart, J. J., Detert, J. R., Treviño, L. K., & Edmondson, A. C. (2009). Silenced by Fear: The Nature, Sources, and Consequences of Fear at Work. Research in Organizational Behavior, 29, 163–193.CrossRefGoogle Scholar
  23. Leonard, M., Graham, S., & Bonacum, D. (2004). The Human Factor: The Critical Importance of Effective Teamwork and Communication in Providing Safe Care. Quality and Safety in Health Care, 13(Suppl 1), i85–i90.CrossRefGoogle Scholar
  24. Lewin, S., & Reeves, S. (2011). Enacting “team” and “teamwork”: Using Goffman’s Theory of Impression Management to Illuminate Interprofessional Practice on Hospital Wards. Social Science & Medicine, 72(10), 1595–1602.CrossRefGoogle Scholar
  25. Lingard, L., Espin, S., Evans, C., & Hawryluck, L. (2004). The Rules of the Game: Interprofessional Collaboration on the Intensive Care Unit Team. Critical Care, 8(6), 403–408.CrossRefGoogle Scholar
  26. Lingard, L., Schryer, C. F., Spafford, M. M., & Campbell, S. L. (2007). Negotiating the Politics of Identity in an Interdisciplinary Research Team. Qualitative Research, 7(4), 501–519.CrossRefGoogle Scholar
  27. Manias, E., Geddes, F., Watson, B., Jones, D., & Della, P. (2015). Communication Failures during Clinical Handovers Lead to a Poor Patient Outcome: Lessons from a Case Report. SAGE Open Medical Case Reports, 3.Google Scholar
  28. Palomares, N. A., Giles, H., Soliz, J., & Gallois, C. (2016). Intergroup Accommodation, Social Categories, and Identities. In H. Giles (Ed.), Communication Accommodation Theory: Negotiating Personal Relationships and Social Identities Across Contexts (pp. 123–151). Cambridge: Cambridge University Press.CrossRefGoogle Scholar
  29. Pitts, M. J., & Harwood, J. (2015). Communication Accommodation Competence: The Nature and Nurture of Accommodative Resources Across the Lifespan. Language & Communication, 41, 89–99.CrossRefGoogle Scholar
  30. Rittel, H. W. J., & Webber, M. M. (1973). Dilemmas in a General Theory of Planning. Policy Sciences, 4(2), 155–169.CrossRefGoogle Scholar
  31. Singer, S., & Vogus, T. J. (2013). Safety Climate Research: Taking Stock and Looking Forward. Quality and Safety in Health Care, 22, 1–4.CrossRefGoogle Scholar
  32. Tajfel, H. (1982). Social Psychology of Intergroup Relations. Annual Review of Psychology, 33, 1–39.CrossRefGoogle Scholar
  33. Tajfel, H., & Turner, J. C. (1986). The Social Identity Theory of Intergroup Behavior. In S. Worchel & W. G. Austin (Eds.), Psychology and Intergroup Relations (pp. 7–24). Chicago: Nelson-Hall.Google Scholar
  34. Teal, C. R., & Street, R. L. (2009). Critical Elements of Culturally Competent Communication in the Medical Encounter: A Review and Model. Social Science & Medicine, 68(3), 533–543.CrossRefGoogle Scholar
  35. Thomson, K., Outram, S., Gilligan, C., & Levett-Jones, T. (2015). Interprofessional Experiences of Recent Healthcare Graduates: A Social Psychology Perspective on the Barriers to Effective Communication, Teamwork, and Patient-Centred Care. Journal of Interprofessional Care, 29, 634–640.CrossRefGoogle Scholar
  36. Vogus, T. J., Sutcliffe, K. M., & Weick, K. E. (2010). Doing No Harm: Enabling, Enacting, and Elaborating a Culture of Safety in Health Care. Academy of Management Perspectives, 24(4), 60–77.Google Scholar
  37. Watson, B. M., & Gallois, C. (1998). Nurturing Communication by Health Professionals Toward Patients: A Communication Accommodation Theory Approach. Health Communication, 10, 343–355.CrossRefGoogle Scholar
  38. Watson, B. M., & Gallois, C. (1999). Communication Accommodation Between Patients and Health Professionals: Themes and Strategies in Satisfying and Unsatisfying Encounters. International Journal of Applied Linguistics, 9(2), 167–183.CrossRefGoogle Scholar
  39. Watson, B. M., Gallois, C., Hewett, D. G., & Jones, E. (2012a). Culture and Health Care: Intergroup Communication and Its Consequences. In J. Jackson (Ed.), The Routledge Handbook of Intercultural Communication (pp. 512–524). London: Routledge.Google Scholar
  40. Watson, B. M., Hewett, D. G., & Gallois, C. (2012b). Intergroup Communication and Healthcare. In H. Giles (Ed.), The Handbook of Intergroup Communication (pp. 293–305). New York: Routledge.Google Scholar
  41. Watson, B. M., Jones, L., & Hewett, D. G. (2016). Accommodating Health. In H. Giles (Ed.), Communication Accommodation Theory: Negotiating Personal Relationships and Social Identities across Contexts (pp. 152–168). Cambridge: Cambridge University Press.CrossRefGoogle Scholar
  42. Williams, A., Giles, H., Coupland, N., Dalby, M., & Manasse, H. (1990). The Communicative Contexts of Elderly Social Support and Health: A Theoretical Approach. Health Communication, 2, 123–143.CrossRefGoogle Scholar
  43. Williams, K. N. (2006). Improving Outcomes of Nursing Home Interactions. Research in Nursing & Health, 29(2), 121–133.CrossRefGoogle Scholar
  44. World Health Organization. (2010). Framework for Action on Interprofessional Education and Collaborative Practice. World Health Organization.Google Scholar
  45. Zegers, M., Hesselink, G., Geense, W., Vincent, C., & Wollersheim, H. (2016). Evidence-Based Interventions to Reduce Adverse Events in Hospitals: A Systematic Review of Systematic Reviews. BMJ Open, 6(9), e012555.CrossRefGoogle Scholar

Copyright information

© The Author(s) 2020

Authors and Affiliations

  1. 1.The Hong Kong Polytechnic UniversityKowloonHong Kong

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