title: Shared communication processes within healthcare teams for rare diseases and their influence on healthcare professionals' innovative behavior and patient satisfaction.
abstract: BACKGROUND
  A rare disease is a pattern of symptoms that afflicts less than five in 10,000 patients. However, as about 6,000 different rare disease patterns exist, they still have significant epidemiological relevance. We focus on rare diseases that affect multiple organs and thus demand that multidisciplinary healthcare professionals (HCPs) work together. In this context, standardized healthcare processes and concepts are mainly lacking, and a deficit of knowledge induces uncertainty and ambiguity. As such, individualized solutions for each patient are needed. This necessitates an intensive level of innovative individual behavior and thus, adequate idea generation. The final implementation of new healthcare concepts requires the integration of the expertise of all healthcare team members, including that of the patients. Therefore, knowledge sharing between HCPs and shared decision making between HCPs and patients are important. The objective of this study is to assess the contribution of shared communication and decision-making processes in patient-centered healthcare teams to the generation of innovative concepts and consequently to improvements in patient satisfaction.
  
  
  METHODS
  A theoretical framework covering interaction processes and explorative outcomes, and using patient satisfaction as a measure for operational performance, was developed based on healthcare management, innovation, and social science literature. This theoretical framework forms the basis for a three-phase, mixed-method study. Exploratory phase I will first involve collecting qualitative data to detect central interaction barriers within healthcare teams. The results are related back to theory, and testable hypotheses will be derived. Phase II then comprises the testing of hypotheses through a quantitative survey of patients and their HCPs in six different rare disease patterns. For each of the six diseases, the sample should comprise an average of 30 patients with six HCP per patient-centered healthcare team. Finally, in phase III, qualitative data will be generated via semi-structured telephone interviews with patients to gain a deeper understanding of the communication processes and initiatives that generate innovative solutions.
  
  
  CONCLUSIONS
  The findings of this proposed study will help to elucidate the necessity of individualized innovative solutions for patients with rare diseases. Therefore, this study will pinpoint the primary interaction and communication processes in multidisciplinary teams, as well as the required interplay between exploratory outcomes and operational performance. Hence, this study will provide healthcare institutions and HCPs with results and information essential for elaborating and implementing individual care solutions through the establishment of appropriate interaction and communication structures and processes within patient-centered healthcare teams.
authors.affiliation: Institute for Technology and Innovation Management, Technische Universität Berlin, Strasse des 17, Juni 135, 10623 Berlin, Germany. henrike.hannemann-weber@tu-berlin.de
authors.forename: Henrike
authors.initials: H
authors.lastname: Hannemann-Weber
authors.forename: Maura
authors.initials: M
authors.lastname: Kessel
authors.forename: Karolina
authors.initials: K
authors.lastname: Budych
authors.forename: Carsten
authors.initials: C
authors.lastname: Schultz
mesh_terms: D003142:Communication; D003299:Cooperative Behavior; D003657:Decision Making; D004059:Diffusion of Innovation; D005858:Germany; D006801:Humans; D010348:Patient Care Team / Q000458:organization & administration*; D017060:Patient Satisfaction; D035583:Rare Diseases / Q000628:therapy*; D011795:Surveys and Questionnaires