Interdisciplinary teamwork for healthcare professionals supporting patients to manage and prevent falls among older adults in Saudi Arabian hospitals: a multi-method study

Abstract

Background: Falls among older adults continue to be a major
patient safety issue globally, associated with a high morbidity, prolonged hospitalisation, loss of independence, and increased healthcare costs. Fall prevention requires interdisciplinary teamwork that includes coordinated communication and shared decision-making among healthcare professionals. Although there is an increasing body of international evidence on the significance of interdisciplinary collaboration, there is a paucity of research on the role of such collaboration in hospital-based falls prevention in the Kingdom of Saudi Arabia (KSA), and no research has combined the perspectives of both professionals and patients on this issue.Aim: To fill this gap, this study examined the role of interdisciplinary teamwork in the prevention, assessment, and management of falls among older adults in KSA hospitals. Three objectives guided the research: first, to investigate the available evidence by conducting a scoping review of the international literature; second, to determine HCPs' perceptions of teamwork in falls prevention using a quantitative survey; and third, to investigate patients’ experiences of interdisciplinary teamwork via qualitative interviews.Methods: A pragmatic multi-method research design informed by constructivist principles was adopted, guided by an integrated theoretical framework combining the WHO Interprofessional Collaborative Practice (IPCP) framework and the TeamSTEPPS model. Phase 1 involved a scoping review based on the framework developed by Arksey and O’Malley, which identified and synthesised evidence from 10 studies. Phase 2 employed a quantitative survey, a descriptive cross-sectional survey with the TeamSTEPPS Teamwork Perceptions Questionnaire on Fall Risk Reduction (T-TPQ) with 190 HCPs in two government hospitals in Hail, KSA. Data were analysed using SPSS version 29, including descriptive statistics, correlations, ANOVA, and multivariate linear regression. Phase 3 involved qualitative interviews with 15 older adults who had experienced a fall in the same hospitals. Interview data were analysed using Braun and Clarke’s thematic analysis approach, supported by NVivo version 14.Results: The scoping review revealed that effective communication, role clarity, and shared decision-making are key elements of falls prevention, and that there is a lack of evidence from non-Western healthcare settings. Quantitative results indicated mixed perceptions of teamwork among HCPs, with levels of agreement remaining below 41% across all domains. Situation monitoring received the lowest ratings, while leadership engagement, situation monitoring and mutual support were also identified as areas requiring improvement. Differences in perceptions were found across professional and demographic groups. Qualitative results revealed four themes: patient vulnerability and risk factors, communication and patient involvement, healthcare team responsiveness and teamwork, and institutional and system-level factors. Patients reported communication deficits, lack of involvement in decision-making, delays in receiving help, and environmental safety concerns. The quantitative and qualitative phases provided complementary perspectives, highlighting a gap between healthcare professionals’ perceptions and patients’ experiences. Although professionals regarded their teams as broadly functional, patients experienced substantial shortcomings in communication, coordination, and patient-centred care.Conclusion: To the researcher’s knowledge, this is the first multi-method study examining interdisciplinary collaboration in hospital-based falls prevention in KSA. The study provided a conceptual and operational understanding of teamwork competencies in clinical practice by combining the WHO IPCP framework and the TeamSTEPPS model. The results indicate the necessity of structured communication protocols, collective professional responsibility, active patient education, and linguistically sensitive strategies of collaborative falls prevention. The study adds to the body of evidence on teamwork and patient safety in the Middle East and provides implications for clinical practice, interdisciplinary education, healthcare policy, and future research recommendations.

Thesis embargoed until 31st December 2028

Date of Award	Dec 2026
Original language	English
Awarding Institution	Queen's University Belfast
Sponsors	Ministry of Education, Saudi Arabia, Royal Embassy of Saudi Arabia & Najran University
Supervisor	Gillian Prue (Supervisor), Gary Mitchell (Supervisor) & James McMahon (Supervisor)