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Butler JI, Fox MT. 'Our Voices Aren't Being Heard': A qualitative descriptive study of nurses' perceptions of interprofessional collaboration in care supporting older people's functioning during a hospital stay. Scand J Caring Sci 2024; 38:398-408. [PMID: 38323707 DOI: 10.1111/scs.13243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 01/10/2024] [Accepted: 01/26/2024] [Indexed: 02/08/2024]
Abstract
INTRODUCTION Older people admitted to hospital are highly susceptible to functional decline and related complications. Care supporting their functioning is complex and requires healthcare professionals working in concert, with nurses playing a central role. Yet, little is known about nurses' perceptions of interprofessional collaboration (IPC) in care supporting functioning in acutely admitted older people. To fill this knowledge gap, we elucidate the perspectives of nurses in Ontario, Canada, on IPC in care supporting older people's functioning during a hospital stay. METHODS We employed a qualitative methodology in conjunction with a qualitative descriptive design. Thirteen focus groups were held with a purposeful, criterion-based sample of 57 acute care nurses practising in a range of acute care settings (e.g. Emergency, General Medicine, General Surgery, Intensive Care, Coronary Care). Data were thematically analysed. RESULTS We identified two overarching themes: (1) IPC is improving, but nurses are excluded from decision-making and (2) nurse advocacy causes friction with other professionals. The first theme captures nurses' perception that IPC in older people's care is improving, but nurses are marginalised in interprofessional decision-making. As a result, nurses perceive that their knowledge is devalued, and their contributions to care supporting older people's functioning are undermined. The second theme underlines a tension between interprofessional team practices and patient- and family-centred care, while also demonstrating nurses' increasing willingness to act as patient and family advocates. CONCLUSIONS Findings can be used to enhance IPC in care supporting the functioning of acutely hospitalised older people. To improve IPC, clinical and administrative leaders should cultivate more egalitarian team relationships that encourage nurses to contribute to decision-making and advocate on behalf of older patients and their families.
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Affiliation(s)
- Jeffrey I Butler
- Faculty of Health, School of Nursing, York University, Toronto, Ontario, Canada
- York University Centre for Aging Research and Education, Toronto, Ontario, Canada
| | - Mary T Fox
- Faculty of Health, School of Nursing, York University, Toronto, Ontario, Canada
- York University Centre for Aging Research and Education, Toronto, Ontario, Canada
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Skyberg H, Jenssen D. What professionals say and do: the tension between egalitarianism and hierarchy in interprofessional teamwork. J Interprof Care 2024; 38:200-208. [PMID: 38117647 DOI: 10.1080/13561820.2023.2289512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 11/27/2023] [Indexed: 12/22/2023]
Abstract
This study aimed to explore the power dynamics in interprofessional teamwork by conducting an ethnographic study of three interprofessional teams working in mental health and substance use services in Norway. Data were collected through 14 observation sessions and 18 in-depth interviews with health and social work professionals. Given the potential difference between "what people say and what people do," we explored how ideas of power were articulated by health and social care professionals and how such structures were observed to be played out in practice. The findings suggest a presence of contrasting egalitarian and hierarchical structures, and that professionals were aware of the resulting tension and operated within it. This study contributes to the literature on interprofessional health and social care through providing an analysis of the power dynamics of teamwork interaction and how professionals relate to such structures. The results are relevant to a broad context of interprofessionalism as they provide valuable insight into how power should be understood as a continuum of changeable positions and motivations.
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Affiliation(s)
- Henriette Skyberg
- Faculty of Social Science, Department of Social Work, Child Welfare and Social Policy, Oslo Metropolitan University, Oslo, Norway
| | - Dag Jenssen
- Faculty of Social Science, Department of Social Work, Child Welfare and Social Policy, Oslo Metropolitan University, Oslo, Norway
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3
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Nankervis K, MacKechnie-Guire R, Maddock C, Pyatt A. Experiences of Interdisciplinary Working from the Perspective of the Society of Master Saddlers Qualified Saddle Fitters. Animals (Basel) 2024; 14:559. [PMID: 38396527 PMCID: PMC10886140 DOI: 10.3390/ani14040559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 01/22/2024] [Accepted: 01/31/2024] [Indexed: 02/25/2024] Open
Abstract
Horse owners seek the advice and support of a number of equestrian professionals in carrying out their duty of care for their animal. In some instances, these professionals form a multi-disciplinary team (MDT). The aim of this study was to explore the experiences of the Society of Master Saddlers' qualified saddle fitters (SMSQSFs) working with other professionals and to understand the nature of inter-disciplinary working from an SMSQSF perspective. Semi-structured, one-to-one online interviews with fourteen SMSQSFs were completed. Areas explored included the nature of the participant's client base; the frequency and nature of their interactions with other professionals; their perceptions of horse owner expectations of an MDT approach; and any benefits, challenges, and barriers to an MDT approach within an equestrian setting. Interviews were video and audio recorded (MS Teams), transcribed verbatim (Otter ai), and imported into qualitative data analysis software (NVivo, version 12). Data were analysed using thematic analysis. Six themes were identified: (1) effective communication; (2) multidisciplinary expectations; (3) horse welfare; (4) professionalism; (5) relationships; (6) working together. Communication was recognised as a crucial component of an effective MDT. Most participants valued and desired an MDT approach. They felt they had a key role to play within the equestrian MDT, not only in the prevention of deterioration in horse welfare but also in improving the functionality and performance of the horse-rider partnership. Effective MDT working was also seen as having benefits to SMSQSFs and other professional stakeholders alike, although time and financial constraints were identified as barriers to MTD working. The role of the horse owner within the MDT was unclear and potentially complex, and this and other factors such as the professional identity of the SMSQSF, personal relationships, and input from others outside of the MDT team were identified as challenges to effective MDT working. This present study found that SMSQSFs experience similar benefits and challenges to an MDT approach as seen in human healthcare settings. The role of the horse owner, communication, and professional recognition are indicated as pivotal to MDT effectiveness in achieving optimal saddle fit.
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Affiliation(s)
- Kathryn Nankervis
- Equine Department, Hartpury University, Gloucestershire GL19 3BE, UK; (R.M.-G.); (C.M.)
| | | | - Christy Maddock
- Equine Department, Hartpury University, Gloucestershire GL19 3BE, UK; (R.M.-G.); (C.M.)
| | - Alison Pyatt
- International Office, Veterinary Medicines Directorate, Addlestone KT15 3LS, UK;
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Eliassen M, Moholt JM. Boundary work in task-shifting practices - a qualitative study of reablement teams. Physiother Theory Pract 2023; 39:2106-2119. [PMID: 35430950 DOI: 10.1080/09593985.2022.2064380] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 03/28/2022] [Accepted: 04/04/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Health services worldwide have provided incentives for establishing teams to accommodate complex health care tasks, enhance patient outcomes and organizational efficiency, and compensate for shortages of health care professionals. Parallel to and partly due to the increased focus on teamwork, task shifting has become a health policy. Task shifting involves new tasks and responsibilities, which may result in social negotiations about occupational boundaries. OBJECTIVE The aim of this study was to explore how the division of tasks, responsibilities, and roles in reablement practices can appear as boundary work between physiotherapists (PTs) and home trainers (HTs). METHODS The study drew on data from fieldwork with seven Norwegian reablement teams, including observations and individual interviews with PTs and HTs. We conducted thematic analysis informed by a theoretical framework on professional boundaries. RESULTS We identified two different practices, which we labeled as: i) "The engine and the assistant" and ii) "The symbiotic team." We drew on these practices and theory of boundary making and boundary blurring to interpret the results. CONCLUSION The findings indicate that boundary-making processes may generate asymmetric power relations that may constrain autonomous work and job satisfaction in teams, whereas boundary-blurring processes may promote collaborative practices that enhance holistic approaches and mutual learning on reablement teams.
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Affiliation(s)
- Marianne Eliassen
- Department of Health and Care sciences, UiT, The Arctic University of Norway
| | - Jill-Marit Moholt
- Center for Care Sciences, North, UiT, The Arctic University of Norway
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Roberts V, Carter P, Barnett P, Mugglestone MA, Pilling S. Committee experiences of using formal consensus in healthcare guidelines: a longitudinal qualitative study. BMC Med Inform Decis Mak 2023; 23:147. [PMID: 37533013 PMCID: PMC10398942 DOI: 10.1186/s12911-023-02220-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 06/27/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND This feasibility study has the primary aim of capturing and comparing participant expectations and experiences of using a formal consensus method (FCM) and to explore whether these views change following participation within a guideline committee where FCM are used. METHODS Twelve healthcare committee members and associated technical team members participated in semi-structured qualitative interviews before and after using FCM during guideline committee meetings. Interviews also focused on past experiences and expectations of informal consensus methods. RESULTS Participants said formal consensus included a greater range of evidence. They described positive reactions and found it a useful way to encourage involvement by balancing group power dynamics. Group discussion time was identified as important to clarify ideas, supported by good group chairing. However, participants reported that undertaking FCM required additional resources and suggested targeting its use for low quality evidence, limited committee expertise, or where the evidence is controversial. CONCLUSIONS FCM is an acceptable alternative to informal consensus methods that has qualities specifically helpful to healthcare guidelines such as encouraging participation, inclusivity of a broad range of evidence, and managing group dynamics. More research is required to better understand when using formal consensus is most appropriate and effective.
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Affiliation(s)
- V Roberts
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational & Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Patrice Carter
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational & Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
- National Guideline Alliance, Royal College of Obstetricians and Gynaecologists, 10-18 Union Street, London, SE1 1SZ, UK.
| | - P Barnett
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational & Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
| | - M A Mugglestone
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational & Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
- National Guideline Alliance, Royal College of Obstetricians and Gynaecologists, 10-18 Union Street, London, SE1 1SZ, UK
| | - S Pilling
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational & Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
- National Guideline Alliance, Royal College of Obstetricians and Gynaecologists, 10-18 Union Street, London, SE1 1SZ, UK
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Mulder J, Teunissen TAM, Peters VMJ, Moors ML, Lagro-Janssen ALM. Views on Interprofessional Collaboration in a Dutch Sexual Assault Center: A Qualitative Study Among Workers. J Multidiscip Healthc 2023; 16:2001-2012. [PMID: 37484817 PMCID: PMC10361082 DOI: 10.2147/jmdh.s416996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 06/29/2023] [Indexed: 07/25/2023] Open
Abstract
Purpose As the response to sexual assault victims proved to be shattered and substandard, sexual assault centers were set up to improve care by providing the victims with medical, psychosocial and legal care. The Dutch Centers for Sexual Assault were launched in 2012. We wished to examine the challenges in interprofessional collaboration experienced in a long-running Dutch Sexual Assault Center. Methods In this qualitative study, data was collected via semi-structured explorative interviews which were analyzed using thematic analysis in an iterative process. The semi-structured interviews were held with fifteen professionals from medical, psychosocial and legal disciplines. An interview guide was developed based on expert opinion and the Bronstein Index of Interprofessional Collaboration. Qualitative analyses were done using the method of thematic analysis in ATLAS.ti and were reported according to the COREQ criteria. The themes of the experienced challenges in interprofessional collaboration were further clarified using quotations. Results Participants mentioned three themes that challenged interprofessional collaboration: 1. discrepancies in professional involvement, 2. conflicting goals and 3. a lack of connection. Discrepancies in motivation and affinity to work with victims of sexual violence between professionals proved to be the most pivotal challenge to collaboration, leading to disturbing differences in professional involvement. A low caseload and time restraints complicated gaining expertise, affinity and motivation. Conflicting goals and confidentiality issues arose between the medical and legal disciplines due to their contrasting aims of caring for victims versus facilitating prosecution. Some professionals felt a lack of connection, particularly due to missing face-to-face personal contact, which hindered the sharing of complex or burdensome cases and gaining insight into the other discipline's competences. Conclusion Building collective ownership and equal professional involvement are crucial for interprofessional collaboration. Professional involvement should be increased by training courses to clarify conflicting goals and to improve reciprocal personal contact between professionals. Training courses should be facilitated with organizational financial support.
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Affiliation(s)
- Jasmijn Mulder
- Department of Primary and Community Care, Gender and Women’s Health, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Theodora Alberta Maria Teunissen
- Department of Primary and Community Care, Gender and Women’s Health, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Veranie Maria Johanna Peters
- Department of Primary and Community Care, Gender and Women’s Health, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Marie Louise Moors
- Emergency Department, Radboud University Medical Center, Nijmegen, the Netherlands
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Holt G, Zabinski JS, Lewis V. MD/MSW: A Call for a New Dual-Degree Program. HEALTH & SOCIAL WORK 2023:7194691. [PMID: 37308315 DOI: 10.1093/hsw/hlad018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 10/15/2022] [Indexed: 06/14/2023]
Affiliation(s)
- Grayson Holt
- MSW and a master of bioethics and medical humanities student, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, USA
| | - Jeffrey S Zabinski
- MD, MSW, is assistant professor of psychiatry, Columbia University Medical Center, New York, NY, USA
| | - Victoria Lewis
- MD, MSW, MPP, is a Solnit Integrated Child/Adult Psychiatry resident, Child Study Center, Yale School of Medicine, New Haven, CT, USA
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Andersen LPS, Biering K, Conway PM. Negative Acts as Risk Factor for Work-Related Violence and Threats from Clients towards Employees: A Follow-Up Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3358. [PMID: 36834051 PMCID: PMC9961764 DOI: 10.3390/ijerph20043358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Work-related violence and threats are major problems in many occupations, especially within the human service sector, with consequences at multiple levels, including reduced physical and mental health, increased absenteeism, and reduced organizational commitment. It is, therefore, crucial to identify risk factors for work-related violence and threats. However, only a few studies have examined whether negative acts at work increase the risk of work-related violence and threats from clients toward employees. OBJECTIVE To examine the associations between exposure to negative acts towards employees from colleagues, clients, or a combination of both, and the risk of work-related violence and threats perpetrated by clients towards employees in a longitudinal study. METHODS Questionnaire data were collected in 2010, 2011, and 2015. In total, 5333 employees from special schools, psychiatric wards, eldercare, and the Prison and Probation Services participated in the first round of data collection in 2010. Negative acts were measured in 2010 using the Short Negative Acts Questionnaire, while work-related threats and violence were measured at all three-time points. The analyses were performed using multilevel logistic regression. RESULTS Negative acts from clients and the combination of negative acts from both clients and colleagues were associated with later exposure to work-related violence and threats. The associations were observed after one year, and work-related threats were still present after four years. CONCLUSION AND IMPLICATIONS Negative acts are associated with an increased risk of work-related violence and threats perpetrated by clients toward employees. Organizations may reduce the risk of work-related violence and threats by preventing negative acts.
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Affiliation(s)
- Lars Peter Sønderbo Andersen
- Danish Ramazzini Centre, Department of Occupational Medicine—University Research Clinic, Goedstrup Hospital, 7400 Herning, Denmark
| | - Karin Biering
- Danish Ramazzini Centre, Department of Occupational Medicine—University Research Clinic, Goedstrup Hospital, 7400 Herning, Denmark
| | - Paul Maurice Conway
- Department of Psychology, University of Copenhagen, 1353 Copenhagen, Denmark
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Gøtzsche-Astrup O, Lindekilde L, Maria Fjellman A, Bjørgo T, Solhjell R, Haugstvedt H, Sivenbring J, Andersson Malmros R, Kangasniemi M, Moilanen T, Magnæs I, Wilchen Christensen T, Mattsson C. Trust in interagency collaboration: The role of institutional logics and hybrid professionals. JOURNAL OF PROFESSIONS AND ORGANIZATION 2023. [DOI: 10.1093/jpo/joac022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
Abstract
Interagency collaboration among social workers, teachers, and police is key to countering violent extremism in the Nordic countries by securing comprehensive assessment of cases of concern. Yet, previous research indicates that different institutional logics—perceptions of fundamental goals, strategies, and grounds for attention in efforts to counter violent extremists—exist across professions and challenge collaboration and trust building in practice. In this article, we empirically investigate these claims across social workers (n = 1,105), teachers (n = 1,387), and police (n = 1,053) in four Nordic countries: Denmark, Sweden, Norway, and Finland. Using results from online surveys with professionals, we investigate the distribution of a ‘societal security logic’ and a ‘social care logic’ across professions and the degree to which these institutional logics translate into mutual trust. Through a comparison of institutional logics among practitioners with and without practical experience of interagency collaboration, we investigate whether and how institutional logics tend to mix and merge in hybrid organizational spaces. We conclude that differences in institutional logics across professions are differences in degree rather than in kind, but that such differences are important in shaping mutual trust and that experiences of interagency collaboration are correlated with a convergence toward a ‘social care logic’ conception of countering violent extremism.
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Affiliation(s)
| | - Lasse Lindekilde
- Department of Political Science, Aarhus University , 8000 Aarhus C , Denmark
| | - Anna Maria Fjellman
- Department of Education, Communication & Learning, University of Gothenburg , 40530 Gothenburg , Sweden
| | - Tore Bjørgo
- Oslo University and Norwegian Police University College , 0315 Oslo , Norway
| | - Randi Solhjell
- Norwegian Police University College , 0369 Oslo , Norway
| | - Håvard Haugstvedt
- Center for Research on Extremism, Oslo University , 0315 Oslo , Norway
| | - Jennie Sivenbring
- Department of Education, Communication & Learning, University of Gothenburg , 40530 Gothenburg , Sweden
| | - Robin Andersson Malmros
- School of Public Administration & The Segerstedt Institute, Gothenburg University , 40530 Gothenburg , Sweden
| | - Mari Kangasniemi
- Department of Nursing Science, University of Turku , 20520 Turku , Finland
| | - Tanja Moilanen
- Department of Nursing Science, University of Turku , 20520 Turku , Finland
| | - Ingvild Magnæs
- Norwegian Police University College , 0369 Oslo , Norway
| | | | - Christer Mattsson
- The Segerstedt Institute, Gothenburg University , 40530 Gothenburg , Sweden
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Lim YM, Lee JS, Kim SK, Cha TH, Yoo DH, Kim H. An exploratory study on the role of occupational therapists in home-based rehabilitation team in South Korea. Hong Kong J Occup Ther 2022; 35:180-189. [DOI: 10.1177/15691861221136262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 10/16/2022] [Indexed: 11/07/2022] Open
Abstract
Introduction: Cooperation among rehabilitation team members is essential in the home-based rehabilitation setting. Q-methodology that can quantitatively analyze the subjectivity of members of the rehabilitation team was used to explore the role of occupational therapists (OTs) in home-based rehabilitation. Methods: The Q-methodology process was implemented in five steps: Step 1 - Representative statements about the role of OTs were collected through in-depth interviews, open questionnaires, and literature reviews (Q-sample); Step 2 - A total of 34 rehabilitation team members (physical therapists, OTs, social workers, nutritionists) were recruited (P-sample); Step 3 - The statements were classified according to their subjective perspective (Q-sort); Step 4 - Factor analysis was performed based on the correlation among the responses from the participants (Q-factor analysis); Step 5 - The awareness factor for roles was interpreted (Interpretation of awareness factors). Results: The roles of OTs perceived by members of the home-based rehabilitation team were formed into five factors (A) Adaptation within home environments; (B) Professional development; (C) Reliable service execution; (D) Client needs resolution; and (E) Focus on activity participation. In all factors, perspectives on the role of OTs in helping clients participate in their roles and activities at home were included. These factors included issues and directions addressed in prior literature on the development of occupational therapy. Conclusions: In home-based rehabilitation, OTs must play a professional role in ensuring clients live fully at home, and cooperate with team members for an effective rehabilitation approach.
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Affiliation(s)
- Young-Myoung Lim
- Department, Super-Aged Society New Normal Lifestyle Research Institute, Wonju-si, Korea
| | - Jae-Shin Lee
- Department Occupational Therapy, Konyang University, Dae-jeon, Korea
| | - Su-Kyoung Kim
- Department Occupational Therapy, Konyang University, Dae-jeon, Korea
| | - Tae-Hyun Cha
- Department Occupational Therapy, Konyang University, Dae-jeon, Korea
| | - Doo-Han Yoo
- Department Occupational Therapy, Konyang University, Dae-jeon, Korea
| | - Hee Kim
- Department Occupational Therapy, Konyang University, Dae-jeon, Korea
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Yip SH, O'Connor D, Shakeri Shemirani F, Brown A, Hyman J. Emergency assistance in situations of abuse, neglect, and self-neglect: exploring the complexity and challenges. J Elder Abuse Negl 2022; 34:124-151. [PMID: 35470776 DOI: 10.1080/08946566.2022.2070317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Health and social care professionals are often called upon to provide emergency intervention without the adult's consent in situations of abuse, neglect, and self-neglect. Little is known about this process despite implications related to health care costs and individual rights. In this qualitative study, 17 health care professionals with experience enacting emergency legislation in BC were interviewed to better understand what leads to an emergency response and how these professionals carry out their role. Five components emerged in the provision of emergency assistance: assessing intolerable risks, assessing incapability, balancing ethical values, exploring resources, and consulting/collaborating. Attention is drawn to the significance of social location, including age, socio-economic, and Indigenous background for influencing the process, sometimes in unintended ways. The challenges in providing emergency interventions may result in social inequities and delay in providing care at times. The importance of bringing a reflexive and intersectional lens to providing interventions is highlighted.
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Affiliation(s)
- So Han Yip
- Manager at the ReAct Adult Protection Program, Vancouver Coastal Health, West Vancouver, British Columbia, Canada
| | - Deborah O'Connor
- Professor at the School of Social Work, University of British Columbia and Co-Director at the Centre for Research on Personhood in Dementia, Vancouver, BC, Canada
| | - Farimah Shakeri Shemirani
- Social worker at Vancouver Coastal Health, North Shore Palliative Care Program, Vancouver, BC, Canada
| | - Amanda Brown
- Director at the ReAct Adult Protection Program, Vancouver Coastal Health, West Vancouver, BC, Canada
| | - Jenny Hyman
- Social Work Site Leader at Providence Health Care, Mount St. Joseph Hospital, Vancouver, BC, Canada
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Skyberg HL. Diversity, friction, and harmonisation: an ethnographic study of interprofessional teamwork dynamics. BMC Health Serv Res 2022; 22:227. [PMID: 35183177 PMCID: PMC8857853 DOI: 10.1186/s12913-022-07596-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 02/02/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Although diversity, friction, and harmonisation in interprofessional teamwork are aspects frequently conceptualised, no empirical study discusses them in combination. Focusing on risk and function with respect to each aspect, this article empirically examines how dynamics between these aspects during interprofessional teamwork interactions fosters conditions for effective teamwork.
Methods
An ethnographic study of three interprofessional teams, in the context of mental health and substance use, was conducted in Norway. Data were collected through observations of 14 team meetings and 18 in-depth interviews with health and social work professionals. Thematic analysis was applied to code the data.
Results
A conceptual ideal-type model, which includes all three aspects was developed to represent the emergent findings. The results suggest that the diversity of professional perspectives inherent in interprofessional teams is the foundation of interprofessional teamwork. However, friction is needed to promote innovation, encourage new insights, and intensify discussions. In addition, harmonisation balances professional distinctions, fosters trust, and ties professionals together.
Conclusion
This article presents a comprehensive model of how professionals work together in interprofessional teams. The model makes visible the functions and risks of each aspect and the dynamics between them. Furthermore, the article argues for mobilisation and balance of all three aspects in combination to maximise the capacity of interprofessional teamwork. Such insight can be used to support the development and successful implementation of interprofessional teamwork in health care.
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Sukhera J, Bertram K, Hendrikx S, Chisolm MS, Perzhinsky J, Kennedy E, Lingard L, Goldszmidt M. Exploring implicit influences on interprofessional collaboration: a scoping review. J Interprof Care 2021; 36:716-724. [PMID: 34602007 DOI: 10.1080/13561820.2021.1979946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Interprofessional collaboration (IPC) is fraught with multiple tensions. This is partly due to implicit biases within teams, which can reflect larger social, physical, organizational, and historical contexts. Such biases may influence communication, trust, and how collaboration is enacted within larger contexts. Despite the impact it has on teams, the influence of bias on IPC is relatively under-explored. Therefore, the authors conducted a scoping review on the influence of implicit biases within interprofessional teams. Using scoping review methodology, the authors searched several online databases. From 2792 articles, two reviewers independently conducted title/abstract screening, selecting 159 articles for full-text eligibility. From these, reviewers extracted, coded, and iteratively analyzed key data using a framework derived from socio-material theories. Authors found that many studies demonstrated how biases regarding dominance and expertise were internalized by team members, influencing collaboration in predominantly negative ways. Articles also described how team members dynamically adapted to such biases. Overall, there was a paucity of research that described material influences, often focusing on a single material element instead of the dynamic ways that humans and materials are known to interact and influence each other. In conclusion, implicit biases are relatively under-explored within IPC. The lack of research on material influences and the relationship among racial, age-related, and gender biases are critical gaps in the literature. Future research should consider the longitudinal and reciprocal nature of both positive and negative influences of bias on collaboration in diverse settings.
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Affiliation(s)
- Javeed Sukhera
- Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Kaitlyn Bertram
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Shawn Hendrikx
- Western University Libraries, Western University, London, Ontario, Canada
| | - Margaret S Chisolm
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | - Erin Kennedy
- Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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Churruca K, Ludlow K, Wu W, Gibbons K, Nguyen HM, Ellis LA, Braithwaite J. A scoping review of Q-methodology in healthcare research. BMC Med Res Methodol 2021; 21:125. [PMID: 34154566 PMCID: PMC8215808 DOI: 10.1186/s12874-021-01309-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 04/30/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Q-methodology is an approach to studying complex issues of human 'subjectivity'. Although this approach was developed in the early twentieth century, the value of Q-methodology in healthcare was not recognised until relatively recently. The aim of this review was to scope the empirical healthcare literature to examine the extent to which Q-methodology has been utilised in healthcare over time, including how it has been used and for what purposes. METHODS A search of three electronic databases (Scopus, EBSCO-CINAHL Complete, Medline) was conducted. No date restriction was applied. A title and abstract review, followed by a full-text review, was conducted by a team of five reviewers. Included articles were English-language, peer-reviewed journal articles that used Q-methodology (both Q-sorting and inverted factor analysis) in healthcare settings. The following data items were extracted into a purpose-designed Excel spreadsheet: study details (e.g., setting, country, year), reasons for using Q-methodology, healthcare topic area, participants (type and number), materials (e.g., ranking anchors and Q-set), methods (e.g., development of the Q-set, analysis), study results, and study implications. Data synthesis was descriptive in nature and involved frequency counting, open coding and the organisation by data items. RESULTS Of the 2,302 articles identified by the search, 289 studies were included in this review. We found evidence of increased use of Q-methodology in healthcare, particularly over the last 5 years. However, this research remains diffuse, spread across a large number of journals and topic areas. In a number of studies, we identified limitations in the reporting of methods, such as insufficient information on how authors derived their Q-set, what types of analyses they performed, and the amount of variance explained. CONCLUSIONS Although Q-methodology is increasingly being adopted in healthcare research, it still appears to be relatively novel. This review highlight commonalities in how the method has been used, areas of application, and the potential value of the approach. To facilitate reporting of Q-methodological studies, we present a checklist of details that should be included for publication.
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Affiliation(s)
- Kate Churruca
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, Sydney, NSW, 2109, Australia.
| | - Kristiana Ludlow
- School of Psychology, University of Queensland, Brisbane, QLD, 4072, Australia
- Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, 2109, Australia
| | - Wendy Wu
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, Sydney, NSW, 2109, Australia
| | - Kate Gibbons
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, Sydney, NSW, 2109, Australia
| | - Hoa Mi Nguyen
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, Sydney, NSW, 2109, Australia
| | - Louise A Ellis
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, Sydney, NSW, 2109, Australia
| | - Jeffrey Braithwaite
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, Sydney, NSW, 2109, Australia
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Hazzard E, Walton K, McMahon AT, Milosavljevic M, Tapsell LC. Healthcare professionals' perspectives on the role of dietitians within multidisciplinary head and neck cancer teams: A qualitative multi-site study. Nutr Diet 2021; 78:506-515. [PMID: 33908185 DOI: 10.1111/1747-0080.12664] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 01/09/2021] [Accepted: 01/28/2021] [Indexed: 11/29/2022]
Abstract
AIM Evidence-based guidelines provide recommendations on how dietitians should work with patients with head and neck cancer for best outcomes. Research with healthcare professionals from head and neck cancer teams would provide insight into how these recommendations are implemented in practice. Therefore, the aim of this study was to explore how the role of the dietitian is perceived and enacted in different head and neck cancer teams from the perspective of healthcare professionals. METHODS This qualitative study recruited radiation oncologists, nurses, dietitians and speech pathologists from four different head and neck cancer teams in Australia and the United States. Data were collected via semi-structured interviews and analysed using a grounded-theory approach. RESULTS Seventeen radiation oncologists, 12 nurses, 11 dietitians and six speech pathologists participated. Perceptions on the role of dietitians were summarised by the category: "Providing expertise in nutritional care: A core role in head and neck cancer." Five categories summarised perceptions of factors that can influence how the role of the dietitian is enacted in practice: "having experience in head and neck cancer"; "initiating nutritional care plans and the role of doctors and nurses"; "clinic structuring"; "an evolving culture in healthcare services" and "the presence of evidence-based guidelines." CONCLUSIONS While dietitians can be perceived to be the experts in nutritional care, several factors influence how their role is enacted in head and neck cancer teams. Further research on patient nutritional outcomes and on clinic structures that best use dietetic expertise is required to strengthen recommendations on how dietitians should work with head and neck cancer patients internationally.
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Affiliation(s)
- Emily Hazzard
- Department of Nutrition and Dietetics, Wollongong Hospital, Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, Australia.,School of Medicine and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Karen Walton
- School of Medicine and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Anne-Therese McMahon
- School of Health and Society Medicine, University of Wollongong, Wollongong, New South Wales, Australia
| | - Marianna Milosavljevic
- Research Central, Wollongong Hospital, Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, Australia
| | - Linda C Tapsell
- School of Medicine and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
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Hazzard E, Walton K, McMahon AT, Milosavljevic M, Tapsell L. Collaborative, interprofessional nutritional care within head and neck cancer teams: an international multi-site qualitative study. J Interprof Care 2021; 35:813-820. [PMID: 33587011 DOI: 10.1080/13561820.2020.1865290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Evidence-based guidelines (EBGs) for patients with head and neck cancer (HNC) recommend that nutritional care is delivered by an interprofessional team inclusive of dietitians, doctors, nurses, and speech pathologists. Barriers to collaboration exist within interprofessional teams. However, research on this is currently lacking in the HNC setting, particularly with regard to the provision of nutritional care. This study aimed to explore what facilitates collaborative nutritional care for patients with HNC from the perspectives of different healthcare professionals. This qualitative study used a grounded theory approach. Healthcare professionals from two radiotherapy departments in the United States and two in Australia were interviewed. Forty-six interviews were completed with 17 radiation-oncologists, 12 nurses, eleven dietitians, and 6 speech-pathologists. Collaborative nutritional care for patients with HNC was underpinned by three categories and six sub-categories: access to dietitians (facilitated by funding for dietitians and the strength of evidence), communication (facilitated by team meetings, communication systems, and multidisciplinary clinics), and role-clarity (facilitated by non-clinical activities and respect). This study highlights opportunities for enhancing collaborative nutritional care within HNC teams. Further studies on the impact of the dietitian, interprofessional education, team meetings, and multidisciplinary clinics are required to promote collaborative nutritional care for HNC patients.
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Affiliation(s)
- Emily Hazzard
- Department of Nutrition and Dietetics, The Wollongong Hospital Illawarra Shoalhaven Local Health District, NSW, Australia.b School of Medicine and Illawarra Health and Medical Research Institute, University of Wollongong, NSW,
| | - Karen Walton
- School of Medicine and Illawarra Health and Medical Research Institute, University of Wollongong, NSW, Australia, .
| | - Anne-Therese McMahon
- Clinical Associate Professor, The Wollongong Hospital, School of Health and Society, University of Wollongong, Northfields Ave, Wollongong NSW, Australia
| | - Marianna Milosavljevic
- Research Central, Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia
| | - Linda Tapsell
- School of Medicine and Illawarra Health and Medical Research Institute, University of Wollongong, NSW, Australia,g School of Medicine and Illawarra Health and Medical Research Institute, University of Wollongong, NSW,
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17
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Exploring the impact of decentralized leadership on knowledge sharing and work hindrance networks in healthcare teams. JOURNAL OF MANAGEMENT & ORGANIZATION 2021. [DOI: 10.1017/jmo.2020.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
This paper adopts an explanatory sequential mixed method design to explore the impact of decentralized (vs. centralized) leadership on cross-functional teams' resource exchanges at a long-term care facility in Canada. In the quantitative phase, social network analyses were used to examine the direct and moderated effects (via leader–follower relationship quality; LMX) of the presence of formal decentralized leaders on: (1) knowledge sharing, and (2) work hindrance networks within cross-functional healthcare teams. In the qualitative phase, team members were interviewed regarding the impact of their decentralized leaders. Collectively, the findings suggest that the presence of a decentralized leader may enhance knowledge sharing and safeguard against work hindrance behaviors in cross-functional healthcare teams. However, these effects are contingent on the situation (e.g., LMX quality and status-based hierarchies). Implications for research and healthcare practice are discussed.
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Hansen TB, Pape B, Thiesen PS, Jakobsen F. Interprofessional versus uniprofessional dyad learning for medical students in a clinical setting. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2020; 11:191-200. [PMID: 32986616 PMCID: PMC7882129 DOI: 10.5116/ijme.5f50.bc76] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 09/03/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES The aim of the present study was to explore and compare medical students' perceived learning outcomes when treating patients under supervision in two different learning settings: a uniprofessional or an interprofessional dyad. METHODS The design of the study is a qualitative interview study. Data were collected from October 2016 to June 2017 via semi-structured group interviews performed at the end of the clinical placement in an orthopaedic outpatient clinic for medical students in the last semester of the curriculum. In the placement, the students worked by turns in either a uniprofessional dyad with two medical students or an interprofessional dyad with a nursing student. The data from the interviews were analysed using Systematic Text Analysis. RESULTS Overall, 21 students were interviewed. The students appreciated the authenticity of dealing with real patient problems. Both dyads provided the possibility of working as a professional, but the interprofessional dyad had a more authentic setting. In both dyads, the students' interdependence and mutual support promoted the acquisition of knowledge and skills. Working in the interprofessional dyad facilitated relationships between the professions, and the medical students became aware of some of their own profession's strengths and weaknesses. The interprofessional collaboration contributed to different perspectives on the patients' course of treatment and led to a more holistic understanding of the treatment. CONCLUSIONS Interprofessional dyads have the potential to improve learning outcomes in the clinical training of medical students. Further studies are needed to explore the benefits across medical specialities and settings.
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Affiliation(s)
- Torben Bæk Hansen
- University Clinic for Hand, Hip and Knee Surgery, Regional Hospital West Jutland, Denmark
| | - Britta Pape
- University Clinic for Hand, Hip and Knee Surgery, Regional Hospital West Jutland, Denmark
| | - Pernille Staal Thiesen
- University Clinic for Hand, Hip and Knee Surgery, Regional Hospital West Jutland, Denmark
| | - Flemming Jakobsen
- University Clinic for Hand, Hip and Knee Surgery, Regional Hospital West Jutland, Denmark
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He S, Lai D, Mott S, Little A, Grock A, Haas MRC, Chan TM. Remote e-Work and Distance Learning for Academic Medicine: Best Practices and Opportunities for the Future. J Grad Med Educ 2020; 12:256-263. [PMID: 32595840 PMCID: PMC7301927 DOI: 10.4300/jgme-d-20-00242.1] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Taylor MJ, Shikaislami C, McNicholas C, Taylor D, Reed J, Vlaev I. Using virtual worlds as a platform for collaborative meetings in healthcare: a feasibility study. BMC Health Serv Res 2020; 20:442. [PMID: 32429971 PMCID: PMC7236942 DOI: 10.1186/s12913-020-05290-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 05/04/2020] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Healthcare teams often consist of geographically dispersed members. Virtual worlds can support immersive, high-quality, multimedia interaction between remote individuals; this study investigated use of virtual worlds to support remote healthcare quality improvement team meetings. METHODS Twenty individuals (12 female, aged 25-67 [M = 42.3, SD = 11.8]) from 6 healthcare quality improvement teams conducted collaborative tasks in virtual world or face-to-face settings. Quality of collaborative task performances were measured and questionnaires and interviews were used to record participants' experiences of conducting the tasks and using the virtual world software. RESULTS Quality of collaborative task outcomes was high in both face-to-face and virtual world settings. Participant interviews elicited advantages for using virtual worlds in healthcare settings, including the ability of the virtual environment to support tools that cannot be represented in equivalent face-to-face meetings, and the potential for virtual world settings to cause improvements in group-dynamics. Reported disadvantages for future virtual world use in healthcare included the difficulty that people with weaker computer skills may experience with using the software. Participants tended to feel absorbed in the collaborative task they conducted within the virtual world, but did not experience the virtual environment as being 'real'. CONCLUSIONS Virtual worlds can provide an effective platform for collaborative meetings in healthcare quality improvement, but provision of support to those with weaker computer skills should be ensured, as should the technical reliability of the virtual world being used. Future research could investigate use of virtual worlds in other healthcare settings.
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Affiliation(s)
- Michael J Taylor
- Department of Surgery and Cancer, Imperial College London, London, SW7 2AZ, UK.,CLAHRC for North West London, CLAHRC offices, Chelsea and Westminster Hospital, 369 Fulham Rd, London, SW10 9NH, UK
| | - Chiya Shikaislami
- Department of Surgery and Cancer, Imperial College London, London, SW7 2AZ, UK
| | - Chris McNicholas
- CLAHRC for North West London, CLAHRC offices, Chelsea and Westminster Hospital, 369 Fulham Rd, London, SW10 9NH, UK
| | - David Taylor
- Department of Surgery and Cancer, Imperial College London, London, SW7 2AZ, UK
| | - Julie Reed
- CLAHRC for North West London, CLAHRC offices, Chelsea and Westminster Hospital, 369 Fulham Rd, London, SW10 9NH, UK
| | - Ivo Vlaev
- Warwick Business School, University of Warwick, Scarman Road, Coventry, CV4 7AL, UK.
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O’donovan R, Mcauliffe E. A systematic review of factors that enable psychological safety in healthcare teams. Int J Qual Health Care 2020; 32:240-250. [DOI: 10.1093/intqhc/mzaa025] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2020] [Indexed: 11/12/2022] Open
Abstract
Abstract
Purpose
The current systematic review will identify enablers of psychological safety within the literature in order to produce a comprehensive list of factors that enable psychological safety specific to healthcare teams.
Data sources
A keyword search strategy was developed and used to search the following electronic databases PsycINFO, ABI/INFORM, Academic search complete and PubMed and grey literature databases OpenGrey, OCLC WorldCAT and Espace.
Study selection
Peer-reviewed studies relevant to enablers of psychological safety in healthcare setting that were published between 1999 and 2019 were eligible for inclusion. Covidence, an online specialized systematic review website, was used to screen records. Data extraction, quality appraisal and narrative synthesis were conducted on identified papers.
Data extraction
Thirty-six relevant studies were identified for full review and data extraction. A data extraction template was developed and included sections for the study methodology and the specific enablers identified within each study.
Results of data synthesis
Identified studies were reviewed using a narrative synthesis. Within the 36 articles reviewed, 13 enablers from across organizational, team and individual levels were identified. These enablers were grouped according to five broader themes: priority for patient safety, improvement or learning orientation, support, familiarity with colleagues, status, hierarchy and inclusiveness and individual differences.
Conclusion
This systematic review of psychological safety literature identifies a list of enablers of psychological safety within healthcare teams. This list can be used as a first step in developing observational measures and interventions to improve psychological safety in healthcare teams.
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Affiliation(s)
- Róisín O’donovan
- School of Nursing, Midwifery & Health Systems, Health Sciences Centre, University College Dublin, Dublin 4, Ireland
| | - Eilish Mcauliffe
- School of Nursing, Midwifery & Health Systems, Health Sciences Centre, University College Dublin, Dublin 4, Ireland
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22
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Maharaj SS, White TL, Kaka B. Does the physiotherapy management of children with cerebral palsy differ between urban and rural public hospitals in KwaZulu-Natal? A physiotherapist’s perspective. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2020. [DOI: 10.1080/21679169.2018.1536892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Sonill S. Maharaj
- Department of Physiotherapy, School of Health Sciences, University of Kwa-Zulu Natal, Durban, South Africa
| | - Tracey-Lee White
- Department of Physiotherapy, School of Health Sciences, University of Kwa-Zulu Natal, Durban, South Africa
| | - Bashir Kaka
- Department of Physiotherapy, School of Health Sciences, University of Kwa-Zulu Natal, Durban, South Africa
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Abrams TE. Exploring the role of social work in U.S. burn centers. SOCIAL WORK IN HEALTH CARE 2020; 59:61-73. [PMID: 31878843 DOI: 10.1080/00981389.2019.1695704] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 10/25/2019] [Accepted: 11/18/2019] [Indexed: 06/10/2023]
Abstract
Because burn injuries most often occur within marginalized populations, there is a greater risk for poor psychosocial outcomes and social workers are trained to identify those psychosocial risk and resilience factors. Very little has been written about the role of social workers working in burn critical care teams, therefore leaving a gap in knowledge regarding this specialized area of social work practice. Social workers participating in multidisciplinary burn care teams were invited to participate in this preliminary descriptive study (n = 29). Frequency statistics were calculated for the brief online survey to learn more about professional preparation and continuing education, job responsibilities, and perspectives on job skills. Respondents were primarily white and female, with a mean age of 43.74 years. Most respondents reported holding an MSSW and a state-issued professional license. Responsibilities were described as discharge planning, case management, patient counseling, family counseling, support group facilitation, community education, school reentry/back to work programs, burn prevention, and "other duties", respectively. More than half of the respondents reported responsibilities in other units. With increased understanding of interventions used by social workers inpatient, there can be a greater understanding of patients' continuing needs once discharged.
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Affiliation(s)
- Thereasa E Abrams
- College of Social Work, University of Tennessee, Nashville, United States
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24
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Lever I, Dyball D, Greenberg N, Stevelink SAM. Health consequences of bullying in the healthcare workplace: A systematic review. J Adv Nurs 2019; 75:3195-3209. [PMID: 30816567 DOI: 10.1111/jan.13986] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 12/01/2018] [Accepted: 12/17/2018] [Indexed: 01/29/2023]
Abstract
AIMS To review both mental and physical health consequences of bullying for healthcare employees. DESIGN Systematic literature review. DATA SOURCES EMBASE, MEDLINE, PsycINFO, PUBMED and Web of Science Core Collection were searched for articles published between 2005 - January 2017. REVIEW METHODS This review was conducted using the framework described by Khan and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Two independent reviewers performed systematic data extraction and appraised the methodological quality of included articles. A pooled mean prevalence of bullying was estimated. RESULTS Forty-five papers met inclusion criteria. Bullying prevalence ranged from 3.9% to 86.5%, with a pooled mean estimate of 26.3%. Perceived bullying was associated with mental health problems including psychological distress, depression and burnout, and physical health problems including insomnia and headache. Bullied staff took more sick leave. CONCLUSION Bullying occurs frequently amongst healthcare staff and is deleterious to health and occupational functionality.
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Affiliation(s)
- Isabel Lever
- Faculty of Life Sciences and Medicine, King's College London, Henriette Raphael House, Guy's Campus, London, UK
| | - Daniel Dyball
- King's Centre for Military Health Research, King's College London, Weston Education Centre, London, UK
| | - Neil Greenberg
- King's Centre for Military Health Research, King's College London, Weston Education Centre, London, UK
| | - Sharon A M Stevelink
- King's Centre for Military Health Research, King's College London, Weston Education Centre, London, UK
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Lemaire JB, Miller EN, Polachek AJ, Wong H. Stakeholder Groups' Unique Perspectives About the Attending Physician Preceptor Role: A Qualitative Study. J Gen Intern Med 2019; 34:1158-1166. [PMID: 30937665 PMCID: PMC6614296 DOI: 10.1007/s11606-019-04950-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Attending physician preceptors are accountable to many stakeholder groups, yet stakeholders' views about what the preceptor role entails have not been sufficiently considered. OBJECTIVE To explore stakeholder groups' unique perspectives of the preceptor role. DESIGN Qualitative study with a constructivist orientation. PARTICIPANTS Semi-structured interviews were conducted with 73 participants from two university teaching hospitals between October 2012 and March 2014. Participants included representatives from seven stakeholder groups: patients and their families, allied healthcare providers, bedside nurses, nurse managers, medical students, internal medicine residents, and preceptors. APPROACH An inductive thematic analysis was conducted where researchers coded transcripts, abstracted codes into themes, and then mapped themes onto six focus areas: role dimensions, role performance, stressors and rewards, mastery, fulfillment, and impact on others. Two authors then identified "recurrent themes" (emerging in two or more focus areas) and compared them across groups to identify "unique themes" (emerging from a maximum of two stakeholder groups). "Unique thematic emphases" (unique themes that would not have emerged if a stakeholder group was not interviewed) are described. KEY RESULTS Patients and their families emphasized preceptors' ultimate authority. Allied healthcare providers described preceptors as engaged collaborators involved in discharge planning and requiring a sense of humor. Bedside nurses highlighted the need for role standardization. Nurse managers stressed preceptors' need for humanism. Medical students highlighted preceptors' emotional labor and their influence on learners' emotional well-being. Residents emphasized preceptors' responsibilities to multiple stakeholders. Preceptors described lifelong learning and exercising control over one's environment. CONCLUSIONS Various stakeholder groups hold unique and nuanced views of the attending physician preceptor role. These views could broaden formal role guidance for medical education and patient care. This study generated real-world, practical examples of what stakeholders feel are important preceptor skills. These skills should be practiced, taught, and role modeled in this clinical setting.
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Affiliation(s)
- Jane B Lemaire
- Division of General Internal Medicine, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada. .,W21C Research and Innovation Center, Cumming School of Medicine, University of Calgary, Calgary, Canada.
| | - Erin Nicole Miller
- Division of Endocrinology and Metabolism, University of Ottawa, Ottawa, Canada
| | - Alicia J Polachek
- W21C Research and Innovation Center, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Holly Wong
- W21C Research and Innovation Center, Cumming School of Medicine, University of Calgary, Calgary, Canada
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Horlait M, Baes S, Dhaene S, Van Belle S, Leys M. How multidisciplinary are multidisciplinary team meetings in cancer care? An observational study in oncology departments in Flanders, Belgium. J Multidiscip Healthc 2019; 12:159-167. [PMID: 30863082 PMCID: PMC6389011 DOI: 10.2147/jmdh.s196660] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background In current cancer care, multidisciplinary team meetings (MDTMs) aim at uniting care professionals from different disciplines to decide upon the best possible treatment plan for the patients based on the available scientific evidence. In Belgium, the multidisciplinary approach is mandatory and formally regulated since 2003. Current research indicates that MDTMs are not always truly multidisciplinary, ie, with a mix of medical as well as paramedical disciplines, and that the medical profession (physicians and medical specialists) tends to dominate the interaction in MDTMs. To ensure that MDTMs can benefit from their diverse membership to achieve their full potential, significant attention should be devoted to the multidisciplinary character of these meetings. The aim of this study is to explore and describe the multidisciplinary character in MDTMs and how it is actually shaped in practice in different Flemish medical oncology departments. Methods For this study, we carried out an observational comparative case study. We studied 59 multidisciplinary team meetings at inpatient medical oncology departments in five different Belgian hospitals (academic as well as general) and explored multidisciplinarity and how it is actually shaped in practice. Results The study is unique in identifying and analyzing three distinct types of MDTMs. The analysis of the three types revealed an inconsistent and, at times, contradictory picture of multidisciplinary team meetings. The findings also align with previous studies arguing that MDTMs in oncology are typically driven by doctors, with limited input of nurses and other nonmedical staff in which decisions are argued on biomedical information and far less consideration of psychosocial aspects. Conclusion The concept of a MDTM should not merely be a group of care professionals who work essentially independently and occasionally liaise with one another. Yet, this study has shown a worryingly low awareness of the true character of multidisciplinarity, particularly among medical disciplines.
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Affiliation(s)
- Melissa Horlait
- Vrije Universiteit Brussel (VUB), Department of Public Health, Research Group Organisation, Policy and Social Inequalities in Health Care (OPIH), 1090 Brussels, Belgium,
| | - Saskia Baes
- Vrije Universiteit Brussel (VUB), Department of Public Health, Research Group Organisation, Policy and Social Inequalities in Health Care (OPIH), 1090 Brussels, Belgium,
| | - Sophie Dhaene
- AZ Sint-Elisabeth Ziekenhuis, Department of Oncology, 9620 Zottegem, Belgium
| | - Simon Van Belle
- Ghent University Hospital, Department of Medical Oncology, 9000 Gent, Belgium
| | - Mark Leys
- Vrije Universiteit Brussel (VUB), Department of Public Health, Research Group Organisation, Policy and Social Inequalities in Health Care (OPIH), 1090 Brussels, Belgium,
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Vassos M, Nankervis K, Chan J. Clinical Governance Climate Within Disability Service Organizations from the Perspective of Allied Health Professionals. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2019. [DOI: 10.1111/jppi.12281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | - Karen Nankervis
- School of Education, University of Queensland; St. Lucia QLD Australia
- Centre of Excellence for Clinical Innovation and Behaviour Support, Department of Communities, Disability Services and Seniors; Brisbane, QLD Australia
| | - Jeffrey Chan
- Quality, Innovations and Safeguards, Yooralla; Melbourne, VIC Australia
- Movement for the Intellectually Disabled of Singapore (MINDS); Singapore
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Advancing a Systemic Perspective on Multidisciplinary Teams: A Comparative Case Study of Work Organisation in Four Multiple Sclerosis Hospitals. Int J Integr Care 2018; 18:3. [PMID: 30214390 PMCID: PMC6133025 DOI: 10.5334/ijic.3745] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Introduction: Many care organisations claim to employ multidisciplinary teams, but the term is used to describe quite different forms of collaboration. A systemic view of the work organisation of care delivery is presented and applied in this article that allows to identify and understand often overlooked yet important differences regarding team composition, working relationships and therapeutic relationships. Theory and Methods: We used modern socio-technical systems theory to study care delivery for a particular patient population as a system of interrelated activities. The concept of work organisation refers to the way in which the composite task of care delivery is divided into distinct tasks and how these are grouped in either monodisciplinary or multidisciplinary organisational units. The systemic perspective was applied in a comparative case study of four Multiple Sclerosis hospitals. Results: Among the hospitals, one was characterised by a functional work organisation, with similar tasks grouped in monodisciplinary teams. Cross-disciplinary working and therapeutic relationships were established on an ad hoc basis. The three other hospitals adopted a more process-oriented work organisation (which groups all tasks related to a specific care process within a single, multidisciplinary team). The more process-oriented the work organisation, the more working relationships and therapeutic relationships appeared to be fixed and continuous. Conclusion and discussion: The systemic view adopted in this study yields a better understanding of multidisciplinary teams through the concept of work organisation. The actual composition of multidisciplinary teams, and the related working and therapeutic relationships will vary depending on the type of underlying work organisation. Further validation of this conclusion will be needed in other settings.
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Marsilio M, Torbica A, Villa S. Health care multidisciplinary teams: The sociotechnical approach for an integrated system-wide perspective. Health Care Manage Rev 2018; 42:303-314. [PMID: 27351480 DOI: 10.1097/hmr.0000000000000115] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The current literature on the enabling conditions of multidisciplinary teams focuses on the singular dimensions of the organizations (i.e., human resources, clinical pathways, objects) without shedding light on to the way in which these organizational factors interact and mutually influence one another. PURPOSE Drawing on a system perspective of organizations, the authors analyze the organizational patterns that promote and support multidisciplinary teams and how they interrelate and interact to enforce the organization work system. METHODOLOGY/APPROACH The authors develop a modified sociotechnical system (STS) model to understand how the two dimensions of technical (devices/tools, layout/organization of space, core process standardization) and social (organizational structure, management of human resources and operations) can facilitate the implementation of multidisciplinary teams in health care. The study conducts an empirical analysis based on a sample of hospital adopters of transcatheter aortic valve implantation using the revised STS model. FINDINGS The modified STS model applied to the case studies improves our understanding of the critical implementation factors of a multidisciplinary approach and the importance of coordinating radical changes in the technical and the social subsystems of health care organizations. The analysis informs that the multidisciplinary effort is not a sequential process and that the interplay between the two subsystems needs to be managed efficaciously as an integrated organizational whole to deliver the goals set. PRACTICE IMPLICATIONS Hospital managers must place equal focus on the closely interrelated technical and social dimensions by investing in (a) shared layouts and spaces that cross the boundaries of the specialized health care units, (b) standardization of the core processes through the implementation of local clinical pathways,
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Affiliation(s)
- Marta Marsilio
- Marta Marsilio, PhD, is Assistant Professor, University of Milan, Italy, and Centre for Research in Health and Social Care Management (CERGAS), Bocconi University, Milan, Italy. Aleksandra Torbica, PhD, is Assistant Professor, Centre for Research in Health and Social Care Management (CERGAS), Department of Policy Analysis and Public Management, Bocconi University, Milan, Italy. E-mail: . Stefano Villa, PhD, is Associate Professor, Department of Management, Catholic University, Rome, Italy, and Coordinator of field research projects at CERISMAS (Research Centre in Health Care Management), Catholic University of Milano, Italy. This material is based on research supported by the European Health Technology Institute for Socio Economic Research (EHTI) through an unrestricted grant awarded to the Centre for Research in Health and Social Care Management (CERGAS). During the project execution, all authors were affiliated with CERGAS, Bocconi University
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Soukup T, Lamb BW, Arora S, Darzi A, Sevdalis N, Green JS. Successful strategies in implementing a multidisciplinary team working in the care of patients with cancer: an overview and synthesis of the available literature. J Multidiscip Healthc 2018; 11:49-61. [PMID: 29403284 PMCID: PMC5783021 DOI: 10.2147/jmdh.s117945] [Citation(s) in RCA: 175] [Impact Index Per Article: 29.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
In many health care systems globally, cancer care is driven by multidisciplinary cancer teams (MDTs). A large number of studies in the past few years and across different literature have been performed to better understand how these teams work and how they manage patient care. The aim of our literature review is to synthesize current scientific and clinical understanding on cancer MDTs and their organization; this, in turn, should provide an up-to-date summary of the current knowledge that those planning or leading cancer services can use as a guide for service implementation or improvement. We describe the characteristics of an effective MDT and factors that influence how these teams work. A range of factors pertaining to teamwork, availability of patient information, leadership, team and meeting management, and workload can affect how well MDTs are implemented within patient care. We also review how to assess and improve these teams. We present a range of instruments designed to be used with cancer MDTs - including observational tools, self-assessments, and checklists. We conclude with a practical outline of what appears to be the best practices to implement (Dos) and practices to avoid (Don'ts) when setting up MDT-driven cancer care.
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Affiliation(s)
- Tayana Soukup
- Health Service and Population Research Department, Centre for Implementation Science, King's College London, London, UK
| | - Benjamin W Lamb
- Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Sonal Arora
- Department of Surgery and Cancer, Center for Patient Safety and Service Quality, Imperial College London
| | - Ara Darzi
- Department of Surgery and Cancer, Center for Patient Safety and Service Quality, Imperial College London
| | - Nick Sevdalis
- Health Service and Population Research Department, Centre for Implementation Science, King's College London, London, UK
| | - James Sa Green
- Whipps Cross University Hospital, Barts Health NHS Trust.,Faculty of Health and Social Care, London South Bank University, London, UK
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A conceptual framework for unlearning in a homecare setting. KNOWLEDGE MANAGEMENT RESEARCH & PRACTICE 2017. [DOI: 10.1057/kmrp.2013.6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Steihaug S, Paulsen B, Melby L. Norwegian general practitioners' collaboration with municipal care providers - a qualitative study of structural conditions. Scand J Prim Health Care 2017; 35:344-351. [PMID: 29116877 PMCID: PMC5730032 DOI: 10.1080/02813432.2017.1397264] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
PURPOSE The purpose of this study was to explore the structural mechanisms that facilitate or counteract collaboration between general practitioners (GPs) and other providers of municipal healthcare. Good collaboration between these actors is crucial for high-quality care, especially for persons in need of coordinated services. MATERIAL AND METHODS The study is based on semistructured interviews with 12 healthcare providers in four Norwegian municipalities: four GPs, six nurses and two physiotherapists. RESULTS GPs are key collaborating partners in the healthcare system. Their ability to collaborate is affected by a number of structural conditions. Mostly, this leads to GPs being too little involved in potential collaborative efforts: (i) individual GPs prioritize with whom they want to collaborate among many possible collaborative partners, (ii) inter-municipal constraints hamper GPs in contacting collaboration partners and (iii) GPs fall outside the hospital-municipality collaboration. CONCLUSIONS We argue a common leadership for primary care services is needed. Furthermore, inter-professional work must be a central focus in the planning of primary care services. However, a dedicated staff, sufficient resources, adequate time and proper meeting places are needed to accomplish good collaboration.
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Affiliation(s)
| | | | - Line Melby
- CONTACT Line Melby SINTEF Technology and Society, Department of Health Research, P.O. Box 4760 Torgarden, N-7465 Trondheim, Norway
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Abrahamsen C, Nørgaard B, Draborg E, Nielsen D. Reflections on two years after establishing an orthogeriatric unit: a focus group study of healthcare professionals' expectations and experiences. BMC Health Serv Res 2017; 17:602. [PMID: 28841861 PMCID: PMC5574105 DOI: 10.1186/s12913-017-2550-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 08/15/2017] [Indexed: 11/27/2022] Open
Abstract
Background For decades hospitals have been “vertically” organized, with the risk that specialization leads to fragmented and one-sided views of patient care and treatment that may cause poor communication and coordination of care and treatment. Two years after the introduction of an orthogeriatric unit for elderly patients admitted with fragility fractures, we studied the involved healthcare professionals’ perspectives and experiences with working in an interprofessional organization. Methods We performed four focus groups interviews with 19 healthcare workers representing different professions. The interviews were analysed using systematic text condensation (STC). Results Three themes were identified: 1) A patient-centred approach, 2) An opportunity for professional growth and 3) The benefits of interprofessional collaboration. The interviewees emphasized in particular the systematic and frequent face-to-face communication enabled by the interprofessional team meetings as essential to their feeling of enhanced collegial solidarity. All groups expressed their respect for other groups’ competences and their vital contributions to good orthogeriatric care. However, collaboration was challenged by the groups’ divergent views of the patients and of the relevance of the information given in the weekly meetings. Heavy workloads were also mentioned. The opportunity for professional growth was also felt to be imperilled by some professionals. Conclusions All participants indicated their view that the orthogeriatric organization had improved the quality of care and treatment. Furthermore, good communication, mutual respect for other professional competences and shared goals were found to have enhanced interprofessional collaboration and improved the sense of having a shared mission. However, differences in approaches and expectations continued to challenge the orthogeriatric model after 2 years. Neither did all professionals find orthogeriatric care professionally challenging.
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Affiliation(s)
- C Abrahamsen
- Department of Orthopaedic Surgery, Kolding Hospital, Sygehusvej 20, 6000, Kolding, Denmark. .,Department of Public Health, University of Southern Denmark, J.B Winsløws Vej 9B, 5000, Odense, Denmark.
| | - B Nørgaard
- Department of Public Health, University of Southern Denmark, J.B Winsløws Vej 9B, 5000, Odense, Denmark
| | - E Draborg
- Department of Public Health, University of Southern Denmark, J.B Winsløws Vej 9B, 5000, Odense, Denmark
| | - D Nielsen
- Centre for Global Health, University of Southern Denmark, Kløvervænget 6, 8th floor, 5000, Odense, Denmark
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Dahlke S, Fox M. Navigating Relationships: Nursing Teamwork in the Care of Older Adults. Can J Nurs Res 2017; 47:97-112. [DOI: 10.1177/084456211504700406] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Abstract
This article summarizes the results of an extensive review of the organizational and health care literature of advanced practice nursing (APN) roles, health care teams, and perceptions of team effectiveness. Teams have a long history in health care. Managers play an important role in mobilizing resources, guiding expectations of APN roles in teams and within organizations, and facilitating team process. Researchers have identified a number of advantages to the addition of APN roles in health care teams. The process within health care teams are dynamic and responsive to their surrounding environment. It appears that teams and perceptions of team effectiveness need to be understood in the broader context in which the teams are situated. Key team process are identified for team members to perceive their team as effective. The concepts of teamwork, perceptions of team effectiveness, and the introduction of APN roles in teams have been studied disparately. An exploration of the links between these concepts may further our understanding the health care team's perceptions of team effectiveness when APN roles are introduced. Such knowledge could contribute to the effective deployment of APN roles in health care teams and improve the delivery of health care services to patients and families.
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Robertson C, Finlay L. Making a Difference, Teamwork and Coping: The Meaning of Practice in Acute Physical Settings. Br J Occup Ther 2016. [DOI: 10.1177/030802260707000205] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Occupational therapists in acute physical settings face challenges and tensions between their holistic professional values and the often reductionist focus of their work. A hermeneutic phenomenological investigation explored the meaning of practice for nine occupational therapists in an acute National Health Service trust in England. Semi-structured interviews were analysed using a framework for interpretive analysis of phenomenological data. Critical reflective evaluation enables readers to judge the quality and relevance of the research. The three main themes described in this paper – making a difference, gaining strength from the team and coping strategies – illustrate the tensions, stresses and rewards of practice. The occupational therapists wanted to make a difference to their patients' lives. Although they could not always do as much as they would have liked, making an immediate difference by the provision of equipment was rewarding. Relationships with multidisciplinary colleagues generated both stress and satisfaction, but membership of the occupational therapy team enabled the therapists to cope with difficult situations. Effective coping strategies included acknowledging the realities of the acute setting and using reflection to identify those aspects providing value and satisfaction. Overall, the therapists experienced pride, excitement, reward and enjoyment from their work in the acute setting and were convinced of the value and importance of their role.
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Rasova K, Freeman J, Martinkova P, Pavlikova M, Cattaneo D, Jonsdottir J, Henze T, Baert I, Van Asch P, Santoyo C, Smedal T, Beiske AG, Stachowiak M, Kovalewski M, Nedeljkovic U, Bakalidou D, Guerreiro JMA, Nilsagård Y, Dimitrova EN, Habek M, Armutlu K, Donzé C, Ross E, Ilie AM, Martić A, Romberg A, Feys P. The organisation of physiotherapy for people with multiple sclerosis across Europe: a multicentre questionnaire survey. BMC Health Serv Res 2016; 16:552. [PMID: 27716390 PMCID: PMC5053346 DOI: 10.1186/s12913-016-1750-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 09/14/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Understanding the organisational set-up of physiotherapy services across different countries is increasingly important as clinicians around the world use evidence to improve their practice. This also has to be taken into consideration when multi-centre international clinical trials are conducted. This survey aimed to systematically describe organisational aspects of physiotherapy services for people with multiple sclerosis (MS) across Europe. METHODS Representatives from 72 rehabilitation facilities within 23 European countries completed an online web-based questionnaire survey between 2013 and 2014. Countries were categorised according to four European regions (defined by United Nations Statistics). Similarities and differences between regions were examined. RESULTS Most participating centres specialized in rehabilitation (82 %) and neurology (60 %), with only 38 % specialising in MS. Of these, the Western based Specialist MS centres were predominately based on outpatient services (median MS inpatient ratio 0.14), whilst the Eastern based European services were mostly inpatient in nature (median MS inpatient ratio 0.5). In almost all participating countries, medical doctors - specialists in neurology (60 %) and in rehabilitation (64 %) - were responsible for referral to/prescription of physiotherapy. The most frequent reason for referral to/prescription of physiotherapy was the worsening of symptoms (78 % of centres). Physiotherapists were the most common members of the rehabilitation team; comprising 49 % of the team in Eastern countries compared to approximately 30 % in the rest of Europe. Teamwork was commonly adopted; 86 % of centres based in Western countries utilised the interdisciplinary model, whilst the multidisciplinary model was utilised in Eastern based countries (p = 0.046). CONCLUSION This survey is the first to provide data about organisational aspects of physiotherapy for people with MS across Europe. Overall, care in key organisational aspects of service provision is broadly similar across regions, although some variations, for example the models of teamwork utilised, are apparent. Organisational framework specifics should be considered anytime a multi-centre study is conducted and results from such studies are applied.
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Affiliation(s)
- Kamila Rasova
- Department of rehabilitation, Third Faculty of Medicine, Charles University in Prague, Ruska 87, Prague 10, 100 00, Czech Republic. .,Third Faculty of Medicine, Charles University in Prague, Ruska 87, Prague 10, 100 00, Czech Republic.
| | - Jenny Freeman
- Faculty of Health and Human Science, Plymouth University, Playmouth, PL6 8BH, England
| | - Patricia Martinkova
- Institute of Computer Science, Academy of Sciences of the Czech Republic, Pod Vodarenskou vezi 2, Prague 8, 182 07, Czech Republic
| | - Marketa Pavlikova
- Third Faculty of Medicine, Charles University in Prague, Ruska 87, Prague 10, 100 00, Czech Republic
| | - Davide Cattaneo
- Don Gnocchi Foundation, Larice Lab, Santa Maria Nascente, Via Capecelatro 66, 20148, Milan, Italy
| | - Johanna Jonsdottir
- Neurorehabilitation at the Don Gnocchi Foundation, Larice Lab, Santa Maria Nascente, Via Capecelatro 66, 20148, Milan, Italy
| | - Thomas Henze
- PASSAUER WOLF Reha-Zentrum Nittenau, Rehabilitations klinik für Neurologie-Geriatrie-Urologie, Eichendorffstr. 21, D-93149, Nittenau, Germany
| | - Ilse Baert
- Hasselt University, Campus Diepenbeek, REVAL Rehabilitation Research Institute (BIOMED), Agoralaan building A, B-3590, Diepenbeek, Belgium
| | - Paul Van Asch
- Fit Up, Fitness- and Physiotherapy Center, Mechelsesteen weg 192a, 2550, Kontich, Belgium
| | - Carme Santoyo
- Cemcat, Neurorehabilitation Unit, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain
| | - Tori Smedal
- Department of Neurology, Norwegian Multiple Sclerosis Competence Centre, Haukeland University Hospital, P.O. Box 1400, 5021, Bergen, Norway.,Department of Physiotherapy, Haukeland University Hospital, P.O. Box 1400, 5021, Bergen, Norway
| | | | | | | | - Una Nedeljkovic
- Clinic for physical medicine and rehabilitation, Clinical Center of Serbia, Pasterova 2, 11000, Belgrade, Serbia
| | - Daphne Bakalidou
- Technological Educational Institute of Athens, 24, Mitrodorou street, Ak. Pratonos, 10441, Athens, Greece
| | - José Manuel Alves Guerreiro
- School of Health Sciences, Health Research Unit, Polytechnic Institute of Leiria, Campus 2 - Morro do Lena - Alto do Vieiro, 2411-901, Leiria, Portugal
| | - Ylva Nilsagård
- Faculty of Medicine and Health, Örebro University Region, SE- 701 82, Örebro, Sweden
| | - Erieta Nikolikj Dimitrova
- Institute of Physical Medicine and Rehabilitation, Faculty of Medicine, "Ss Cyril and Methodius" University, Elisie Popovski 28, 1000, Skopje, Macedonia, Republic of The former Yugoslav
| | - Mario Habek
- Referral Center for Demyelinating Diseases of the Central Nervous System University Department of Neurology Zagreb School of Medicine and University Hospital Center, Kispaticeva 12, HR-10000, Zagreb, Croatia
| | - Kadriye Armutlu
- Physical Therapy and Rehabilitation departmant of Health Science Faculty, Hacettepe University, Ankara, Turkey
| | - Cécile Donzé
- Groupe Hospitalier de l'institut Catholique de Lille, Department of physical Medicine and Rehabilitation hospital Saint Philibert, Faculté Libre de Médecine, Univ Nord de France, F-59000, Lille, France
| | - Elaine Ross
- St. James's Hospital, St. James's street, Dublin 8, Ireland
| | - Ana Maria Ilie
- "Elias" University Emergency Hospital, 17 Marasti Bulevard, Bucharest, 01146, Romania
| | - Andrej Martić
- Divison of Neurology, Neurorehabilitation unit, University Medical Centre Ljubljana, Zaloška 2, 1000, Ljubljana, Slovenia
| | - Anders Romberg
- Masku Neurological Rehabilitation Centre, Physiotherapy, Vaihemäentie 10, PO Box 15, 21251, Masku, Finland
| | - Peter Feys
- Hasselt University, Campus Diepenbeek, REVAL Rehabilitation Research Institute (BIOMED), Agoralaan building A, B-3590, Diepenbeek, Belgium
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Pain T, Kingston G, Askern J, Smith R, Phillips S, Bell L. How are allied health notes used for inpatient care and clinical decision-making? A qualitative exploration of the views of doctors, nurses and allied health professionals. Health Inf Manag 2016; 46:23-31. [PMID: 27574187 DOI: 10.1177/1833358316664451] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Inpatient care is dependent upon the effective transfer of clinical information across multiple professions. However, documented patient clinical information generated by different professions is not always successfully transferred between them. One obstacle to successful information transfer may be the reader's perception of the information, which is framed in a particular professional context, rather than the information per se. OBJECTIVE The aim of this research was to investigate how different health professionals perceive allied health documentation and to investigate how clinicians of all experience levels across medicine, nursing and allied health perceive and use allied health notes to inform their decision-making and treatment of patients. METHOD The study used a qualitative approach. A total of 53 speech pathologists, nurses, doctors, occupational therapists, dieticians and social workers (8 males; 43 females) from an Australian regional tertiary hospital participated in eleven single discipline focus groups, conducted over 4 months in 2012. Discussions were recorded and transcribed verbatim and coded into themes by content analysis. FINDINGS Six themes contributing to the efficacy of clinical information transference emerged from the data: day-to-day care, patient function, discharge and discharge planning, impact of busy workloads, format and structure of allied health documentation and a holistic approach to patient care. DISCUSSION Other professions read and used allied health notes albeit with differences in focus and need. Readers searched for specific pieces of information to answer their own questions and professional needs, in a process akin to purposive sampling. Staff used allied health notes to explore specific aspects of patient function but did not obtain a holistic picture. CONCLUSION Improving both the relationship between the various health professions and interpretation of other professions' documented clinical information may reduce the frequency of communication errors, thereby improving patient care.
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Affiliation(s)
- Tilley Pain
- 1 Queensland Health, The Townsville Hospital, Townsville, Queensland, Australia.,2 College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Gail Kingston
- 1 Queensland Health, The Townsville Hospital, Townsville, Queensland, Australia.,2 College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Janet Askern
- 1 Queensland Health, The Townsville Hospital, Townsville, Queensland, Australia
| | - Rebecca Smith
- 1 Queensland Health, The Townsville Hospital, Townsville, Queensland, Australia
| | - Sandra Phillips
- 1 Queensland Health, The Townsville Hospital, Townsville, Queensland, Australia
| | - Leanne Bell
- 1 Queensland Health, The Townsville Hospital, Townsville, Queensland, Australia
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Kobayashi R, McAllister CA. Hospice Core Professions' Views on Interdisciplinary Teams: A Qualitative Investigation. JOURNAL OF SOCIAL WORK IN END-OF-LIFE & PALLIATIVE CARE 2016; 12:214-230. [PMID: 27462950 DOI: 10.1080/15524256.2016.1201565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The hospice interdisciplinary team (IDT) has been recognized as an ideal model for interprofessional collaboration. To address the manner in which interdisciplinary practices are perceived by team members, this study explored profession-based similarities and differences in perceptions among the four core hospice IDT members (physicians, nurses, social workers, and spiritual care providers) as well as experiences on the IDT. Semistructured interviews with 20 hospice professionals, 5 from each profession, were completed. Findings suggested that while hospice professions share some perceptions and experiences about hospice team membership, strengths of and barriers to teamwork, and individual members' contribution to the team, significant profession-based differences exist largely in the area of hospice team membership beyond the core members, type of language and descriptions used, perceptions of causes and effects of barriers to teamwork, and understandings of how team effectiveness is evaluated. Changes at the team-based, organizational, policy, and educational levels are needed to further maximize strengths of individual hospice IDT member and team qualities.
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Affiliation(s)
- Rie Kobayashi
- a School of Social Work , Eastern Washington University , Cheney , Washington , USA
| | - Carolyn A McAllister
- b School of Social Work , California State University , San Bernardino , California , USA
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Laapotti T, Mikkola L. Social interaction in management group meetings: a case study of Finnish hospital. J Health Organ Manag 2016; 30:613-29. [PMID: 27296882 DOI: 10.1108/jhom-02-2015-0040] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose - The purpose of this paper is to understand the role of management group meetings (MGMs) in hospital organization by examining the social interaction in these meetings. Design/methodology/approach - This case study approaches social interaction from a structuration point of view. Social network analysis and qualitative content analysis are applied. Findings - The findings show that MGMs are mainly forums for information sharing. Meetings are not held for problem solving or decision making, and operational coordinating is limited. Meeting interaction is very much focused on the chair, and most of the discussion takes place between the chair and one other member, not between members. The organizational structures are maintained and reproduced in the meeting interaction, and they appear to limit discussion. Meetings appear to fulfil their goals as a part of the organization's information structure and to some extent as an instrument for management. The significance of the relational side of MGMs was recognized. Research limitations/implications - The results of this study provide a basis for future research on hospital MGMs with wider datasets and other methodologies. Especially the relational role of MGMs needs more attention. Practical implications - The goals of MGMs should be reviewed and MG members should be made aware of meeting interaction structures. Originality/value - The paper provides new knowledge about interaction networks in hospital MGMs, and describes the complexity of the importance of MGMs for hospitals.
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Affiliation(s)
- Tomi Laapotti
- Department of Communication, University of Jyväskylä, Jyväskylä, Finland
| | - Leena Mikkola
- Department of Communication, University of Jyväskylä, Jyväskylä, Finland
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Abstract
We studied an interprofessional collaboration to understand how professionals engaged with paradox in collective decision-making. At the beginning of our study, we observed vicious cycles in which conflict led to negative tension. Professionals were holding tightly to a particular pole of the paradox, and the higher-status pole was consistently overrepresented in collective decision-making. By the end of our study we observed the presence of virtuous cycles, where conflict led to more positive tension, and where professionals engaged in collective decision-making with more equal representation of conflicting approaches. We call this change process protecting the paradox and we identify three strategies that support this process: (1) promoting equality of both poles, (2) strengthening the weaker pole, and (3) looking beyond the paradox by focusing on desired outcomes. We contribute to the paradox literature by showing how vicious cycles can be shifted to virtuous cycles, how professionals and managers can work together to protect a paradox, and how status differences between poles can be redistributed.
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Ginnelly A, Greenwood N. Screening adult patients with a tracheostomy tube for dysphagia: a mixed-methods study of practice in the UK. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2016; 51:285-295. [PMID: 26575499 DOI: 10.1111/1460-6984.12205] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 07/01/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Patients with tracheostomy tubes are at risk of aspiration and swallowing problems (dysphagia), and because of their medical acuity, complications in this patient population can be severe. It is well recognized that swallow screening in stroke significantly reduces potential complications by allowing early identification and appropriate management of patients at risk (by health professionals), thereby reducing delays in commencing oral intake and preventing unnecessary, costly interventions by speech and language therapists (SLTs). However, there is no standardized swallow screen for the tracheostomised population and there is a paucity of literature regarding either current or best practice in this area. AIMS To investigate current UK practice for dysphagia screening in adult patients with tracheostomy tubes and to explore and describe health professionals' perceptions of their current practice or current systems used. METHODS & PROCEDURES A mixed-methods approach was adopted comprising a semi-structured online questionnaire and recorded follow-up telephone interviews. Participants were SLTs, nurses and physiotherapists working with patients with tracheostomies. Responses were analysed to determine current practice with regard to swallow screening. Thematic analysis of interviews allowed further exploration and clarification of the questionnaire findings. OUTCOMES & RESULTS A total of 221 questionnaires were completed. Approximately half (45%) the participants worked in trusts with formal swallow screens, whilst the remainder used a variety of other approaches to identify patients at risk, often relying on informal links with multidisciplinary teams (MDT). In line with current evidence, patients with neurological diagnoses and a tracheostomy were consistently referred directly to speech and language therapy (SLT). Only one-quarter of questionnaire participants thought their current system was effective at identifying patients at risk of swallowing problems. Eleven questionnaire participants were interviewed. They highlighted the important role of MDT team working here, emphasizing both its strengths and weaknesses when working with these patients. CONCLUSIONS & IMPLICATIONS Current practice in the UK for screening patients with a tracheostomy for swallow problems is varied and often suboptimal. Despite the evidence for enhancing outcomes, MDT working is still perceived as problematic. A swallow screening tool for use with this population, to enhance MDT working whilst also ensuring that practice fits in line with current evidence, may improve patient safety and care.
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Affiliation(s)
- Aeron Ginnelly
- St George's University Hospitals NHS Foundation Trust, London, UK
| | - Nan Greenwood
- St George's University Hospitals NHS Foundation Trust, London, UK
- Faculty of Health, Social Care and Education, Kingston University, Kingston, UK
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Tsou P, Shih J, Ho MJ. A comparative study of professional and interprofessional values between health professional associations. J Interprof Care 2015; 29:628-33. [DOI: 10.3109/13561820.2015.1046159] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Clarke DJ, Forster A. Improving post-stroke recovery: the role of the multidisciplinary health care team. J Multidiscip Healthc 2015; 8:433-42. [PMID: 26445548 PMCID: PMC4590569 DOI: 10.2147/jmdh.s68764] [Citation(s) in RCA: 96] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Stroke is a leading cause of serious, long-term disability, the effects of which may be prolonged with physical, emotional, social, and financial consequences not only for those affected but also for their family and friends. Evidence for the effectiveness of stroke unit care and the benefits of thrombolysis have transformed treatment for people after stroke. Previously viewed nihilistically, stroke is now seen as a medical emergency with clear evidence-based care pathways from hospital admission to discharge. However, stroke remains a complex clinical condition that requires health professionals to work together to bring to bear their collective knowledge and specialist skills for the benefit of stroke survivors. Multidisciplinary team working is regarded as fundamental to delivering effective care across the stroke pathway. This paper discusses the contribution of team working in improving recovery at key points in the post-stroke pathway.
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Affiliation(s)
- David J Clarke
- Academic Unit of Elderly Care and Rehabilitation, Bradford Institute for Health Research, Bradford, UK
| | - Anne Forster
- Academic Unit of Elderly Care and Rehabilitation, Bradford Institute for Health Research, Bradford, UK
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Liff R, Wikström E. The problem-avoiding multi professional team—On the need to overcome protective routines. SCANDINAVIAN JOURNAL OF MANAGEMENT 2015. [DOI: 10.1016/j.scaman.2014.12.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Mitchell R, Boyle B, Parker V, Giles M, Chiang V, Joyce P. Managing Inclusiveness and Diversity in Teams: How Leader Inclusiveness Affects Performance through Status and Team Identity. HUMAN RESOURCE MANAGEMENT 2015. [DOI: 10.1002/hrm.21658] [Citation(s) in RCA: 103] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Rebecca Mitchell
- Newcastle Business School at the University of Newcastle; Australia
| | - Brendan Boyle
- Newcastle Business School at the University of Newcastle; Australia
| | - Vicki Parker
- Hunter New England Area Health Service and University of New England; Conjoint University of Newcastle
| | - Michelle Giles
- Hunter New England Nursing and Midwifery Research Centre
| | - Vico Chiang
- School of Nursing, Hong Kong Polytechnic University
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Improving the experience of hip fracture care: A multidisciplinary collaborative approach to implementing evidence-based, person-centred practice. Int J Orthop Trauma Nurs 2015; 19:24-35. [DOI: 10.1016/j.ijotn.2014.03.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Revised: 03/26/2014] [Accepted: 03/31/2014] [Indexed: 12/21/2022]
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Altin SV, Tebest R, Kautz-Freimuth S, Redaelli M, Stock S. Barriers in the implementation of interprofessional continuing education programs--a qualitative study from Germany. BMC MEDICAL EDUCATION 2014; 14:227. [PMID: 25335560 PMCID: PMC4288664 DOI: 10.1186/1472-6920-14-227] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 10/13/2014] [Indexed: 05/24/2023]
Abstract
BACKGROUND Insufficient communication and coordination is one of the most problematic issues in German health care delivery leading to detrimental effects on health care outcomes. As a consequence interprofessional continuing education (CIPE) is gathering momentum in German health policy and health care practice aiming to enhance service quality and patient safety. Nevertheless, there is limited evidence on the course of implementation and the perceived effectiveness/acceptance of CIPE in German health care. This paper describes the objectives and formal characteristics of CIPE trainings and maps important determinants influencing the success of CIPE implementation from the perspective of providers offering CIPE trainings for German health care professionals. METHODS Forty-nine training institutions offering CIPE for health care professionals were identified by a structured web search including the websites of German medical education associations and public/private training institutions. Directors and managers of the identified institutions were invited to participate in a semi-structured interview. The interview guideline was developed using the SPSS method by Helferich and colleges. Interviews were analyzed using the summarizing content analysis developed by Mayring resulting in a paradigm that contextualizes hindering factors regarding the implementation of CIPE in the German health care system. RESULTS Overall, 19 of the identified institutions agreed to participate with one director/manager per institution resulting in a response rate of almost 38.8%. The included institutions offer n = 85 CIPE trainings for health care professionals. Trainings offered mainly address the enhancement of domain, social and personal competencies of the participating health care professionals and follow three main objectives comprising better care of severely ill patients, improvement of patient safety by sustained risk management as well as a more patient centered care. Implementation of CIPE in Germany is influenced by various hindering factors mostly coming from systemic (missing incentives), behavioral (hierarchy problems) and methodological (limited quality assurance) factors. CONCLUSION CIPE is an evolving concept in the German health care system. There are various difficulties that impede a successful implementation of CIPE and might be mitigated by specific health policy interventions such as mandatory CIPE participation of health care professionals and comprehensive pre-license interprofessional education.
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Affiliation(s)
- Sibel V Altin
- />Institute for Health Economics and Clinical Epidemiology, University Hospital of Cologne, Gleuelerstr. 176-178, 50935 Cologne, Germany
| | - Ralf Tebest
- />Institute for Health Economics and Clinical Epidemiology, University Hospital of Cologne, Gleuelerstr. 176-178, 50935 Cologne, Germany
| | - Sibylle Kautz-Freimuth
- />Institute for Health Economics and Clinical Epidemiology, University Hospital of Cologne, Gleuelerstr. 176-178, 50935 Cologne, Germany
| | - Marcus Redaelli
- />Institute for Health Economics and Clinical Epidemiology, University Hospital of Cologne, Gleuelerstr. 176-178, 50935 Cologne, Germany
- />Institute of General Practice, Medical Faculty, Heinrich-Heine University, Moorenstraße 5, 40225 Düsseldorf, Germany
| | - Stephanie Stock
- />Institute for Health Economics and Clinical Epidemiology, University Hospital of Cologne, Gleuelerstr. 176-178, 50935 Cologne, Germany
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Sollami A, Caricati L, Sarli L. Nurse-physician collaboration: a meta-analytical investigation of survey scores. J Interprof Care 2014; 29:223-9. [PMID: 25208089 DOI: 10.3109/13561820.2014.955912] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This meta-analysis investigated differences between nurses and physicians in interprofessional collaboration (IPC) ratings. Fifty-one surveys, representing a total of 18 782 professionals and students (13 132 nurses and nursing students, and 5650 physicians and medical students), were meta-analyzed, considering several moderating variables. Overall, nurses scored higher on IPC than physicians. Sensitivity analysis revealed that while physicians perceived more existing collaboration than nurses, nurses had a more positive attitude toward collaboration than physicians. Moreover, IPC ratings of nursing and medical students did not differ from those of practitioners. Finally, it appeared that interprofessional education interventions were able to reduce the difference in IPC between nurses and physicians.
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Aase I, Hansen BS, Aase K. Norwegian nursing and medical students' perception of interprofessional teamwork: a qualitative study. BMC MEDICAL EDUCATION 2014; 14:170. [PMID: 25124090 PMCID: PMC4139134 DOI: 10.1186/1472-6920-14-170] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 08/08/2014] [Indexed: 05/25/2023]
Abstract
BACKGROUND Little is known about the ways in which nursing and medical students perceive and understand their roles in interprofessional teamwork. A 2010 report by the World Health Organization highlights the importance of students' understanding of teamwork in healthcare, and their ability to be effective team players. This study aims at describing nursing and medical students' perceptions of interprofessional teamwork, focusing on experiences and recommendations that can be used to guide future educational efforts. METHODS The study uses a qualitative research design. Data were collected from four focus group interviews: two homogenous groups (one with medical students, one with nursing students) and two mixed groups (medical and nursing students). RESULTS The results show that traditional patterns of professional role perception still prevail and strongly influence students' professional attitudes about taking responsibility and sharing responsibility across disciplinary and professional boundaries. It was found that many students had experienced group cultures detrimental to team work. Focusing on clinical training, the study found a substantial variation in perception with regard to the different arenas for interprofessional teamwork, ranging from arenas with collaborative learning to arenas characterized by distrust, confrontation, disrespect and hierarchical structure. CONCLUSIONS This study underlines the importance of a stronger focus on interprofessional teamwork in health care education, particularly in clinical training. The study results suggest that the daily rounds and pre-visit "huddles," or alternatively psychiatric wards, offer arenas suitable for interprofessional training, in keeping with the students' assessments and criteria proposed in previous studies.
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Affiliation(s)
- Ingunn Aase
- Department of Health Studies, University of Stavanger, Stavanger N-4036, Norway
| | - Britt Sæthre Hansen
- Department of Health Studies, University of Stavanger and Stavanger University Hospital, Stavanger N-4036, Norway
| | - Karina Aase
- Department of Health Studies, University of Stavanger, Stavanger N-4036, Norway
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