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Calder Stegemann KJ, Lewis L. Complementary Care Collaboration: A Call to Action. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024; 30:416-419. [PMID: 38265479 DOI: 10.1089/jicm.2023.0558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
Collaboration among members of a client's/patient's wellness team is a key goal for effective service delivery, and yet often remains elusive. It is proposed that complementary health care practitioners are well situated to lead the way in collaboration. In this article, a framework for how practitioners in any discipline can begin to develop these professional collaborations is presented-NOTP! Network, openness, time, patience. It is a call to action.
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Affiliation(s)
- Kim J Calder Stegemann
- School of Education, Faculty of Education and Social Work, Thompson Rivers University, Kamloops, British Columbia, Canada
| | - Lora Lewis
- Strength in Balance, Kamloops, British Columbia, Canada
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Coates A, Mihailescu M, Bourgeault IL. Emergency responses for a health workforce under pressure: Lessons learned from system responses to the first wave of the pandemic in Canada. Int J Health Plann Manage 2024; 39:906-916. [PMID: 38369691 DOI: 10.1002/hpm.3778] [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: 11/29/2023] [Revised: 01/26/2024] [Accepted: 01/29/2024] [Indexed: 02/20/2024] Open
Abstract
The global health workforce crisis, simmering for decades, was brought to a rolling boil by the COVID-19 pandemic in 2020. With scarce literature, evidence, or best practices to draw from, countries around the world moved to flex their workforces to meet acute challenges of the pandemic, facing demands related to patient volume, patient acuity, and worker vulnerability and absenteeism. One early hypothesis suggested that the acute, short-term pandemic phase would be followed by several waves of resource demands extending over the longer term. However, as the acute phase of the pandemic abated, temporary workforce policies expired and others were repealed with a view of returning to 'normal'. The workforce needs of subsequent phases of pandemic effects were largely ignored despite our new equilibrium resting nowhere near our pre-COVID baseline. In this paper, we describe Canada's early pandemic workforce response. We report the results of an environmental scan of the early workforce strategies adopted in Canada during the first wave of the COVID-19 pandemic. Within an expanded three-part conceptual framework for supporting a sustainable health workforce, we describe 470 strategies and policies that aimed to increase the numbers and flexibility of health workers in Canada, and to maximise their continued availability to work. These strategies targeted all types of health workers and roles, enabling changes to the places health work is done, the way in which care is delivered, and the mechanisms by which it is regulated. Telehealth strategies and virtual care were the most prevalent, followed by role expansion, licensure flexibility, mental health supports for workers, and return to practice of retirees. We explore the degree to which these short-term, acute response strategies might be adapted or extended to support the evolving workforce's long-term needs.
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Affiliation(s)
- Alison Coates
- Telfer School of Management, University of Ottawa, Ottawa, Ontario, Canada
| | - Mara Mihailescu
- Telfer School of Management, University of Ottawa, Ottawa, Ontario, Canada
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Ivy Lynn Bourgeault
- School of Sociological & Anthropological Studies, University of Ottawa, Ottawa, Ontario, Canada
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KLEMENC-KETIŠ Z, ZAFOŠNIK U. Interprofessional Education with Simulations in Primary Care. Zdr Varst 2024; 63:1-4. [PMID: 38156341 PMCID: PMC10751883 DOI: 10.2478/sjph-2024-0001] [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: 10/16/2023] [Accepted: 11/16/2023] [Indexed: 12/30/2023] Open
Abstract
The introduction of interprofessional primary care (IPC) as a model of collaborative patient care is increasingly vital in the context of complex healthcare systems and the growing needs of patients. Its benefits include improved patient outcomes, enhanced efficiency, and reduced costs. However, the successful implementation of IPC faces challenges due to the differences in training and backgrounds among healthcare professionals, emphasising the importance of effective teamwork and collaborative education. Educational approaches utilising simulations have gained prominence, particularly in addressing the challenges of interprofessional primary care. Notably, simulations facilitate team learning, enhancing team management and confidence, which ultimately leads to improved performance in real-life scenarios. They also contribute to patient safety by providing comprehensive training and creating a safe environment for professionals to practice and refine their skills without risking real patient harm. Moreover, simulations promote psychological safety, allowing healthcare workers to manage stress effectively and prepare for critical situations. Ethical considerations are met through simulation-based education, ensuring patient confidentiality, and creating a standardised and just learning environment for all students. Simulations contribute to promoting equity in medical education by providing equal access to high-quality training opportunities for all healthcare professionals. In conclusion, successful IPC implementation requires a comprehensive approach that includes interprofessional education and the integration of simulations as an essential component of the curriculum at all levels of healthcare education. This approach fosters effective communication, teamwork, and confidence among primary care teams, ultimately leading to improved patient care and outcomes.
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Affiliation(s)
- Zalika KLEMENC-KETIŠ
- Community Health Centre Ljubljana, Metelkova 9, 1000Ljubljana, Slovenia
- University of Maribor, Faculty of Medicine, Department of Family Medicine, Taborska 8, 2000Maribor, Slovenia
- University of Ljubljana, Faculty of Medicine, Department of Family Medicine, Poljanski nasip 58, 1000Ljubljana, Slovenia
| | - Uroš ZAFOŠNIK
- Community Health Centre Ljubljana, Metelkova 9, 1000Ljubljana, Slovenia
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Styczen LM, Helseth S, Groven KS, Hauge MI, Dahl-Michelsen T. Interprofessional collaboration for children with physical disabilities: a scoping review. J Interprof Care 2024:1-17. [PMID: 38339970 DOI: 10.1080/13561820.2023.2295922] [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: 04/05/2023] [Accepted: 12/12/2023] [Indexed: 02/12/2024]
Abstract
Interprofessional collaboration is vital in the context of service delivery for children with physical disabilities. Despite the established importance of interprofessional collaboration and an increasing focus on research on this topic, there is no overview of the research. A scoping review was conducted to explore current knowledge on interprofessional collaboration for children with physical disabilities from the point of view of the actors involved. The steps of this review included identifying a research question, developing a protocol, identifying relevant research, selecting studies, summarizing and analyzing the data, and reporting and discussing the results. Through databases and studies from hand-searches, 4,688 records were screened. A total of 29 studies were included. We found that four themes: communication, knowledge, roles, and culture in interprofessional collaboration illustrate current knowledge on the topic. Interprofessional collaboration for children with physical disabilities is shown to be composed of these four themes, depending on the actors involved. Interprofessional collaboration is affected by how these four themes appear; they mainly act as barriers and, to a lesser extent, as facilitators for interprofessional collaboration. Whether and how the themes appear as facilitators need further exploration to support innovation of interprofessional collaboration.
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Affiliation(s)
- Line Myrdal Styczen
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Sølvi Helseth
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Karen Synne Groven
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Mona-Iren Hauge
- Faculty of Social Studies, VID Specialised University, Oslo, Norway
| | - Tone Dahl-Michelsen
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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Zimansky M, Ceylan B, Klukas E, Hamacher M, van de Sand H, Gustaevel M, Wiegelmann S, Hämel K. [Interprofessional collaboration of general practitioners and nurses in primary care: A qualitative study]. Pflege 2024; 37:11-18. [PMID: 37317705 DOI: 10.1024/1012-5302/a000942] [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] [Indexed: 06/16/2023]
Abstract
Interprofessional collaboration of general practitioners and nurses in primary care: A qualitative study Abstract. Background: There is a need to strengthen interprofessional collaboration of general practitioners and home care nurses in the primary care of people with chronic diseases and long-term care needs. Aim: This study investigated a) how general practitioners and nurses in Germany perceive their collaboration in primary care and b) which development perspectives of collaboration exist from their point of view. Methods: Expert interviews were conducted with seven general practitioners and eight home care nurses. The data were analysed using thematic-structured qualitative content analysis. Results: The interviewees from both professional groups report that their collaboration is hindered by poor mutual accessibility. At the same time, they emphasise their appreciation of the professional exchange with the other professional group. Nevertheless, the perceptions of the professional competence of home care nurses differ. To improve their cooperation, the interviewees recommend the establishment of interprofessional meetings and cooperation in spatial proximity for regular professional exchange. They expect this to lead to a joint development of trust and competence and to an expansion of the area of responsibility of home care nurses in primary care. Conclusions: Binding communication structures, cooperation in spatial proximity and an expansion of the area of responsibility of home care nurses offer high potential for strengthening primary care in Germany.
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Affiliation(s)
- Manuel Zimansky
- Fakultät für Gesundheitswissenschaften, Universität Bielefeld, Deuschland
| | - Betül Ceylan
- Fakultät für Gesundheitswissenschaften, Universität Bielefeld, Deuschland
| | - Eduard Klukas
- Fakultät für Gesundheitswissenschaften, Universität Bielefeld, Deuschland
| | - Marie Hamacher
- Fakultät für Gesundheitswissenschaften, Universität Bielefeld, Deuschland
| | - Heike van de Sand
- Fakultät für Gesundheitswissenschaften, Universität Bielefeld, Deuschland
| | - Malin Gustaevel
- Fakultät für Gesundheitswissenschaften, Universität Bielefeld, Deuschland
| | - Saskia Wiegelmann
- Fakultät für Gesundheitswissenschaften, Universität Bielefeld, Deuschland
| | - Kerstin Hämel
- Fakultät für Gesundheitswissenschaften, Universität Bielefeld, Deuschland
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Messer J, Tzartzas K, Marion-Veyron R, Cohidon C. A Cross-Sectional Study of the Prevalence and Determinants of Common Mental Health Problems in Primary Care in Switzerland. Int J Public Health 2023; 68:1606368. [PMID: 38162336 PMCID: PMC10756069 DOI: 10.3389/ijph.2023.1606368] [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: 07/03/2023] [Accepted: 11/27/2023] [Indexed: 01/03/2024] Open
Abstract
Objective: This study investigated the prevalence of the most common mental health symptoms in a large primary care patient population and characterized their determinants. Methods: Data came from a 2015-16 cross-sectional study of a primary care population in Switzerland. An investigator presented the study to patients in waiting rooms, and 1,103 completed a tablet-based questionnaire measuring stress in daily life, sleep disorders and anxiety and depressive symptoms. Diagnoses and treatments were recorded. Results: Moderate-to-high anxiety and depressive symptoms concerned 7.7% of patients; 27.6% felt stressed at least once a week; 17.2% had severe sleep disorders. Sociodemographic determinants were associated with psychiatric symptoms: female sex, young age, and frequency of consultations with a GP. Participants taking psychotropics had high levels of mental distress. Conclusion: Even though most patients were regularly monitored by their GP, a significant number of mental health problems were found. GPs should be provided with concrete tools to manage these patients better. Collaboration with mental health specialists should be encouraged in primary care settings.
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Affiliation(s)
- Juliane Messer
- Department of Family Medicine, University Center of General Medicine and Public Health, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Konstantinos Tzartzas
- Department of Ambulatory Care and Community Medicine, University Center of General Medicine and Public Health, Lausanne, Switzerland
| | - Régis Marion-Veyron
- Department of Ambulatory Care and Community Medicine, University Center of General Medicine and Public Health, Lausanne, Switzerland
| | - Christine Cohidon
- Department of Family Medicine, University Center of General Medicine and Public Health, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
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Skumsnes R, Thygesen H, Groven KS. Facilitators and barriers to communication in rehabilitation services across healthcare levels: a qualitative case study in a Norwegian context. BMC Health Serv Res 2023; 23:1353. [PMID: 38049788 PMCID: PMC10696812 DOI: 10.1186/s12913-023-10222-2] [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: 05/16/2023] [Accepted: 10/27/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND People with problems in functioning following severe injury or illness often need multiple and combined interventions in their rehabilitation processes. In these processes, communication and collaboration between the involved healthcare professionals are essential. Despite efforts in research and policy, communication across hospital and primary healthcare services and within the primary healthcare settings remains challenging. In one region of Norway, a new intermunicipal rehabilitation team has been established to supplement the traditional services and context-bound research is needed to gain insight into the complexity of the new communication structures that are developing. The aim of this study was to explore facilitators and barriers to communication to inform further improvement of the services. METHODS A qualitative case study design was used to explore the exchange of patient information in the rehabilitation processes of four patients. Data collection included participant observations in communication situations and an exploration of the electronic patient records of these four patients. Reflexive thematic analysis was used to analyse the empirical data. RESULTS The complex rehabilitation processes explored involved a large number of actors across healthcare organisational levels. Lacking a common culture for rehabilitation, poor access to written information and unclear responsibility for sharing information across organisational boundaries seemed to represent barriers to interprofessional communication. Joint meetings, the use of common rehabilitation tools and language and establishing informal communication channels served to facilitate communication. CONCLUSION The intermunicipal team collaborating across different organisational levels added complexity to communication structures, but also facilitated interprofessional communication by promoting formal and informal ways of exchanging information. However, the intricate organisational divisions of healthcare provision in the Norwegian context represent boundaries which can be difficult to overcome. Therefore, cross-organisational coordination services should be developed.
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Affiliation(s)
- Randi Skumsnes
- Centre for Diaconia and Professional Practice, VID Specialized University, Oslo, Norway.
- Department of Innovation and Research, City of Stavanger, Stavanger, Norway.
| | - Hilde Thygesen
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Borre, Norway
- Department of Rehabilitation Sciences and Health Technolgy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Karen Synne Groven
- Department of Rehabilitation Sciences and Health Technolgy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Faculty of Health Studies, VID Specialized University, Oslo, Norway
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Wiener JC. Models of shared care for the management of psychotic disorder after first diagnosis in Ontario. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2023; 69:859-866. [PMID: 38092451 PMCID: PMC10949256 DOI: 10.46747/cfp.6912859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
OBJECTIVE To describe the provision of care for young people following first diagnosis of psychotic disorder. DESIGN Retrospective cohort study using health administrative data. SETTING Ontario. PARTICIPANTS People aged 14 to 35 years with a first diagnosis of nonaffective psychotic disorder in Ontario between 2005 and 2015 (N=39,449). MAIN OUTCOME MEASURES Models of care, defined by psychosis-related service contacts with primary care physicians and psychiatrists during the 2 years after first diagnosis of psychotic disorder. RESULTS During the 2-year follow-up period, 29% of the cohort received only primary care, 30% received only psychiatric care, and 32% received both primary and psychiatric care (shared care). Among the shared care group, 72% received care predominantly from psychiatrists, 20% received care predominantly from primary care physicians, and 9% received approximately equal care from psychiatry and primary care. Variation in patient and physician characteristics was observed across the different models of care. CONCLUSION One in 3 young people with psychotic disorder received shared care during the 2-year period after first diagnosis. The findings highlight opportunities for increasing collaboration between primary care physicians and psychiatrists to enhance the quality of care for those with early psychosis.
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Affiliation(s)
- Joshua C. Wiener
- Doctoral candidate, Department of Epidemiology and Biostatistics in the Schulich School of Medicine and Dentistry at Western University in London, Ont
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Bouton C, Journeaux M, Jourdain M, Angibaud M, Huon JF, Rat C. Interprofessional collaboration in primary care: what effect on patient health? A systematic literature review. BMC PRIMARY CARE 2023; 24:253. [PMID: 38031014 PMCID: PMC10685527 DOI: 10.1186/s12875-023-02189-0] [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: 12/09/2022] [Accepted: 10/20/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND In a period of change in the organization of primary care, Interprofessional Collaboration (IPC) is presented as one of the solutions to health issues. Although the number of inter-professional interventions grounded in primary care increases in all developed countries, evidence on the effects of these collaborations on patient-centred outcomes is patchy. The objective of our study was to assess the effects of IPC grounded in the primary care setting on patient-centred outcomes. METHODS We conducted a systematic literature review using the PubMed, Embase, PsycINFO and CINAHL databases from 01/01/1995 to 01/03/2021, according to the PRISMA guidelines. Studies reporting the effects of IPC in primary care on patient health outcomes were included. The quality of the studies was assessed using the revised Downs and Black checklist. RESULTS Sixty-five articles concerning 61 interventions were analysed. A total of 43 studies were prospective and randomized. Studies were classified into 3 main categories as follows: 1) studies with patients at cardiovascular risk (28 studies)-including diabetes (18 studies) and arterial hypertension (5 studies); 2) studies including elderly and/or polypathological patients (18 studies); and 3) patients with symptoms of mental or physical disorders (15 studies). The number of included patients varied greatly (from 50 to 312,377). The proportion of studies that reported a positive effect of IPC on patient-centred outcomes was as follows: 23 out of the 28 studies including patients at cardiovascular risk, 8 out of the 18 studies of elderly or polypathological patients, and 11 out of the 12 studies of patients with mental or physical disorders. CONCLUSIONS Evidence suggests that IPC is effective in the management of patients at cardiovascular risk. In elderly or polypathological patients and in patients with mental or physical disorders, the number of studies remains very limited, and the results are heterogeneous. Researchers should be encouraged to perform studies based on comparative designs: it would increase evidence on the positive effect and benefits of IPC on patient variables.
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Affiliation(s)
- Céline Bouton
- Department of General Practice, Faculty of Medicine, University of Nantes, 1, Rue Gaston Veil, 44035, Nantes, France.
- Primary Care Federative Department, Faculty of Medicine, University of Nantes, Nantes, France.
| | - Manon Journeaux
- Department of General Practice, Faculty of Medicine, University of Nantes, 1, Rue Gaston Veil, 44035, Nantes, France
| | - Maud Jourdain
- Department of General Practice, Faculty of Medicine, University of Nantes, 1, Rue Gaston Veil, 44035, Nantes, France
- Primary Care Federative Department, Faculty of Medicine, University of Nantes, Nantes, France
| | - Morgane Angibaud
- Primary Care Federative Department, Faculty of Medicine, University of Nantes, Nantes, France
| | - Jean-François Huon
- Primary Care Federative Department, Faculty of Medicine, University of Nantes, Nantes, France
- Faculty of Pharmacy, University of Nantes, Nantes, France
| | - Cédric Rat
- Department of General Practice, Faculty of Medicine, University of Nantes, 1, Rue Gaston Veil, 44035, Nantes, France
- Primary Care Federative Department, Faculty of Medicine, University of Nantes, Nantes, France
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Carter C, Mohammed S, Upshur R, Kontos P. "I don't see the whole picture of their health": a critical ethnography of constraints to interprofessional collaboration in end-of-life conversations in primary care. BMC PRIMARY CARE 2023; 24:225. [PMID: 37898764 PMCID: PMC10612350 DOI: 10.1186/s12875-023-02171-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 10/04/2023] [Indexed: 10/30/2023]
Abstract
CONTEXT Interprofessional collaboration is recommended in caring for frail older adults in primary care, yet little is known about how interprofessional teams approach end-of-life (EOL) conversations with these patients. OBJECTIVE To understand the factors shaping nurses' and allied health clinicians' involvement, or lack of involvement in EOL conversations in the primary care of frail older adults. METHODS/SETTING A critical ethnography of a large interprofessional urban Family Health Team in Ontario, Canada. Data production included observations of clinicians in their day-to-day activities excluding direct patient care; one-to-one semi-structured interviews with clinicians; and document review. Analysis involved coding data using an interprofessional collaboration framework as well as an analysis of the normative logics influencing practice. PARTICIPANTS Interprofessional clinicians (n = 20) who cared for mildly to severely frail patients (Clinical Frailty Scale) at the Family Health Team. RESULTS Findings suggest primary care nurses and allied health clinicians have the knowledge, skills, and inclination to engage frail older adults in EOL conversations. However, the culture of the clinic prioritizes biomedical care, and normalizes nurses and allied health clinicians providing episodic task-based care, which limits the possibility for these clinicians' engagement in EOL conversations. The barriers to nurses' and allied health clinicians' involvement in EOL conversations are rooted in neoliberal-biomedical ideologies that shapes the way primary care is governed and practiced. CONCLUSIONS Our findings help to explain why taking an individual-level approach to addressing the challenge of delayed or avoided EOL conversations, is unlikely to result in practice change. Instead, primary care teams can work to critique and redevelop quality indicators and funding models in ways that promote meaningful interprofessional practice that recognize the expertise of nursing and allied health clinicians in providing high quality primary care to frail older patients, including EOL conversations.
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Affiliation(s)
- Celina Carter
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
| | - Shan Mohammed
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Ross Upshur
- Department of Family and Community Medicine and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Pia Kontos
- KITE Research Institute, Toronto Rehabilitation Institute - University Health Network, Toronto, Canada
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Parker SM, Paine K, Spooner C, Harris M. Barriers and facilitators to the participation and engagement of primary care in shared-care arrangements with community mental health services for preventive care of people with serious mental illness: a scoping review. BMC Health Serv Res 2023; 23:977. [PMID: 37697280 PMCID: PMC10494334 DOI: 10.1186/s12913-023-09918-2] [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: 01/24/2023] [Accepted: 08/14/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND People with serious mental illness die about 20 years earlier than the general population from preventable diseases. Shared-care arrangements between general practitioners and mental health services can improve consumers' access to preventive care, but implementing shared care is challenging. This scoping review sought to describe current evidence on the barriers and facilitators to the participation and engagement of primary care (specifically general practitioners) in shared-care arrangements with community mental health services for preventive health care of this population. METHODS We searched Medline, Embase, CINAHL, Scopus, APA PsychINFO and EBM Reviews from 2010 to 2022. Data was extracted against a Microsoft Excel template developed for the review. Data was synthesised through tabulation and narrative methods. RESULTS We identified 295 records. After eligibility screening and full-text review, seven studies were included. Facilitators of engagement included a good fit with organisation and practice and opportunities to increase collaboration, specific roles to promote communication and coordination and help patients to navigate appointments, multidisciplinary teams and teamwork, and access to shared medical/health records. Barriers included a lack of willingness and motivation on the part of providers and low levels of confidence with tasks, lack of physical structures to produce capacity, poor alignment of funding/incentives, inability to share patient information and challenges engaging people with severe mental illness in the service and with their care. CONCLUSION Our results were consistent with other research on shared care and suggests that the broader literature is likely to be applicable to the context of general practitioner/mental health services shared care. Specific challenges relating to this cohort present difficulties for recruitment and retention in shared care programs. Sharing "goals and knowledge, mutual respect" and engaging in "frequent, timely, accurate, problem-solving communication", supported by structures such as shared information systems are likely to engage primary care in shared care arrangements more than the traditional focus on incentives, education, and guidelines.
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Affiliation(s)
- Sharon M Parker
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia.
| | - Katrina Paine
- Susan Wakil School of Nursing, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales , Australia
| | - Catherine Spooner
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia
| | - Mark Harris
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia
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Malone S, Rivera J, Puerto-Torres M, Prewitt K, Sakaan F, Counts L, Al Zebin Z, Arias AV, Bhattacharyya P, Gunasekera S, Johnson S, Kambugu J, Kaye EC, Mandrell B, Mack JW, McArthur J, Mendez A, Morrissey L, Sharara-Chami R, Snaman J, Sniderman E, Luke DA, Graetz DE, Agulnik A. A new measure for multi-professional medical team communication: design and methodology for multilingual measurement development. Front Pediatr 2023; 11:1127633. [PMID: 37334217 PMCID: PMC10272604 DOI: 10.3389/fped.2023.1127633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 05/09/2023] [Indexed: 06/20/2023] Open
Abstract
Background As implementation science in global health continues to evolve, there is a need for valid and reliable measures that consider diverse linguistic and cultural contexts. A standardized, reproducible process for multilingual measure development may improve accessibility and validity by participants in global health settings. To address this need, we propose a rigorous methodology for multilingual measurement development. We use the example of a novel measure of multi-professional team communication quality, a determinant of implementation efforts. Methods The development and translation of this novel bilingual measure is comprised of seven steps. In this paper, we describe a measure developed in English and Spanish, however, this approach is not language specific. Participants are engaged throughout the process: first, an interprofessional panel of experts and second, through cognitive interviewing for measure refinement. The steps of measure development included: (1) literature review to identify previous measures of team communication; (2) development of an initial measure by the expert panel; (3) cognitive interviewing in a phased approach with the first language (English); (4): formal, forward-backward translation process with attention to colloquialisms and regional differences in languages; (5) cognitive interviewing repeated in the second language (Spanish); (6) language synthesis to refine both instruments and unify feedback; and (7) final review of the refined measure by the expert panel. Results A draft measure to assess quality of multi-professional team communication was developed in Spanish and English, consisting of 52 questions in 7 domains. This measure is now ready for psychometric testing. Conclusions This seven-step, rigorous process of multilingual measure development can be used in a variety of linguistic and resource settings. This method ensures development of valid and reliable tools to collect data from a wide range of participants, including those who have historically been excluded due to language barriers. Use of this method will increase both rigor and accessibility of measurement in implementation science and advance equity in research and practice.
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Affiliation(s)
- Sara Malone
- Department of Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO, United States
| | - Jocelyn Rivera
- Department of Pediatrics, Hospital Infantil Teletón de Oncologia (HITO), Querétaro, Mexico
| | - Maria Puerto-Torres
- Division of Critical Care Medicine, Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Kim Prewitt
- Center for Public Health Systems Science, Washington University, St. Louis, MO, USA
| | - Firas Sakaan
- Division of Critical Care Medicine, Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Lara Counts
- Department of Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO, United States
| | - Zebin Al Zebin
- Pediatric Hematology and Oncology, King Hussein Cancer Center, Amman, Jordan
| | - Anita V Arias
- Division of Critical Care Medicine, Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, United States
| | | | | | - Sherry Johnson
- Division of Critical Care Medicine, Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Joyce Kambugu
- Pediatric Oncology, Uganda Cancer Institute, Kampala, Uganda
| | - Erica C Kaye
- Division of Critical Care Medicine, Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Belinda Mandrell
- Division of Critical Care Medicine, Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Jennifer W Mack
- Department of Hematology and Oncology, Dana-Farber Cancer Institute and Boston Children's Hospital, Boston, MA, United States
| | - Jennifer McArthur
- Division of Critical Care Medicine, Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Alejandra Mendez
- Pediatric Intensive Care Unit, Unidad Nacional de Oncologia Pediatrica (UNOP), Guatemala City, Guatemala
| | - Lisa Morrissey
- Department of Hematology and Oncology, Dana-Farber Cancer Institute and Boston Children's Hospital, Boston, MA, United States
| | - Rana Sharara-Chami
- Pediatric Critical Care Medicine, American University of Beirut, Beirut, Lebanon
- Pediatric Intensive Care Unit, LJ Murphy Inova Children's Hospital, Fairfax, VA, United States
| | - Jennifer Snaman
- Department of Hematology and Oncology, Dana-Farber Cancer Institute and Boston Children's Hospital, Boston, MA, United States
| | - Elizabeth Sniderman
- Northern Alberta Children's Cancer Program, Stollery Children's Hospital, Edmonton, AB, Canada
| | - Douglas A Luke
- Center for Public Health Systems Science, Washington University, St. Louis, MO, USA
| | - Dylan E Graetz
- Division of Critical Care Medicine, Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Asya Agulnik
- Division of Critical Care Medicine, Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, United States
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13
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Sturm H, Kaiser F, Leibinger P, Drechsel-Grau E, Joos S, Schmid A. The Contribution of Intersectoral Healthcare Centres with an Extended Outpatient Care Model to Improve Regional Care-Structures-A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5365. [PMID: 37047979 PMCID: PMC10094656 DOI: 10.3390/ijerph20075365] [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: 02/13/2023] [Revised: 03/14/2023] [Accepted: 03/23/2023] [Indexed: 06/19/2023]
Abstract
Many smaller hospitals in Germany are currently threatened with closure due to economic reasons and politically derived centralization. In some-especially rural areas-this may result in a lack of accessible local care structures. At the same time, patients are unnecessarily admitted to hospitals due to insufficient primary care structures and healthcare coordination. Intersectoral health centers (IHC), as new intermediary structures, may offer round-the-clock monitoring (Extended Outpatient Care, EOC), with fewer infrastructure needs than hospitals and, thus, could offer a sustainable solution. In an iterative process, 30 expert interviews (with physicians, nurses and other healthcare experts) formed the basis for the derivation of diagnostic groups, relevant related patient characteristics and scenarios, as well as structural preconditions necessary for safe care in the setting of the new model of IHC/EOC. Additionally, three workshops within the multidisciplinary research team (including healthcare services researchers, GPs, and health economists) were performed. Inductive categories on disease-, case-, sociodemographic- and infrastructure-related criteria were derived following thematic analysis. Due to the expert interviews, general practice equipment plus continuous monitoring beds should form the basic infrastructure for EOCs, which should be adjusted to local needs and infrastructure demands. GPs could be aided through (electronic) support by other specialists. IHC, as a physician-led facility, should rely on experienced nurses to allow for 24-h services and to support integrated team-based primary care with GPs. Alongside nurses, case managers, therapists and social workers can be included in the structure, allowing for improved integration of (primary) care services. In order to sustain low-threshold, local access to care, especially in rural areas, IHC with extended monitoring and integration of coordinative support, emerged as a promising solution that could solve many common patient needs without the need for hospital-based inpatient care.
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Affiliation(s)
- Heidrun Sturm
- Institute of General Practice and Interprofessional Care, University Hospital Tübingen, 72076 Tübingen, Germany
| | - Florian Kaiser
- Oberender AG, Wahnfriedstraße 3, 95440 Bayreuth, Germany
| | | | - Edgar Drechsel-Grau
- Institute of General Practice and Interprofessional Care, University Hospital Tübingen, 72076 Tübingen, Germany
| | - Stefanie Joos
- Institute of General Practice and Interprofessional Care, University Hospital Tübingen, 72076 Tübingen, Germany
| | - Andreas Schmid
- Oberender AG, Wahnfriedstraße 3, 95440 Bayreuth, Germany
- Management im Gesundheitswesen, Rechts-und Wirtschaftswissenschaftliche Fakultät, Universität Bayreuth, Universitätsstraße 30, 95447 Bayreuth, Germany
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14
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Verbeek FHO, van Lierop MEA, Meijers JMM, van Rossum E, Zwakhalen SMG, Laurant MGH, van Vught AJAH. Facilitators for developing an interprofessional learning culture in nursing homes: a scoping review. BMC Health Serv Res 2023; 23:178. [PMID: 36810021 PMCID: PMC9945386 DOI: 10.1186/s12913-023-09092-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 01/23/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Healthcare professionals in nursing homes face complex care demands and nursing staff shortages. As a result, nursing homes are transforming into home-like personalised facilities that deliver person-centred care. These challenges and changes require an interprofessional learning culture in nursing homes, but there is little understanding of the facilitators that contribute to developing such a culture. This scoping review aims to identify those facilitators. METHODS A scoping review was performed in accordance with the JBI Manual for Evidence Synthesis (2020). The search was carried out in 2020-2021 in seven international databases (PubMed, Cochrane Library, CINAHL, Medline, Embase, PsycINFO and Web of Science). Two researchers independently extracted reported facilitators that contribute to an interprofessional learning culture in nursing homes. Then the researchers inductively clustered the extracted facilitators into categories. RESULTS In total, 5,747 studies were identified. After removing duplicates and screening titles, abstracts and full texts, 13 studies that matched the inclusion criteria were included in this scoping review. We identified 40 facilitators and clustered them into eight categories: (1) shared language, (2) shared goals, (3) clear tasks and responsibilities, (4) learning and sharing knowledge, (5) work approaches, (6) facilitating and supporting change and creativity by the frontline manager, (7) an open attitude, and (8) a safe, respectful and transparent environment. CONCLUSION We found facilitators that could be used to discuss the current interprofessional learning culture in nursing homes and identify where improvements are required. Further research is needed to discover how to operationalise facilitators that develop an interprofessional learning culture in nursing homes and to gain insights into what works, for whom, to what extent and in what context.
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Affiliation(s)
- Frank H. O. Verbeek
- grid.450078.e0000 0000 8809 2093HAN University of Applied Sciences, School of Health Studies, Research Group Organisation of Healthcare and Services, Nijmegen, The Netherlands
| | - Merel E. A. van Lierop
- grid.5012.60000 0001 0481 6099Maastricht University, Care and Public Health Research Institute, Department of Health Services, Maastricht, The Netherlands ,Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - Judith M. M. Meijers
- grid.5012.60000 0001 0481 6099Maastricht University, Care and Public Health Research Institute, Department of Health Services, Maastricht, The Netherlands ,Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands ,Zuyderland Care, Zuyderland Medical Center, Sittard-Geleen, the Netherlands
| | - Erik van Rossum
- grid.5012.60000 0001 0481 6099Maastricht University, Care and Public Health Research Institute, Department of Health Services, Maastricht, The Netherlands ,Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands ,grid.413098.70000 0004 0429 9708Zuyd University of Applied Sciences, Research Centre for Community Care, Academy of Nursing, Heerlen, The Netherlands
| | - Sandra M. G. Zwakhalen
- grid.5012.60000 0001 0481 6099Maastricht University, Care and Public Health Research Institute, Department of Health Services, Maastricht, The Netherlands ,Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - Miranda G. H. Laurant
- grid.450078.e0000 0000 8809 2093HAN University of Applied Sciences, School of Health Studies, Research Group Organisation of Healthcare and Services, Nijmegen, The Netherlands
| | - Anneke J. A. H. van Vught
- grid.450078.e0000 0000 8809 2093HAN University of Applied Sciences, School of Health Studies, Research Group Organisation of Healthcare and Services, Nijmegen, The Netherlands
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15
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Normandin C, Hayes V, Cyr P, Schirmer J. Implementation and impact of an interprofessional education curriculum on medical, pharmacy, and social work students' attitudes, perceptions, and self-assessed teamwork skills. J Interprof Care 2023:1-5. [PMID: 36747337 DOI: 10.1080/13561820.2023.2169260] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Health professionals are actively contributing to interprofessional collaboration, yet implementation and assessment of interprofessional education (IPE) within Family Medicine is not well documented. From October 2014 to December 2018, social work, pharmacy, and medical students worked as an IP team involving inpatient, outpatient, and home visit experiences. Students completed two validated surveys pre- and post- their interprofessional education rotation: the Interdisciplinary Education Perception Scale (IEPS) and the Teams Skills Scale (TSS). Paired t-test analyses were conducted on individual pre- and post-survey scores. Twenty-seven (77%) of the 35 participating students completed pre- and post-surveys. Significant differences were found in mean change in pre-IEPS mean scores (4.95) and post-IEPS mean scores (5.29), with a mean difference in matched pairs of 0.31 (p < .001, p = 27). A significant difference was found in student pre-TSS mean scores (3.52) and post-TSS mean scores (4.31), with a mean difference in matched pairs of 0.79 (p < .0001, p = 27). Our findings demonstrate that the IPE curriculum had a positive impact on students' attitudes and self-assessed teamwork skills, with greater learning outcomes identified amongst pharmacy and social work students than medical students. Implementing IP curriculum into Family Medicine experiences is both feasible and worthy of further investigation.
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Affiliation(s)
- Corinn Normandin
- Department of Family Medicine, Maine Medical Center, Portland, ME.,Department of Family Medicine, Tufts University School of Medicine, Boston, MA
| | - Vicki Hayes
- Department of Family Medicine, Maine Medical Center, Portland, ME.,Department of Family Medicine, Tufts University School of Medicine, Boston, MA
| | - Peggy Cyr
- Department of Family Medicine, Maine Medical Center, Portland, ME.,Department of Family Medicine, Tufts University School of Medicine, Boston, MA
| | - Julie Schirmer
- Department of Family Medicine, Maine Medical Center, Portland, ME.,Department of Family Medicine, Tufts University School of Medicine, Boston, MA
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16
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Kaiser L, Neugebauer EAM, Pieper D. Interprofessional collaboration and patient-reported outcomes: a secondary data analysis based on large scale survey data. BMC Health Serv Res 2023; 23:5. [PMID: 36597063 PMCID: PMC9809039 DOI: 10.1186/s12913-022-08973-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 12/15/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND While interprofessional collaboration (IPC) is widely considered a key element of comprehensive patient treatment, evidence focusing on its impact on patient-reported outcomes (PROs) is inconclusive. The aim of this study was to investigate the association between employee-rated IPC and PROs in a clinical inpatient setting. METHODS We conducted a secondary data analysis of the entire patient and employee reported data collected by the Picker Institute Germany in cross-sectional surveys between 2003 and 2016. Individual patient data from departments within hospitals was matched with employee survey data from within 2 years of treatment at the department-level. Items assessing employee-rated IPC (independent variables) were included in Principal Component Analysis (PCA). All questions assessing PROs (overall satisfaction, less discomforts, complications, treatment success, willingness to recommend) served as main dependent variables in ordered logistic regression analyses. Results were adjusted for multiple hypothesis testing as well as patients' and employees' gender, age, and education. RESULTS The data set resulted in 6154 patients from 19 hospitals respective 103 unique departments. The PCA revealed three principal components (department-specific IPC, interprofessional organization, and overall IPC), explaining 67% of the total variance. The KMO measure of sampling adequacy was .830 and Bartlett's test of sphericity highly significant (p < 0.001). An increase of 1 SD in department-specific IPC was associated with a statistically significant chance of a higher (i.e., better) PRO-rating about complications after discharge (OR 1.07, 95% CI 1.00-1.13, p = 0.029). However, no further associations were found. Exploratory analyses revealed positive coefficients of department-specific IPC on all PROs for patients which were treated in surgical or internal medicine departments, whereas results were ambiguous for pediatric patients. CONCLUSIONS The association between department-level IPC and patient-level PROs remains - as documented in previous literature - unclear and results are of marginal effect sizes. Future studies should keep in mind the different types of IPC, their specific characteristics and possible effect mechanisms. TRIAL REGISTRATION Study registration: Open Science Framework (DOI https://doi.org/10.17605/OSF.IO/2NYAX ); Date of registration: 09 November 2021.
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Affiliation(s)
- Laura Kaiser
- grid.412581.b0000 0000 9024 6397Witten/Herdecke University, Witten, Germany
| | | | - Dawid Pieper
- grid.412581.b0000 0000 9024 6397Witten/Herdecke University, Witten, Germany ,Institute for Research in Operative Medicine, Witten, Germany ,grid.473452.3Institute for Health Services and Health Systems Research, Brandenburg Medical School Theodor Fontane, Rüdersdorf, Germany ,grid.473452.3Center for Health Services Research, Brandenburg Medical School Theodor Fontane, Rüdersdorf, Germany ,Faculty of Health Sciences Brandenburg, Potsdam, Germany
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17
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Madisa M, Filmalter CJ, Heyns T. Considerations for promoting the implementation of work-based interprofessional education programmes: A scoping review. NURSE EDUCATION TODAY 2023; 120:105617. [PMID: 36368119 DOI: 10.1016/j.nedt.2022.105617] [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: 03/15/2022] [Revised: 10/11/2022] [Accepted: 10/23/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Effective inter-professional collaboration may improve healthcare outcomes, including maternal and child healthcare settings where unfavourable outcomes are often due to communication and collaboration failures. OBJECTIVE Explore the considerations for promoting the implementation of work-based interprofessional education programmes. METHODS A scoping review guided by the methodological framework of Arksery and O'Malley was used to analyse 28 articles published between 2000 and 2020. The reporting was guided by the PRISMA extension for Scoping Reviews. RESULTS Twenty-seven of 28 articles were studies conducted in high-income countries. The review revealed considerations which were themed as 1) mobilisation of resources, 2) helpful learning environment, 3) healthcare professional's valuation and 4) barriers prior to implementing IPE/IPC. Successful implementation of interventions triggered motivation, confidence, self-efficacy, value for IPE/IPC. CONCLUSION Our findings demonstrate that there are specific considerations that can contribute to the uptake of IPE/IPC interventions in the clinical setting.
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Affiliation(s)
- Montlenyane Madisa
- University of Pretoria, Department of Nursing Science, Pretoria, South Africa.
| | - Celia J Filmalter
- University of Pretoria, Department of Nursing Science, Pretoria, South Africa.
| | - Tanya Heyns
- University of Pretoria, Department of Nursing Science, Pretoria, South Africa.
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18
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Prætorius T, Baymler Lundberg AS, Søndergaard E, Tang Knudsen S, Sandbæk A. The effect of virtual specialist conferences between endocrinologists and general practitioners about type 2 diabetes: study protocol for a pragmatic randomized superiority trial. Trials 2022; 23:1059. [PMID: 36578024 PMCID: PMC9795951 DOI: 10.1186/s13063-022-06961-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 11/25/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND To support the primary care sector in delivering high-quality type 2 diabetes (T2D), literature reviews emphasize the need for implementing models of collaboration that in a simple and effective way facilitate clinical dialogue between general practitioners (GPs) and endocrinologists. The overall aim of the project is to evaluate if virtual specialist conferences between GPs and endocrinologists about patients living with T2D is clinically effective and improves diabetes competences and organization in general practice in comparison to usual practice. METHODS A prospective, pragmatic, and superiority RCT with two parallel arms of general practices in the Municipality of Aarhus, Denmark. All general practices are invited (n = 100). The intervention runs for 12 months and consists of four virtual conferences between endocrinologists and an individual general practice. Before the first conference, an introductory webinar teaches GPs about how to use an IT-platform to identify and manage T2D patients. The main analysis (month 12) concerns the difference between the intervention and control arm. It is expected that the virtual conferences at the patient level will improve adherence to international recommendations on diabetes medication for T2D patients and improve the risk profile with a reduction in glycated haemoglobin, blood pressure, and cholesterol. The study design allows for identifying a significant difference between the intervention (n = 15) and control group (n = 15) regarding the three primary clinical outcomes with a power of 0.8870-0.9941. At the general practice level, it is expected that general practitioners and practice staff in the intervention group will improve self-reported diabetes competence and organization. The control arm will get the intervention when the primary intervention ends (months 12-24), and the intervention arm transitions to a maintenance phase. DISCUSSION The potential of virtual conferences is yet to be fully tapped because of methodological limitations. Studies have also not yet systematically evaluated virtual conferences in the context of chronic care using a high-quality research design. Given the nature of this real-life intervention, general practitioners and endocrinologists cannot be blinded to their allocation to either the intervention or comparison arm. TRIAL REGISTRATION ClinicalTrials.gov, United States National Institutes of Health trial ID: NCT05268081. Registered on 4 March 2022.
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Affiliation(s)
- Thim Prætorius
- grid.154185.c0000 0004 0512 597XSteno Diabetes Center Aarhus, Aarhus University Hospital, Palle Juul-Jensens Boulevard 11, 8200 Aarhus N, Denmark
| | - Anne Sofie Baymler Lundberg
- grid.154185.c0000 0004 0512 597XSteno Diabetes Center Aarhus, Aarhus University Hospital, Palle Juul-Jensens Boulevard 11, 8200 Aarhus N, Denmark ,grid.7048.b0000 0001 1956 2722 Research Unit for General Practice, Aarhus University, Aarhus, Denmark
| | - Esben Søndergaard
- grid.154185.c0000 0004 0512 597XSteno Diabetes Center Aarhus, Aarhus University Hospital, Palle Juul-Jensens Boulevard 11, 8200 Aarhus N, Denmark
| | - Søren Tang Knudsen
- grid.154185.c0000 0004 0512 597XSteno Diabetes Center Aarhus, Aarhus University Hospital, Palle Juul-Jensens Boulevard 11, 8200 Aarhus N, Denmark
| | - Annelli Sandbæk
- grid.154185.c0000 0004 0512 597XSteno Diabetes Center Aarhus, Aarhus University Hospital, Palle Juul-Jensens Boulevard 11, 8200 Aarhus N, Denmark ,grid.7048.b0000 0001 1956 2722 Department of Public Health, Aarhus University, Aarhus, Denmark
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Rioux-Dubois A, Perron A. Enacting primary healthcare interprofessional collaboration: a multisite ethnography of nurse practitioner integration in Ontario, Canada. J Interprof Care 2022; 37:532-540. [PMID: 35997230 DOI: 10.1080/13561820.2022.2102591] [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: 10/15/2022]
Abstract
Interprofessional collaboration (IPC) is known to enhance patient outcomes and satisfaction. In primary healthcare (PHC), IPC aims to transform care provision and team functioning, but its implementation is challenging and has yielded mixed results. We aimed to describe the enactment of IPC in PHC settings, particularly as it relates to nurse practitioner (NP) integration. A multisite ethnography involving 6 Canadian PHC clinics was carried out. We conducted 330 hours of direct observation, 23 semi-structured interviews with PHC NPs, informal interviews with key PHC partners, and document analysis. IPC in PHC was found to rest on human and non-human actors that interact in complex ways. Organizational mandates and remuneration models, physical spaces and schedules played a decisive role in the enactment of IPC. Power structures embedded in certain designations (i.e., most responsible provider) or NPs' commitments to physicians' practices stood in contrast with the principles of IPC. NPs enacted various role to develop, enhance, and maintain IPC. Despite shifts in PHC provision, IPC remains poorly defined and precariously sustained.
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Affiliation(s)
- Annie Rioux-Dubois
- Department des sciences infirmières, Université du Québec en Outaouais, Saint-Jérôme, QC, Canada
| | - Amélie Perron
- School of Nursing, University of Ottawa, Ottawa, ON, Canada
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20
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Abstract
Interprofessional Collaboration in Health Care Abstract. Interprofessional collaboration is a hallmark of good and efficient patient care, where several healthcare professionals put their competencies together to care for patients. Interprofessional education is a necessary first step to prepare the different professions for collaborations in their later professional practices. Shared training courses help to empower collaborative healthcare teams so they can respond in an adapted and effective way to individual and local health needs.
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Affiliation(s)
- Claudia Huber
- Hochschule für Gesundheit Freiburg, HES-SO Fachhochschule Westschweiz, Freiburg
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