Interprofessional Collaboration During COVID-19: A Case Study of a Shanghai Quarantine Center for Medical Observation

2021 ◽  
pp. 101053952110531
Author(s):  
Jie Zhuang ◽  
Lili Ma ◽  
Yan-Yan Chen ◽  
Yifei Wu
Keyword(s):  
Interprofessional Collaboration ◽  
Medical Observation

scholarly journals How medical dominance and interprofessional conflicts undermine patient-centred care in hospitals: historical analysis and multiple embedded case study in Morocco

2021 ◽  
Vol 6 (7) ◽  
pp. e006140
Author(s):  
Zakaria Belrhiti ◽  
Sara Van Belle ◽  
Bart Criel
Keyword(s):  
Soft Power ◽  
Health Workers ◽  
Interprofessional Collaboration ◽  
Historical Analysis ◽  
Best Interests ◽  
Group Discussions ◽  
Power Struggles ◽  
Embedded Case Study ◽  
Health Managers

BackgroundIn Morocco’s health systems, reforms were accompanied by increased tensions among doctors, nurses and health managers, poor interprofessional collaboration and counterproductive power struggles. However, little attention has focused on the processes underlying these interprofessional conflicts and their nature. Here, we explored the perspective of health workers and managers in four Moroccan hospitals.MethodsWe adopted a multiple embedded case study design and conducted 68 interviews, 8 focus group discussions and 11 group discussions with doctors, nurses, administrators and health managers at different organisational levels. We analysed what health workers (doctors and nurses) and health managers said about their sources of power, perceived roles and relationships with other healthcare professions. For our iterative qualitative data analysis, we coded all data sources using NVivo V.11 software and carried out thematic analysis using the concepts of ‘negotiated order’ and the four worldviews. For context, we used historical analysis to trace the development of medical and nursing professions during the colonial and postcolonial eras in Morocco.ResultsOur findings highlight professional hierarchies that counterbalance the power of formal hierarchies. Interprofessional interactions in Moroccan hospitals are marked by conflicts, power struggles and daily negotiated orders that may not serve the best interests of patients. The results confirm the dominance of medical specialists occupying the top of the professional hierarchy pyramid, as perceived at all levels in the four hospitals. In addition, health managers, lacking institutional backing, resources and decision spaces, often must rely on soft power when dealing with health workers to ensure smooth collaboration in care.ConclusionThe stratified order of care professions creates hierarchical professional boundaries in Moroccan hospitals, leading to partitioning of care and poor interprofessional collaboration. More attention should be placed on empowering health workers in delivering quality care by ensuring smooth interprofessional collaboration.

scholarly journals Interprofessional collaboration in health promotion: changing tasks as leverage for innovation

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
L Ledderer ◽  
M Christensen ◽  
V Burau
Keyword(s):  
Health Promotion ◽  
Interprofessional Collaboration ◽  
Professional Practices ◽  
School Teachers ◽  
Professional Activities ◽  
Increasing Demand ◽  
Danish School ◽  
Home And School ◽  
Learning Focused

Abstract Background Increasing demand for interprofessional collaboration calls for change in organisational practice and interactions of professionals. Health promotion is a particularly interesting area for observing these changes, because it involves professionals with different disciplinary backgrounds usually also working in different sectors. In Denmark new health promotion strategies in organisations were introduced to engage professionals in new tasks and establish interprofessional ways of working. Our research aimed to explore how these strategies impact in professional practices, using a cookery project for children as a case study, which involved care assistants and school teachers. Methods A qualitative case study was conducted to investigate how care assistants from a nursing home and school teachers implemented a cookery project in a Danish school; the focus was on joint care and teaching situations among the two professions and their users. Our data consisted of documents, participatory observations, and interviews with professionals; a sociological institutional framework was applied to analyse the data. Results Institutional changes and the demand for joint care and teaching activities in the cooking project fostered new interprofessional collaboration. Three themes of new professional activities emerged: 1) ‘interplay’ related to making different generations collaborate on the tasks involved in the cookery session, 2) ‘care’ concerned with caregiving activities, and 3) ‘learning” focused on schooling on healthy food and cooking. The activities were related to traditional and new roles in professional practices of both groups. Conclusions Changes in professional practices evolved in an informal manner from new tasks and ‘lived’ experiences in the cookery project. The specific practical tasks of health promotion offer an important leverage for future interprofessional collaborations.

Observation of interprofessional collaboration in primary care practice: A multiple case study

2016 ◽  
Vol 30 (6) ◽  
pp. 787-794 ◽  
Author(s):  
Susan Pullon ◽  
Sonya Morgan ◽  
Lindsay Macdonald ◽  
Eileen McKinlay ◽  
Ben Gray
Keyword(s):  
Primary Care ◽  
Primary Care Practice ◽  
Interprofessional Collaboration ◽  
Multiple Case Study ◽  
Care Practice ◽  
Multiple Case

scholarly journals Evaluation of interprofessional teamwork modules implementation in an emergency department – A mixed-methods case study of implementation fidelity

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jenny Liu ◽  
Sari Ponzer ◽  
Nasim Farrokhnia ◽  
Italo Masiello
Keyword(s):  
Emergency Department ◽  
Mixed Methods ◽  
Interprofessional Collaboration ◽  
Implementation Process ◽  
Implementation Fidelity ◽  
Work Conditions ◽  
Mixed Methods Case Study ◽  
Interprofessional Teamwork ◽  
Initial Implementation

Abstract Background The need for interprofessional collaboration has been emphasized by health organizations. This study was part of a mixed-methods evaluation of interprofessional teamwork modules implementation in an emergency department (ED), where a major intervention was didactic training of team roles and behaviours in combination with practice scenarios. The aim of the study was to evaluate the implementation of interprofessional teamwork modules from a staff perspective and focus on how implementation fidelity may be sustained. Methods In this mixed-methods case study we triangulated staff data from structured observations, semi-structured interviews, and a questionnaire repeated at intervals over 5 years. A protocol of key team behaviours was used for the observations conducted in June 2016 and June 2018, 1½ and 3½ years after the initial implementation. A purposeful sample of central informants, including nursing and medical professionals and section managers, was interviewed from May to June 2018. The interview guide consisted of open-ended questions about the experiences of interprofessional teamwork modules and the implementation process. The questionnaire consisted of five statements about the perceived workload, interprofessional collaboration and patient satisfaction, where each was rated on a Likert scale. Results Good fidelity to four out of five key team behaviours was observed during the first year. However, fidelity was sustained only for one key team behaviour after 3 years. We conducted a qualitative content analysis of 18 individual interviews. The theme Enjoying working together, but feeling less efficient emerged of the interprofessional teamwork modules, despite shorter ED stays for the patients. Negative experiences of the staff included passive team leaders and slow care teams. The theme Stimulating to create, but challenging to sustain emerged of the implementation process, where barriers were not adressed and implementation fidelity not sustained. The staff questionnaire showed that the perceived work conditions was improved in periods of high fidelity, but deteriorated to pre-implementation levels as fidelity to the key team behaviours decayed in 2018. Conclusions Extensive planning and successful initial implementation were not enough to sustain the key behaviour changes in the study. The use of implementation frameworks can be helpful in future projects.

scholarly journals Health Professions Students' Teamwork Before and After an Interprofessional Education Co-Curricular Experience

2018 ◽  
Vol 8 (1) ◽  
Author(s):  
Shelley C. Mishoe ◽  
Kimberly Adams Tufts ◽  
Leigh A. Diggs ◽  
James D. Blando ◽  
Denise M. Claiborne ◽  
...  
Keyword(s):  
Learning Strategies ◽  
Interprofessional Education ◽  
Interprofessional Collaboration ◽  
Roles And Responsibilities ◽  
Study Approach ◽  
Positive Attitudes ◽  
Before And After ◽  
Moderate Effect Size ◽  
Health Sciences Students

Background: Effective interprofessional collaboration may positively impact clinical outcomes, patient satisfaction, and cost effectiveness. However, educational silos and discipline-specific socialization have reinforced each health profession’s independent values, attitudes, and problem-solving approaches.Methods and Findings: Students’ (N = 376) attitudes about teamwork were measured with the Interprofessional Attitudes Scale, Teamwork, Roles, and Responsibilities subscale using a pretest-posttest design. Experiential learning strategies and a case study approach were used to introduce students to the roles and responsibilities of the students’ disciplines. There was a positive mean difference in pretest-posttest measures (p < .001) with a moderate effect size (r = .27).Conclusions: Providing opportunities for pre-licensure health sciences students to understand the roles and responsibilities of other disciplines through IPE co-curricular learning can enhance positive attitudes toward teamwork.

scholarly journals Interprofessional collaboration and barriers among health and social workers caring for older adults: a Philippine case study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
TJ Robinson T. Moncatar ◽  
Keiko Nakamura ◽  
Kathryn Lizbeth L. Siongco ◽  
Kaoruko Seino ◽  
Rebecca Carlson ◽  
...  
Keyword(s):  
Older Adults ◽  
Service Delivery ◽  
Social Workers ◽  
Interprofessional Collaboration ◽  
Care Delivery ◽  
The Philippines ◽  
Geriatric Care ◽  
Care Providers ◽  
Care Workers

Abstract Background There is limited information on how the barriers to interprofessional collaboration (IPC) across various professionals, organizations, and care facilities influence the health and welfare of older adults. This study aimed to describe the status of IPC practices among health and social workers providing care for older adults in the Philippines; investigate the perceived barriers to its implementation and perceived effects on geriatric care; and identify possible solutions to address the barriers limiting collaborative practice. Methods A case study approach was utilized employing 12 semi-structured in-depth interviews and 29 focus group discussions with care workers from selected primary health care units, public and private hospitals, and nursing homes that are directly involved in geriatric care delivery in two cities in the Philippines. Overall, 174 health and social workers consented to participate in this study. All interviews were audio-recorded and transcribed verbatim. An inductive thematic analysis using NVivo 12® was used to identify and categorize relevant thematic codes. Results Interprofessional geriatric care provided by health and social workers was observed to be currently limited to ad hoc communications typically addressing only administrative concerns. This limitation is imposed by a confluence of barriers such as personal values and beliefs, organizational resource constraints, and a silo system care culture which practitioners say negatively influences care delivery. This in turn results in inability of care providers to access adequate care information, as well as delays and renders inaccessible available care provided to vulnerable older adults. Uncoordinated care of older adults also led to reported inefficient duplication and overlap of interventions. Conclusion Geriatric care workers fear such barriers may aggravate the increasing unmet needs of older adults. In order to address these potential negative outcomes, establishing a clear and committed system of governance that includes IPC is perceived as necessary to install a cohesive service delivery mechanism and provide holistic care for older adults. Future studies are needed to measure the effects of identified barriers on the potential of IPC to facilitate an integrated health and social service delivery system for the improvement of quality of life of older adults in the Philippines.

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