Background: The number of people with multiple chronic conditions demanding primary care services is increasing. To deal with the complex health care demands of these people, professionals from different disciplines collaborate. This study aims to explore influential factors regarding interprofessional collaboration related to care plan development in primary care. Methods: A qualitative study, including four semi-structured focus group interviews (n = 4). In total, a heterogeneous group of experts (n = 16) and health care professionals (n = 15) participated. Participants discussed viewpoints, barriers, and facilitators regarding interprofessional collaboration related to care plan development. The data were analysed by means of inductive content analysis. Results: The findings show a variety of factors influencing the interprofessional collaboration in developing a care plan. Factors can be divided into 5 key categories: (1) patient-related factors: active role, self-management, goals and wishes, membership of the team; (2) professional-related factors: individual competences, domain thinking, motivation; (3) interpersonal factors: language differences, knowing each other, trust and respect, and motivation; (4) organisational factors: structure, composition, time, shared vision, leadership and administrative support; and (5) external factors: education, culture, hierarchy, domain thinking, law and regulations, finance, technology and ICT. Conclusions: Improving interprofessional collaboration regarding care plan development calls for an integral approach including patient- and professional related factors, interpersonal, organisational, and external factors. Further, the leader of the team seems to play a key role in watching the patient perspective, organising and coordinating interprofessional collaborations, and guiding the team through developments. The results of this study can be used as input for developing tools and interventions targeted at executing and improving interprofessional collaboration related to care plan development.
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Background: Due to multimorbidity and geriatric problems, older people often require both psychosocial and medical care. Collaboration between medical and social professionals is a prerequisite to deliver high-quality care for community-living older people. Effective, safe, and person-centered care relies on skilled interprofessional collaboration and practice. Little is known about interprofessional education to increase interprofessional collaboration in practice (IPCP) in the context of community care for older people. This study examines the feasibility of the implementation of an IPCP program in three community districts and determines its potential to increase interprofessional collaboration between primary healthcare professionals caring for older people. Method: A feasibility study was conducted to determine the acceptability and feasibility of data collection and analysis regarding interprofessional collaboration in network development. A questionnaire was used to measure the learning experience and the acquisition of knowledge and skills regarding the program. Network development was assessed by distributing a social network survey among professionals attending the program as well as professionals not attending the program at baseline and 5.5 months after. Network development was determined by calculating the number, reciprocity, value, and diversity of contacts between professionals using social network analysis. Results: The IPCP program was found to be instructive and the knowledge and skills gained were applicable in practice. Social network analysis was feasible to conduct and revealed a spill-over effect regarding network development. Program participants, as well as non-program participants, had larger, more reciprocal, and more diverse interprofessional networks than they did before the program. Conclusions: This study showed the feasibility of implementing an IPCP program in terms of acceptability, feasibility of data collection, and social network analysis to measure network development, and indicated potential to increase interprofessional collaboration between primary healthcare professionals. Both program participants and non-program participants developed a larger, more collaborative, and diverse interprofessional network.
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As the COVID-19 pandemic prevented planned international travel opportunities for students and faculty, faculty at three universities from three professions created a four-day innovative, online learning experience. Each session included presentations from each country, small-group discussions, and evaluation. The topics appealed to students regardless of profession or nationality. Daily evaluations showed attendees valued the experience. The benefits of international and interprofessional learning were evident; students gained better understanding of other professions and health care systems through sessions that expanded their thinking. International appreciation and learning can be prioritized without physical travel.
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Abstract Primary healthcare professionals face an increasing number of geriatrics patients, and patient care often involves different disciplines. eHealth offers opportunities to support interprofessional collaboration (IPC). This exploratory study aimed to gain insight in 1) IPC in community-based rehabilitation, 2) facilitators and barriers for technology-based IPC and 3) technological IPC solutions envisioned by the primary healthcare professionals An focus group with six primary healthcare professionals and a design thinking session with four participants were conducted. Data analysis was based upon an IPC model. Results indicate that facilitators and barriers for IPC can be clustered in three categories: human, organization and technology, and provide some requirements to develop suitable IPC technological solutions Primary healthcare professionals recognise the urgency of working collaboratively. Current barriers are understanding each other’s professional vocabulary, engaging the older adults, and using technology within the patient’s environment. Further research is needed to integrate IPC components in a technological solution
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Background: Frailty and multimorbidity are common among patients in geriatric rehabilitation care (GRC). Proper care of these patients involves multiple professionals which requires optimal interprofessional collaboration to provide the best possible support. Interprofessional collaboration (IPC) goes beyond multi-professional collaboration. It requires professionals to think beyond the expertise of their own discipline and work on joint outcomes in which the patient is actively involved. This study describes the development of the GRC teams of an elderly care organization towards the IPC. Methods: Mixed method pre-post study of 15 months. The interprofessional training program comprised team trainings, webinars, and online team sessions. Data was aggregated by administering the Extended Professional Identity Scale (EPIS) and QuickScan Interprofessional Collaboration (QS) measurements to GRC staff and by observations of the multi-professional team consultation (MPC) meetings of six GRC teams of an organization for elderly care in Drachten and Dokkum in the Netherlands. ADL independence (Barthel Index) and number of inpatient days were analyzed before and after the project. Results: Pretest healthcare professional response was 106, patients for analyses was 181; posttest response was 84, patients was 170. The EPIS shows improvement on “interprofessional belonging” (P =.001, 95%CI: 0.57–2.21), “interprofessional commitment” (P =.027, 95%CI: 0.12–1.90), and overall “interprofessional identity” (P =.013, 95%CI: 0.62 − 5.20). On the QS, all domains improved; “shared values” (P =.009, 95%CI: 0.07 − 0.47), “context” (P =.005, 95%CI: 0.08 − 0.44), “structure & organization” (P =.001, 95%CI: 0.14 − 0.56), “group dynamics & interaction” (P
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The significance of effective interprofessional teamwork to improve the quality of care has been widely recognised. Effective interprofessional teamwork calls on good collaboration between professionals and patients, coordination between professionals, and the development of teamwork over time. Effective development of teams also requires support from the wider organisational context. In a Dutch village, healthcare professionals work closely together, and mutual consultations as well as interprofessional meetings take place on a regular basis. The network was created as a precondition for sustainable interprofessional teamwork in elderly care. However, several external barriers were experienced regarding the supportive structure and cooperative attitude of the healthcare insurer and municipality. The aim of the article is to examine these experience-based issues regarding internal organisation, perspective, and definition of effective teamwork. Complicating factors refer to finding the right key figures, and the different perspectives on team development and team effectiveness. Our conclusion is that the organisation of healthcare insurance companies needs to implement fundamental changes to facilitate an interprofessional care approach. Furthermore, municipalities should work on their vision of the needs and benefits of a fruitful collaboration with interprofessional healthcare teams. The challenge for healthcare teams is to learn to speak the language of external partners. To support the development of interprofessional teams, external parties need to recognise and trust in a shared aim to provide quality of care in an efficient and effective way.
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Background: The number of people suffering from one or more chronic conditions is rising, resulting in an increase in patients with complex health care demands. Interprofessional collaboration and the use of shared care plans support the management of complex health care demands of patients with chronic illnesses. This study aims to get an overview of the scientific literature on developing interprofessional shared care plans. Methods: We conducted a scoping review of the scientific literature regarding the development of interprofessional shared care plans. A systematic database search resulted in 45 articles being included, 5 of which were empirical studies concentrating purely on the care plan. Findings were synthesised using directed content analysis. Results: This review revealed three themes. The first theme was the format of the shared care plan, with the following elements: patient’s current state; goals and concerns; actions and interventions; and evaluation. The second theme concerned the development of shared care plans, and can be categorised as interpersonal, organisational and patient-related factors. The third theme covered tools, whose main function is to support professionals in sharing patient information without personal contact. Such tools relate to documentation of and communication about patient information. Conclusion: Care plan development is not a free-standing concept, but should be seen as the result of an underlying process of interprofessional collaboration between team members, including the patient. To integrate the patients’ perspectives into the care plans, their needs and values need careful consideration. This review indicates a need for new empirical studies examining the development and use of shared care plans and evaluating their effects.
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Introduction: It is unknown whether interprofessional identity is able to explain interprofessional behaviours. Extended professional identity theory provides clues by combining two psychological identity approaches. The aim of this study is to investigate whether interprofessional identity is a source for intrinsic motivation towards interprofessional collaboration related to wider group membership. Methods: Participants of this double-blinded study were 47 dentistry and 41 dental hygiene students (86.3% response) without interprofessional education (IPE) experience. Group productivity was used as indicator of group effort and equal communication as indication for interprofessional direction. The extended professional identity scale (EPIS) was used to measure interprofessional identity eight weeks prior to a mandatory IPE course. Based on EPIS levels, students were assigned to a low or high interprofessional identity group condition. Subsequently, 12 interprofessional teams (four to five members) were randomly composed per condition. Each group received eight problems (regarding roles, responsibilities and collaborative practice) for which they were expected to provide up to 10 solutions. Six trained psychologists rated the validity of solutions after which the percentage of solutions per group was calculated. Additionally, the psychologists rated interprofessional direction by observing team communication (asking questions, topic control, prosocial formulations, and speech frequency) during the second group meeting. Results: No interprofessional identity differences were found with regard to gender and profession. The mean difference between groups with low versus high interprofessional identity was 0.5 (M = 3.4; SD = 0.5 and M = 3.9, SD = 0.4, respectively), t = −5.880, p < 0.001. Groups with high identity generated more solutions compared to low identity groups (91.5% vs. 86.4%), t = −2938, p = 0.004. The correlation between individual interprofessional identity and group effort was significant, r = 0.22, p = 0.036. Groups with high identity showed more interprofessional direction, t = −2.160, p = 0.034. Discussion: Interprofessional identity has a positive effect on congruent interprofessional behaviours after 10 weeks. More research is required to understand interprofessional identity in relation to performance in education and work.
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Care for older people with multiple chronic conditions and complex care require different disciplines which are often simultaneously involved. Interprofessional collaboration between professionals from medical and social care in the community is necessary to enhance quality of life and support of older people. LinkedIn: https://www.linkedin.com/in/jeroen-dikken-phd-rn-83230765/
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The growing complexity of care and healthcare workforce shortages in the Netherlands necessitates exploring interprofessional collaboration (IPC). However, the predominant single-professional education may result in a professional identity (PI) among healthcare students, which may not support successful IPC. Internships in student-run interprofessional learning wards (SR-IPLW) could foster interprofessional identity (IPI) development. There is a need for a better understanding of the intricacies involved in learning to work collaboratively, particularly when undergraduates are still shaping their professional identities. Our aim, therefore, was to identify facilitators and barriers for interprofessional education (IPE), IPC, and identity development among 21 healthcare students during a 20-week clinical placement on a SR-IPLW in rehabilitation medicine. An action-based prospective study using grounded theory analysis of nine focus groups across three semesters identified 17 theoretical codes. These codes are elaborated in a conceptual model highlighting facilitators and barriers for IPC and identity development, emphasizing the importance of fostering feelings of relatedness, competence, and autonomy. There are indications that professional and interprofessional identities changed during the internship. Implications for preceptors are delineated, showing the importance of personal relationships and elements of a positive learning climate.
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