Background: Shared decision-making is one key element of interprofessional collaboration. Communication is often considered to be the main reason for inefficient or ineffective collaboration. Little is known about group dynamics in the process of shared decision-making in a team with professionals, including the patient or their parent. This study aimed to evaluate just that. Methods: Simulation-based training was provided for groups of medical and allied health profession students from universities across the globe. In an overt ethnographic research design, passive observations were made to ensure careful observations and accurate reporting. The training offered the context to directly experience the behaviors and interactions of a group of people. Results: Overall, 39 different goals were defined in different orders of prioritizing and with different time frames or intervention ideas. Shared decision-making was lacking, and groups chose to convince the parents when a conflict arose. Group dynamics made parents verbally agree with professionals, although their non-verbal communication was not in congruence with that. Conclusions: The outcome and goalsetting of an interprofessional meeting are highly influenced by group dynamics. The vision, structure, process, and results of the meeting are affected by multiple inter- or intrapersonal factors.
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Purpose This study aims to enhance understanding of the collaboration between chairs of nurse councils (CNCs) and members of executive hospital boards (BM) from a relational leadership perspective. Design/methodology/approach The authors used a qualitative and interpretive methodology. The authors study the daily interactions of BM and CNCs of seven Dutch hospitals through a relational leadership lens. The authors used a combination of observations, interviews and document analysis. The author’s qualitative analysis was used to grasp the process of collaborating between BM and CNCs. Findings Knowing each other, relating with and relating to are distinct but intertwined processes that influence the collaboration between BM and CNC. The absence of conflict is also regarded as a finding in this paper. Combined together, they show the importance of a relational process perspective to understand the complexity of collaboration in hospitals. Originality/value Collaboration between professional groups in hospitals is becoming more important due to increasing interdependence. This is a consequence of the complexity in organizing qualitative care. Nevertheless, research on the process of collaborating between nurse councils (NCs) and executive hospital boards is scarce. Furthermore, the understanding of the workings of boards, in general, is limited. The relational process perspective and the combination of observations, interviewing and document analysis proved valuable in this study and is underrepresented in leadership research. This process perspective is a valuable addition to skills- and competencies-focused leadership literature.
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Overzicht van wat werkt geïllustreerd met uitspraken van professionals werkzaam in het onderwijs en de jeugdhulpverlening.
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Ageing potentially poses a threat to independent functioning of older adults. Although clinicians commonly focus on physical factors limiting Functional Independence (FI), it is likely that personal and environmental interactions also seem important to maintain FI. Herewith, FI exceeds several professional borders and calls for a uniform, multidisciplinary interdisciplinary supported definition of FI. This study aims to provide such a definition of FI in community dwelling older people. A scoping review was performed. Pubmed/Medline, Psychinfo and CINAHL were searched for studies describing aspects of FI. A literature-based definition of FI was discussed by experts (n = 7), resulting in a formulated final definition of FI and insight into contributing factors to FI. A multidisciplinairy focusgroup a stakeholder consultation (n = 15) ensured clinical relevance for daily practice. Data from the focusgroup stakeholder consultation were analyzed by using Atlas.ti (version 8). Based on the literature search, 25 studies were included. FI was finally defined as “Functioning physically safely and independent from another person, within one’s own context”. The contributing factors of FI comprised physical capacity combined with coping, empowerment and health literacy. Moreover, the level of FI is influenced by someone’s own context. This study confirms the relevance of the physical aspect of FI, but additionally stresses the importance of psychological factors. In addition, this study shows that one’s context may affect the level of FI as well. This underlines the importance of a holistic view and calls for multidisciplinary interdisciplinary collaboration in community-dwelling older people.
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Abstract Study Objective To provide an overview of patients' needs concerning goal‐setting, and indications of how those needs can be met by nurses. Methods A narrative review. Pubmed and Cinahl were searched through March 1, 2020 for: patients' experiences concerning goal‐setting and the role of nursing in rehabilitation. Additional articles were found through snowballing. A total of 22 articles were reviewed on patients' experiences, and 12 on the nursing role. Results Patients need to be prepared for collaborating in goal‐setting and to receive an explanation about their part in that process. The multiplicity of disciplines may cloud patients' understanding of the process. The nurse's planning of the rehabilitation process should be aimed at resolving this issue. Goals need to be meaningful, and patients need support in attaining them. The interpretive, integrative, and consoling functions of Kirkevold's nursing role are suitable to meet these needs. Conclusions Both the literature about patients' needs regarding goal‐setting and the nursing role make clear that the way nurses work in rehabilitation can gain in clarity. Strengthening the role of nurses will improve the goal‐setting process for patients. Interprofessional collaboration, clear work procedures, continuity of care, time and trust, and the physical environment all are important to reinforce this role.
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Objectives: To understand healthcare professionals' experiences and perceptions of nurses' potential or ideal roles in pharmaceutical care (PC). Design: Qualitative study conducted through semi-structured in-depth interviews. Setting: Between December 2018 and October 2019, interviews were conducted with healthcare professionals of 14 European countries in four healthcare settings: hospitals, community care, mental health and long-term residential care. Participants: In each country, pharmacists, physicians and nurses in each of the four settings were interviewed. Participants were selected on the basis that they were key informants with broad knowledge and experience of PC. Data collection and analysis: All interviews were conducted face to face. Each country conducted an initial thematic analysis. Consensus was reached through a face-to-face discussion of all 14 national leads. Results: 340 interviews were completed. Several tasks were described within four potential nursing responsibilities, that came up as the analysis themes, being: 1) monitoring therapeutic/adverse effects of medicines, 2) monitoring medicines adherence, 3) decision making on medicines, including prescribing 4) providing patient education/information. Nurses' autonomy varied across Europe, from none to limited to a few tasks and emergencies to a broad range of tasks and responsibilities. Intended level of autonomy depended on medicine types and level of education. Some changes are needed before nursing roles can be optimised and implemented in practice. Lack of time, shortage of nurses, absence of legal frameworks and limited education and knowledge are main threats to European nurses actualising their ideal role in PC. Conclusions: European nurses have an active role in PC. Respondents reported positive impacts on care quality and patient outcomes when nurses assumed PC responsibilities. Healthcare professionals expect nurses to report observations and assessments. This key patient information should be shared and addressed by the interprofessional team. The study evidences the need of a unique and consensus-based PC framework across Europe.
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Interprofessioneel samenwerken tussen onderwijs- en jeugdhulpprofessionals is belangrijk om leerlingen met een ingewikkelde zorgvraag goed te ondersteunen, zowel op beleids- als op uitvoeringsniveau. Maar de vraag is hoe dit moet worden vormgegeven. Dit artikel gaat in op de ervaringen van professionals, met als hoofdvraag: Wat noemen professionals werkzaam in onderwijs en jeugdhulpverlening als het gaat om samenwerken; wat zien zij als succesfactoren en knelpunten? In een vooronderzoek (Van Veen Schleurholts et al., 2021) met als doel om te inventariseren wat werkt volgens beleids- en uitvoerende professionals, zijn semigestructureerde interviews afgenomen. Hierin komt naar voren dat op organisatieniveau stabiliteit in de personele bezetting essentieel is; op schoolniveau zijn vaste partners binnen de school belangrijk, samenhangend met wederzijds gedeelde expertise en gezamenlijke professionalisering. Op leerkrachtniveau springt het investeren in het aangaan van de relatie met de ouders, de leerling en de jeugdhulpverlening eruit. Binnen het project 1+1=3 ’t PASST Samen volgen jeugdhulpverleners en leerkrachten samen een professionalisering gericht op het versterken van een integrale aanpak voor leerlingen met een autismespectrumstoornis (ASS). Bij aanvang van het project is een digitale vragenlijst ingevuld door 63 onderwijs- en jeugdhulpprofessionals. Via stellingen en open vragen gaven de professionals op de domeinen: 1) Onderlinge verbondenheid, 2) Nieuw gecreëerde professionele activiteiten, 3) Flexibiliteit, 4) Collectief eigenaarschap van doelen en 5) Reflectie op het proces (Bronstein, 2002) aan hoe zij zichzelf inschatten, en wat succes- en knelpunten zijn. Resultaten laten zien dat professionals de domeinen van interprofessioneel samenwerken Onderlinge afhankelijkheid en Flexibiliteit en Collectieve eigenaarschap van doelen hoog waarderen. Zij noemen hierin ook knelpunten en succesfactoren: waarderen van elkaars expertise, gemeenschappelijke eigenaarschap en kennisdeling. Andere domeinen van interprofessioneel samenwerken als Nieuw gecreëerde professionele activiteiten en Reflectie op het proces worden weinig belicht, terwijl randvoorwaarden benadrukt worden zoals overlegmomenten, communicatie en tijd. Opvallend is dat er weinig naar voren komt wat specifiek over leerlingen met een autismespectrumstoornis gaat. Kijkend naar zowel de voorstudie als de hoofdstudie kan geconcludeerd worden dat stabiliteit, tijd, overlegmomenten en communicatie belangrijke randvoorwaarden zijn. Daarnaast is het een wens om het aantal samenwerkingspartners te verminderen. Het verstevigen van de waardering van elkaars expertise, gezamenlijke eigenaarschap vergroten en kennis delen zijn essentieel om daarna de samenwerking verder te kunnen opbouwen door integrale aanpakken te ontwerpen en te reflecteren op de samenwerking. Door gezamenlijk professionaliseren en opleiden van onderwijs- en jeugdhulpprofessionals zouden deze vaardigheden versterkt kunnen worden
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Background: Patient involvement in interprofessional education (IPE) is a new approach in fostering person-centeredness and collaborative competencies in undergraduate students. We developed the Patient As a Person (PAP-)module to facilitate students in learning from experts by experience (EBEs) living with chronic conditions, in an interprofessional setting. This study aimed to explore the experiences of undergraduate students, EBEs and facilitators with the PAP-module and formulate recommendations on the design and organization of patient involvement in IPE. Methods: We collected data from students, EBEs and facilitators, through eight semi-structured focus group interviews and two individual interviews (N = 51). The interviews took place at Maastricht University, Zuyd University of Applied Sciences and Regional Training Center Leeuwenborgh. Conventional content analysis revealed key themes. Results: Students reported that learning from EBEs in an interprofessional setting yielded a more comprehensive approach and made them empathize with EBEs. Facilitators found it challenging to address multiple demands from students from different backgrounds and diverse EBEs. EBEs were motivated to improve the personcentredness of health care and welcomed a renewed sense of purpose. Conclusions: This study yielded six recommendations: (a) students from various disciplines visit an EBE to foster a comprehensive approach, (b) groups of at least two students visit EBEs, (c) students may need aftercare for which facilitators should be receptive, (d) EBEs need clear instruction on their roles, (e) multiple EBEs in one session create diversity in perspectives and (f) training programmes and peer-to-peer sessions for facilitators help them to interact with diverse students and EBEs.
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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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Transitions can be facilitated through collective networked action, moving from coordinated learning towards more forceful interventions. This coordinated effort is challenging in more extended learning and innovation networks. Creating and maintaining an overview of activities within such a network and connecting them to a common cause can be a powerful approach. A tool named MissionMapping was developed in an iterative process in applied co-design research. With the tool, we intend to allow for a more holistic perspective when navigating the activities of the network related to the transition by working towards more of an overview of the questions and activities within the network. This article describes three cases in which MissionMapping was applied to facilitate synergy in networks of people collaborating on societal challenges. A cross-case analysis was done to develop insights on how MissionMapping supports the synergy of goals and projects within societal challenges. MissionMapping allows participants to build their mission landscape. They combine individual activities to create shared territories. The tool was developed in an iterative process. In the three cases, different versions of the tool were used during live workshops. After the cases and applying MissionMapping in other cases, the tool results in a flexible set that can be adapted to different purposes for a workshop and adopted by others who like to apply the tool. The article presents insights resulting from a cross-case analysis of applying the MissionMapping tool. One insight was that it is difficult to keep track of adjustments over time when the network dynamics change. Additionally, we found that while preparing the workshop, adjusting and printing the tiles cost time and are not easily transferable to others who might be interested in applying the tool. Navigating the mission resulted in increased enthusiasm for the topic at hand. The form factor also seems to contribute to a sense of agency. However, the increased agency does not automatically transfer to actions, as organisations are often inflexible. MissionMapping stimulates the development of a shared language through the landscape metaphor. This helps to cross boundaries in multidisciplinary networks. Capturing and transferring insights visually and digitally was quite challenging. Further exploration is needed to find an effective method. It is difficult to capture the impact of the MissionMaps and requires monitoring over time. For now, we conclude that it benefits collaboration, creates overviews in complex networks, and may fuel idea generation.
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