Communication and Interprofessional Collaboration in Primary Care: From Ideal to Reality in Practice

Fox, Stéphanie; Gaboury, Isabelle; Chiocchio, François; Vachon, Brigitte

doi:10.1080/10410236.2019.1666499

Cited by 28 publications

(28 citation statements)

References 32 publications

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“…In line with our findings, in the case of influenza outbreaks, teamwork and interprofessional collaboration were described as factors that can lead to a more adequate response (48). Healthy teams showed to be effective in preventing burnout among GPs (49), in improving professional motivation (50,51), and patient and family-centered care (52). That said, interprofessional collaboration and teamwork is not wellestablished among Italian GPs (53), and further research is needed to address the impact of the working environment on mental health, safety, and care delivery of Italian GPs during the COVID-19 pandemic.…”

Section: Comparison To Existing Literaturesupporting

confidence: 86%

“…(39) "There was no coordination (...) we received directives that an hour later were denied by the other department." (52) The respondents indicated a lack of leadership as a trigger for the inadequacy of the services that were coordinating the response to the pandemic.…”

Section: Communication Coordination and Leadership In The Hsmentioning

confidence: 99%

“…"Hearth attacks and strokes that probably have occurred and have remained unrecognized because we do not have PPE to protect ourselves..." (52) The lack of PPE led to a sense of loneliness, vulnerability, and to psychological distress.…”

Section: Lack Of Resourcesmentioning

confidence: 99%

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General Practitioners' Experiences During the First Phase of the COVID-19 Pandemic in Italy: A Critical Incident Technique Study

Kurotschka

Serafini

Demontis³

et al. 2021

Front. Public Health

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Since February 2020, when coronavirus disease began to spread in Italy, general practitioners (GPs) were called to manage a growing number of health situations. The challenges experienced by Italian GPs remained unrevealed. This study aimed at exploring Italian GPs' care experiences and practices associated with critical incidents during the first wave of the pandemic. A qualitative study design involving the critical incident technique through an online survey was applied. Sociodemographic data and open-ended responses were collected. While participants' characteristics were analyzed through descriptive statistics, qualitative data were thematically analyzed employing the framework method. 149 GPs responded to the survey and 99 participants completed the survey (dropout rate = 33%). Eight themes emerged indicating factors related to the organization of the healthcare system and factors related to the clinical management of patients, that were perceived as impacting on the GPs' care provision. The analysis revealed difficulties in communicating with other local services. This, together with the lack of coordination among services, was reported as a major challenge. Primary care was perceived as having been undervalued and criticalities in the organization of GP courses, led in a bureaucratic fashion, posed at risk some trainees to be infected. The digital technologies adopted for remote patient consultations were seen as useful tools for daily practice helping the GPs to stay emotionally connected with their patients. Besides, the improvement in the GP–patient relationship in terms of solidarity between patients and doctors and compliance to rules, had a positive impact. Moreover, many respondents addressed the importance of professional collaboration and teamwork, in terms of both support in practical issues (to find PPE, diagnostics and guidelines) and emotional support. At the same time, the lack of resources (e.g., PPE, swabs) and of specific guidelines and protocols impacted on the care provision. Our findings suggest that GPs in Italy are at risk of being left behind within the epidemic management. Communication and coordination among services are essential and should be substantially improved, and primary care research should be initiated to collect the context-specific evidence necessary to enhance the system's preparedness to public health emergencies and the quality of primary care services.

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Section: Comparison To Existing Literaturesupporting

confidence: 86%

Section: Communication Coordination and Leadership In The Hsmentioning

confidence: 99%

See 1 more Smart Citation

General Practitioners' Experiences During the First Phase of the COVID-19 Pandemic in Italy: A Critical Incident Technique Study

Kurotschka

Serafini

Demontis³

et al. 2021

Front. Public Health

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“…The data used for the current study come from observations of two teams located in different organizations and different clinical contexts. However, in both contexts, physician dominance in interactional dynamics was repeatedly observed, and in fact this was the impetus for the current study, as it contrasted with the ideals of "clinical democracy" (Long et al, 2006) and shared decision making that are associated with interprofessional collaboration in health care (Fox et al, 2019).…”

Section: Research Context and Datamentioning

confidence: 92%

The negotiation of sharing leadership in the context of professional hierarchy: Interactions on interprofessional teams

Fox

Comeau-Vallée

2020

Leadership

Self Cite

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While there is growing recognition of leadership as a collective phenomenon, the question of how leadership is shared in the context of hierarchical asymmetry has been neglected in the collective leadership literature. Our article addresses this gap by examining how sharing leadership is negotiated in team interactions that are steeped in asymmetry deriving from the professional hierarchy. Adopting a leadership-in-interaction approach, we draw on fine-grained analysis of observed interactions on interprofessional teams from two health care organizations to compare the discursive strategies used by professionals in a superior hierarchical position to the ones used by those in inferior positions to share leadership. These strategies are organized into a matrix of interactional moves that resist or enact the professional hierarchy. Empirical vignettes are provided to demonstrate how sharing leadership and hierarchical leadership can be co-present and even intertwined in an interaction. We show that leadership is shared (or not) as a result of how the professional hierarchy gets negotiated in interactions. More specifically, we conclude that the sharing of leadership in this context tends to occur prior to decision making, especially around problem formulation, if the interactional climate allows. Furthermore, it requires concrete effort: Those in superior positions of influence mindfully relax the hierarchy whereas those in inferior positions create moments of sharing leadership through resistance and struggle.

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“…Based on the participants’ recognition of the boundaries between professions, which are sometimes mobile and overlap, attention is paid to the importance of collaborative competences in the profile of the health professionals, as they allow for the resolution of interprofessional conflicts, shared decision-making, clarity of roles, attention centered on the user/family/community, and effective interprofessional communication ( 33 - 34 , 37 ).…”

Section: Discussionmentioning

confidence: 99%

Multiprofessional family health residency as a setting for education and interprofessional practices

Araújo

Santos

Domingos

et al. 2021

Rev. Latino-Am. Enfermagem

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Objective: to know the experiences lived during the residency by graduates of a Multiprofessional Residency Program in Family Health that could contribute to the development of Interprofessional Education and/or Collaborative Practice. Method: a qualitative study with residents who entered a Multiprofessional Residency Program of a Brazilian public university in 2017, a period in which the theme of interprofessionality was implemented in the activities of the residency. Data was collected using an electronic form built from the theoretical framework of interprofessional education. Content analysis was used to process the data. Results: nine residents participated, distributed among the professions of Physical Education, Nursing, Nutrition, Dentistry, Psychology and Social Work, five of whom were female and with a mean age of 28.4. Two categories emerged: the Residency as a setting for learning from the other, and the Residency as a setting for understanding the role of the other. Interprofessional education and practice provided opportunities for the development of collaborative skills, enhancing teamwork and interprofessional work. Conclusion: the multiprofessional logic was evidenced in the resident’s practice; and the gradual insertion of activities such as case discussions, shared services and inter-sectoral actions aligned with the theoretical-methodological framework of interprofessionality favored an approach to interprofessional work.

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Communication and Interprofessional Collaboration in Primary Care: From Ideal to Reality in Practice

Cited by 28 publications

References 32 publications

General Practitioners' Experiences During the First Phase of the COVID-19 Pandemic in Italy: A Critical Incident Technique Study

General Practitioners' Experiences During the First Phase of the COVID-19 Pandemic in Italy: A Critical Incident Technique Study

The negotiation of sharing leadership in the context of professional hierarchy: Interactions on interprofessional teams

Multiprofessional family health residency as a setting for education and interprofessional practices

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