Establishing community-based integrated care for elderly patients through interprofessional teamwork: a qualitative analysis

Abstract

BackgroundWorking in multidisciplinary teams is indispensable for ensuring high-quality care for elderly people in Japan’s rapidly aging society. However, health professionals often experience difficulty collaborating in practice because of their different educational backgrounds, ideas, and the roles of each profession. In this qualitative descriptive study, we reveal how to build interdisciplinary collaboration in multidisciplinary teams.MethodsSemi-structured interviews were conducted with a total of 26 medical professionals, including physicians, nurses, public health nurses, medical social workers, and clerical personnel. Each participant worked as a team member of community-based integrated care. The central topic of the interviews was what the participants needed to establish collaboration during the care of elderly residents. Each interview lasted for about 60 minutes. All the interviews were recorded, transcribed verbatim, and subjected to content analysis.ResultsThe analysis yielded the following three categories concerning the necessary elements of building collaboration: 1) two types of meeting configuration; 2) building good communication; and 3) effective leadership. The two meetings described in the first category – “community care meetings” and “individual care meetings” – were aimed at bringing together the disciplines and discussing individual cases, respectively. Building good communication referred to the activities that help professionals understand each other’s ideas and roles within community-based integrated care. Effective leadership referred to the presence of two distinctive human resources that could coordinate disciplines and move the team forward to achieve goals.ConclusionTaken together, our results indicate that these three factors are important for establishing collaborative medical teams according to health professionals. Regular meetings and good communication facilitated by effective leadership can promote collaborative practice and mutual understanding between various professions.

<p>Stimulating Students’ Interprofessional Teamwork Skills Through Community-Based Education: A Mixed Methods Evaluation</p>

“…[17][18][19] Community-based education (CBE) is suggested as a model for facilitating IPE in collaborative skills in the workplace. [20][21][22] CBE is defined as learning activities that use the community extensively as a learning environment, in which not only students but also teachers, members of the community, and representatives of other sectors are actively engaged throughout the educational experience. 23 Community-based IPE (CBIPE) is the process by which a group of two or more students from different health-related occupations with different educational backgrounds learn together while utilising the community as a learning environment, with collaboration and interaction as part of their learning goals.…”

“…27 Various approaches to CBIPE have been previously reported such as learning in rural and primary healthcare settings, 24,28,29 community-based learning within broader community context 16,22,30 and for specific community context; the commonly used model of CBIPE in the western countries. 21,[31][32][33][34][35] The nature of interprofessional learning activities is mainly to provide healthcare services primary healthcare setting, not in the community. Examples of CBIPE in specific community contexts have often been limited to specific settings like senior housing 32 or child healthcare.…”

“… 24 CBIPE students learn in the context of the community itself and are expected to work collaboratively in interprofessional teams to provide an expected health service despite limited resources. 21 CBIPE programmes may also produce the added benefit of exposing students to concepts that might not be accounted for, or explicitly taught, in all health profession curricula, especially those dealing with family medicine, primary care, social determinants of health and cultural competence. 25 , 26 Moreover, CBIPE helps stimulate social accountability in health profession students.…”

Interprofessional case conferences to bridge perception gaps regarding ethical dilemmas in home-based end-of-life care: a qualitative study

“…Within the framework of the community-based integrated care system, interprofessional education has been the focus of increasing attention 9 , 10 , 11 ) . Interprofessional discussions concerning patient care planning are commonly facilitated within the Japanese long-term care insurance system 12 ) .…”

Implementation of interprofessional education in community setting

“…Previous studies reported that communication and collaboration skills increased, and also they were satisfied with their collaborative practice by participating in the community-based interprofessional education programs. [9][10][11][12] The Faculty of Medicine, Universitas Diponegoro, as one of the health education institutions in Central Java, has taken the responsibility to help the local government to increase maternal health by implementing the IPE program in the community. This program has recently been implemented in collaboration with the health district and primary health center.…”