Healthcare aide involvement in team decision‐making in long‐term care: A narrative review of the literature

Abstract

Aims and Objectives:To provide an overview and synthesis of the current evidence on healthcare aides' involvement in team decision-making in long-term care.Background: Healthcare aides provide the most direct care to residents in long-term care homes and are uniquely positioned to influence the quality of care. Yet, they are not typically included in team decisions for improving resident care. As demand for long-term care increases, it is essential that we have a comprehensive understanding of ways to support healthcare aides' role on the interprofessional team for decisionmaking about resident care.Design: Narrative review.Method: Five electronic databases were searched for articles published in English between 2008 and 2020. Thematic analysis was conducted to synthesise findings using an organising framework. Reporting followed the PRISMA-ScR. Results: Twelve studies were included. Results indicate that work environment factors that influenced (supported or hindered) healthcare aides' involvement in decisionmaking included information access/availability, hierarchical staffing structures and supervisor support/shared governance. Relational processes that influenced team decision-making included team communication and collaboration, information sharing and exchange, and the quality of work relationships among team members. Strategies are discussed that could address the identified barriers and support healthcare aides' active involvement in team decisions regarding resident care. Conclusions: This review highlights the pervasive underutilization of healthcare aides, who have the most knowledge of residents to support person-centred care. There remains a paucity of research on healthcare aides' involvement in team decisionmaking. Research is needed to examine the effectiveness of interventions to support healthcare aides' participation in decision-making and the impact on staff and resident outcomes.

Interprofessional clinical decision‐making process in health: A scoping review

“…This key‐element label was attributed to 89 sources (Abramson & Mizrahi, 2003; Ambrose‐Miller & Ashcroft, 2016; Andermo et al, 2015; Anquinet et al, 2015; Baggs, 1994; Baggs et al, 2007; Baggs & Schmitt, 1995; Bajwa et al, 2020; Bartholdson et al, 2021; Bentovim & Gilmour, 1981; Berg et al, 2020. ; Bokhour, 2006; Borrett & Gould, 2021; Botes, 2000; Briggs, 1999; Brooks et al, 2017; Bunch, 2000; Caenepeel & Jobin, 2005; Cook et al, 2001; Coombs, 2003, 2014; Coombs & Ersser, 2004; Cranley et al, 2022; de Casterlé et al, 2006; Dekussche, 2005; Dimech et al, 2021; Duner, 2013; Durand et al, 2022; Ervin et al, 2018; Faith & Chidwick, 2009; Fein et al, 2016; Fiddick et al, 2020; Firn et al, 2020; Forbes et al, 2020; Forsgärde et al, 2021; Fox & Comeau‐Vallée, 2020; Fratianne et al, 1992; Friedman, 2020; Gair & Hartery, 2001; Geist & Chandler, 1984; Grafham et al, 2004; Greenhalgh et al, 2008; Gundrosen et al, 2018; Hagoel et al, 2011; Haines et al, 2018; Heath et al, 2016; Heerschap et al, 2019; Helzer et al, 2020; Ho et al, 2005; Husson, 2011; Jensen et al, 2013; Johal & Danbury, 2021; Jordan, 1982; Joseph & Conrad, 1989; Kane, 1975; Kayser & Kaplan, 2020; Kilpatrick...…”

“…The group dynamics considered included the issues of hierarchy, communication and group processes. This key-element label was attributed to 89 sources (Abramson & Mizrahi, 2003; Ambrose-Miller & Ashcroft, 2016; Andermo et al, 2015;Anquinet et al, 2015;Baggs, 1994;Baggs et al, 2007;Baggs & Schmitt, 1995;Bajwa et al, 2020;Bartholdson et al, 2021;Bentovim & Gilmour, 1981;Berg et al, 2020.;Bokhour, 2006;Borrett & Gould, 2021;Botes, 2000;Briggs, 1999;Brooks et al, 2017;Bunch, 2000;Caenepeel & Jobin, 2005;Cook et al, 2001;Coombs, 2003Coombs, , 2014Coombs & Ersser, 2004;Cranley et al, 2022;de Casterlé et al, 2006;Dekussche, 2005;Dimech et al, 2021;Duner, 2013;Durand et al, 2022;Ervin et al, 2018;Faith & Chidwick, 2009;Fein et al, 2016;Fiddick et al, 2020;Firn et al, 2020;Forbes et al, 2020;Forsgärde et al, 2021;Fox & Comeau-Vallée, 2020;Fratianne et al, 1992;Friedman, 2020;Gair & Hartery, 2001;Geist & Chandler, 1984;Grafham et al, 2004;Greenhalgh et...…”

“…A department could organize itself to support interprofessionalism (Todd et al, 2005), through departmental (interprofessional visits and training early in internships) or individual (following the example of peers and teaching) activities (Goldman et al, 2015). Working conditions, particularly night work (Ferrand et al, 2003;Nathan et al, 2021), may prevent professionals from participating in decision-making meetings or sharing information (Brooks et al, 2017;Cranley et al, 2022;Kilpatrick, 2013;Todd et al, 2005).…”

“…Bringing professionals together may prove complicated in practice (Simpson et al, 2013), but could be favoured by a regularity of organization over time (Briggs, 1999;Ferrand et al, 2003;Mitchell et al, 2013) and allocated time (Cranley et al, 2022;Nathan et al, 2021). It would be preferable to allocate a particular shared time and place to a particular team (Briggs, 1999;Duner, 2013;Husson, 2011;Mitchell et al, 2013).…”

“…Four reviews have dealt with interprofessional decision‐making in clinical contexts, in the fields of intensive care (Ervin et al, 2018) oncology (Lamb, Brown, et al, 2011; Lamb, Green, et al, 2011), and long‐term care (Cranley et al, 2022). The first one focused on team‐working rather than specifically on decision‐making.…”