Invisible walls within multidisciplinary teams: Disciplinary boundaries and their effects on integrated care

Liberati, Elisa Giulia; Gorli, Mara; Scaratti, Giuseppe

doi:10.1016/j.socscimed.2015.12.002

Cited by 154 publications

(181 citation statements)

References 36 publications

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“…It is well documented in the field of health sociology, that healthcare professionals' need to maintain professional identities hinders interdisciplinary collaboration. 26 Hartgerink et al 27 found that physicians were less open to interdisciplinary collaboration compared to nurses. Even within the medical profession, doctors have been found to share more information with colleagues from the same discipline.…”

Section: Discussionmentioning

confidence: 99%

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Heart transplant centers with multidisciplinary team show a higher level of chronic illness management – Findings from the International BRIGHT Study

et al. 2017

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a b s t r a c tObjectives: The objectives of this study were to: (1) explore the proportion of HTx centers that have a multidisciplinary team and (2) assess the relationship between multidisciplinarity and the level of chronic illness management (CIM). Background: The International Society for Heart and Lung Transplantation (ISHLT) recommends a multidisciplinary approach in heart transplant (HTx) follow-up care but little is known regarding the proportion of HTx centers that meet this recommendation and the impact on patient care. HTx centers

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Section: Discussionmentioning

confidence: 99%

“…Even within the medical profession, doctors have been found to share more information with colleagues from the same discipline. 26 Given the potential of the multidisciplinary approach to significantly improve CIM and, ultimately, health outcomes, concerted effort should be taken to foster interdisciplinary collaboration.…”

Section: Discussionmentioning

confidence: 99%

Heart transplant centers with multidisciplinary team show a higher level of chronic illness management – Findings from the International BRIGHT Study

et al. 2017

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“…The understanding that health and social care has been characterised by fragmentation, hierarchical tensions and rivalries between professional groups has underpinned the push for interprofessional practice and education (Carmel and Baker-McClearn 2012;Carpenter and Hewstone 1996;Liberati et al 2016;Mandy et al 2004). The nature of these professional relationships has at times had disastrous consequences.…”

Section: Ipe and Professional Knowledge And Powermentioning

confidence: 99%

“…Sociological analyses of the basis of professional power have repeatedly pointed to the role played by a specialist body of knowledge, recognising that the boundaries of knowledge are fiercely defended by professional groups in order to protect their own niche (Freidson 1970;Johnson 1972;Liberati et al 2016;Turner 1995;Vuolanto 2015). Foucault famously argued that, 'power and knowledge directly imply one another; that there is no power relation without the correlative constitution of a field of knowledge, nor any knowledge that does not presuppose and constitute at the same time power relations ' (1991 [1977]: 27).…”

Section: Ipe and Professional Knowledge And Powermentioning

confidence: 99%

“…Demographic and epidemiological transitions mean health care has shifted towards a greater emphasis on community-based chronic and complex care with goals around quality of life and treatment management, involving a range of health professionals in the care of a single patient (Duckett and Willcox 2015;Little et al 2012;. In acute care too, multi-disciplinary teams, with increased roles for allied health professionals, are being encouraged as alternatives to traditional medical and 'silo' approaches to patient management (Liberati et al 2016; New South Wales Department of Health 2011). The World Health Organization (1988,2010) promotes IPE as a means of addressing urgent health workforce shortages.…”

Section: Introductionmentioning

confidence: 99%

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Examining Interprofessional Education Through the Lens of Interdisciplinarity: Power, Knowledge and New Ontological Subjects

Olson

Brosnan

2017

Minerva

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Interprofessional education (IPE) -students of different professions learning together, from and about each other -is increasingly common in health professional degrees. Despite its explicit aims of transforming identities, practices and relationships within/across health professions, IPE remains under-theorised sociologically, with most IPE scholarship focussed on evaluating specific interventions. In particular, the significance of a shared knowledge base for shaping professional power and subjectivity in IPE has been overlooked. In this paper we begin to develop a framework for theorising IPE in allied health, by drawing parallels with a cognate area in which there has already been fruitful conceptual development: interdisciplinarity. Specifically, we offer a worked example of how the two areas may be brought into dialogue, by deploying Barry, Born and Weszkalnys' (2008) conceptualisation of interdisciplinarity as a lens for understanding IPE. Following Barry et al. (2008) we delineate a number of 'modes' and 'logics' of knowledge-production that emerge both in IPE literature and in our own empirical study of IPE. Our empirical data are drawn from 32 semi-structured interviews with 19 allied health students participating in an IPE curriculum at one Australian university. Findings point to the emergence of interprofessional practitioner identities among students that have the potential to undermine traditional epistemological boundaries and transcend role-based distinctions in future health profession(al)s. We argue that Barry et al.'s 'logic of ontology' sheds light on previously unidentified processes of transformation within IPE, and offers a theoretical framework that can explain the importance of a shared pan-professional knowledge base for the reflexive individual construction of new interprofessional ontological subjects.

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Thematic Analysis of Challenges of Care Coordination for Underinsured and Uninsured Cancer Survivors With Chronic Conditions

et al. 2021

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Key Points Question What are the barriers to coordinating care for underinsured and uninsured patients with cancer and chronic conditions during and after cancer treatment at a safety-net health system? Findings This qualitative study of interviews and observation of 93 health system stakeholders identified system-level challenges (ie, challenges to accessing primary care, lack of communication between oncology and primary care clinicians, leadership awareness of care coordination challenges) and clinician-level challenges (ie, unclear role delineation, lack of clinician knowledge and preparedness to manage cancer and chronic conditions). Meaning These findings suggest that survivorship care delivery strategies that bridge oncology and primary care may be required to meet the care coordination needs of underinsured and uninsured patients with cancer amid the fragmented US health care system.

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Invisible walls within multidisciplinary teams: Disciplinary boundaries and their effects on integrated care

Cited by 154 publications

References 36 publications

Heart transplant centers with multidisciplinary team show a higher level of chronic illness management – Findings from the International BRIGHT Study

Heart transplant centers with multidisciplinary team show a higher level of chronic illness management – Findings from the International BRIGHT Study

Examining Interprofessional Education Through the Lens of Interdisciplinarity: Power, Knowledge and New Ontological Subjects

Thematic Analysis of Challenges of Care Coordination for Underinsured and Uninsured Cancer Survivors With Chronic Conditions

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