Observation of interprofessional collaboration in primary care practice: A multiple case study

Abstract

Interprofessional collaboration (IPC) is known to improve and enhance care for people with complex healthcare and social care needs and is ideally anchored in primary care. Such care is complex, challenging, and often poorly undertaken. In countries such as Canada, the United Kingdom, the Netherlands, Australia, and New Zealand, primary care is provided predominantly via general practices, where groups of general practitioners and nurses typically work. Using a case study design, direct observations were made of interprofessional activity in three diverse general practices in New Zealand to determine how collaboration is achieved and maintained. Non-participant observation of health professional interaction was undertaken and recorded using field notes and video recordings. Observational data were subject to analysis prior to collection of interview data, subsequently gathered independently at each site. Case-specific themes were developed before determining cross-case themes. Cross-case themes revealed five key elements to IPC: the built environment, practice demographics and location, practice business models, shared goals, and team structure and climate. The combination of elements at each practice site indicated that strengths in one area helped offset challenges in others. The three practices (cases) collectively demonstrated the importance of an "all of practice" commitment to collaborative practice so that shared decision-making can occur.

Measuring the performance of interprofessional primary health care teams: understanding the teams perspective

“…Primary health care is the pillar of the health care system, with interprofessional collaborative teams being increasingly considered a key tenet and an important means for providing quality primary health care services (Starfield et al , 2005; Samuelson et al , 2012; Pullon et al , 2016. While interprofessional collaboration is recognized as an essential aspect of care for patients with complex and chronic conditions (Reeves et al , 2011; Pullon et al, 2016), the evidence remains in its infancy.…”

“…While interprofessional collaboration is recognized as an essential aspect of care for patients with complex and chronic conditions (Reeves et al , 2011; Pullon et al, 2016), the evidence remains in its infancy. For these reasons, policy makers in Canada and elsewhere have continued to call for greater integration of interprofessional team-based primary health care and the development of indicators that specifically recognize the value of this added lens (Hutchison et al , 2011; Ministry of Health and Long-Term Care, 2015).…”

A new surgical approach for O-C2 fusion, solving the problem of dysphagia.

“…possible. Research has shown that an increase in collaboration between medical fields is linked with improved patient care, especially those with complex medical conditions (Pullon, Morgan, Macdonald, McKinlay, & Gray, 2016). In a study across primary care providers in New Zealand, aspects of interprofessional collaboration as simple as sharing a common space and having short interactions with co-workers provided increased positive relationships and care within the practice (Pullon et al, 2016).…”

“…In a study across primary care providers in New Zealand, aspects of interprofessional collaboration as simple as sharing a common space and having short interactions with co-workers provided increased positive relationships and care within the practice (Pullon et al, 2016). This research showed that relationships between healthcare workers as a team and between the team or business and the community at large are contributing factors to improved care for patients with complicated social or health concerns (Pullon et al, 2016). Another study stresses the importance of communication and compassion for effective interprofessional collaboration (Rider et al, 2014).…”

“…Research has shown that an increase in collaboration between medical fields is linked with improved patient care, especially those with complex medical conditions (Pullon, Morgan, Macdonald, McKinlay, & Gray, 2016). In a study across primary care providers in New Zealand, aspects of interprofessional collaboration as simple as sharing a common space and having short interactions with co-workers provided increased positive relationships and care within the practice (Pullon et al, 2016). This research showed that relationships between healthcare workers as a team and between the team or business and the community at large are contributing factors to improved care for patients with complicated social or health concerns (Pullon et al, 2016).…”