Using realist synthesis to understand the mechanisms of interprofessional teamwork in health and social care

Abstract

Realist synthesis offers a novel and innovative way to interrogate the large literature on interprofessional teamwork in health and social care teams. This article introduces realist synthesis and its approach to identifying and testing the underpinning processes (or "mechanisms") that make an intervention work, the contexts that trigger those mechanisms and their subsequent outcomes. A realist synthesis of the evidence on interprofessional teamwork is described. Thirteen mechanisms were identified in the synthesis and findings for one mechanism, called "Support and value" are presented in this paper. The evidence for the other twelve mechanisms ("collaboration and coordination", "pooling of resources", "individual learning", "role blurring", "efficient, open and equitable communication", "tactical communication", "shared responsibility and influence", "team behavioural norms", "shared responsibility and influence", "critically reviewing performance and decisions", "generating and implementing new ideas" and "leadership") are reported in a further three papers in this series. The "support and value" mechanism referred to the ways in which team members supported one another, respected other's skills and abilities and valued each other's contributions. "Support and value" was present in some, but far from all, teams and a number of contexts that explained this variation were identified. The article concludes with a discussion of the challenges and benefits of undertaking this realist synthesis.

Evidence of a shared purpose, critical reflection, innovation and leadership in interprofessional healthcare teams: a realist synthesis

“…This article completes a series of four articles (Hewitt, Sims, & Harris, 2014 that report on a realist synthesis of interprofessional teamworking addressing the question: ''through what mechanisms does teamworking affect outcomes and experience (patient, carer, staff and service) and how does context influence those mechanisms and outcomes?'' This synthesis was conducted as part of a wider study exploring the impact of interprofessional teamworking on patient and carer experience and outcomes after stroke (Harris et al, 2013).…”

Interprofessional education and practice in Sweden / Interprofessionelle Bildung und Praxis in Schweden

“…Das heute bestehende Konzept der Gesundheitsfakultät Linköping wurde von dem im OECD-Prozess involvierten Rektor Areskog vorangetrieben und 1986 von den nationalen Gremien genehmigt (Areskog, 1981(Areskog, , 1992 (Hylin, 2010, S. 11-13). Berlin et al, 2013;Hylin, 2010;Reeves et al, 2013;Hewitt et al, 2014. (Nordenström et al, 2013;Regeringskansliet, 2010;Berlin et al, 2013).…”

Inter professional teamwork: A case study examining the practice patterns and perceptions of pediatric psychologists

“…The development of trust and respect among team members is thought to be one key relational factor central to successful interprofessional teams [1]. Using realist synthesis of multiple interprofessional studies, Hewitt, Sims & Harris [17] also identified "support and value" as one of the key mechanisms for interprofessional teamwork. Particularly when psychologists are often "late to the party" in terms of joining already established medical teams, some of which may already have psychosocial providers involved such as social work, it is critical that they get to know the culture of the team and contribute to a mutually respectful working environment.…”