Development of a measure of professional collaboration in primary health care.

Abstract

The aim was to develop indices of the degree of collaboration between district nurses, general practitioners, and health visitors. Semistructured interviews were conducted with each member of a pair of professionals who had patients in common. In each district a stratified random sample of six general practitioners and six community nurses was drawn, and for each a "partner" of the other profession was sampled. A stratified random sample of 20 district health authorities in England. Complete interviews were obtained with 148 doctor-nurse and 161 doctor-health visitor pairs. Only 27% of general practitioners and district nurses with patients in common and 11% of general practitioners and health visitors collaborate. Stepwise logistic discriminant analysis was used to develop measures of collaboration between general practitioners and district nurses and between general practitioners and health visitors. The indices of collaboration were calculated from the responses of the community nurse to at most 10 questions. The indices developed here might be used as a measure of one aspect of the quality of service offered by a primary health care team or to assess the effect of changes in working patterns or the degree of collaboration within the organisation.