Abstract
BackgroundInterprofessionalism, considered as collaboration between medical professionals, has gained prominence over recent decades and evidence for its impact has grown. The steadily increasing number of residents in nursing homes will challenge medical care and the interaction across professions, especially nurses and general practitioners (GPs). The nursing home visit, a key element of medical care, has been underrepresented in research. This study explores GP perspectives on interprofessional collaboration with a focus on their visits to nursing homes in order to understand their experiences and expectations. This research represents an aspect of the interprof study, which explores medical care needs as well as the perceived collaboration and communication by nursing home residents, their families, GPs and nurses. This paper focusses on GPs’ views, investigating in particular their visits to nursing homes in order to understand their experiences.MethodsOpen guideline-interviews covering interprofessional collaboration and the visit process were conducted with 30 GPs in three study centers and analyzed with grounded theory methodology. GPs were recruited via postal request and existing networks of the research partners.ResultsFour different types of nursing home visits were found: visits on demand, periodical visits, nursing home rounds and ad-hoc-decision based visits. We identified the core category “productive performance” of home visits in nursing homes which stands for the balance of GPs´ individual efforts and rewards. GPs used different strategies to perform a productive home visit: preparing strategies, on-site strategies and investing strategies.ConclusionWe compiled a theory of GPs home visits in nursing homes in Germany. The findings will be useful for research, and scientific and management purposes to generate a deeper understanding of GP perspectives and thereby improve interprofessional collaboration to ensure a high quality of care.
Highlights
Interprofessionalism, considered as collaboration between medical professionals, has gained prominence over recent decades and evidence for its impact has grown
The feeling that the visit was worthwhile served to strengthen this balance. This process was influenced by their evaluation of the benefit for their patients, their personal commitment, the maintenance of their own medical practice as an independent business and the wish to provide care in nursing homes, with an overall economic thought kept in mind
Types of home visits The “productive performance” approach was found in the context of four different types of home visits: 1. on demand, 2. periodic, 3. nursing home round and 4. based on ad-hoc-decisions
Summary
Interprofessionalism, considered as collaboration between medical professionals, has gained prominence over recent decades and evidence for its impact has grown. The steadily increasing number of residents in nursing homes will challenge medical care and the interaction across professions, especially nurses and general practitioners (GPs). This study explores GP perspectives on interprofessional collaboration with a focus on their visits to nursing homes in order to understand their experiences and expectations. This research represents an aspect of the interprof study, which explores medical care needs as well as the perceived collaboration and communication by nursing home residents, their families, GPs and nurses. The increasing number of residents in nursing homes will challenge medical care and the interaction across the professions, especially nurses and general practitioners (GPs). Nursing home staff usually consist of specialized geriatric nurses with three years of professional education and training, and nursing aids as well as temporary staff with or with-out vocational training [15]
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