Abstract
Role clarity is a crucial issue for effective interprofessional collaboration. Poorly defined roles can become a source of conflict in clinical teams and reduce the effectiveness of care and services delivered to the population. Our objective in this paper is to outline processes for clarifying professional roles when a new role is introduced into clinical teams, that of the primary healthcare nurse practitioner (PHCNP). To support our empirical analysis we used the Canadian National Interprofessional Competency Framework, which defines the essential components for role clarification among professionals. A qualitative multiple-case study was conducted on six cases in which the PHCNP role was introduced into primary care teams. Data collection included 34 semistructured interviews with key informants involved in the implementation of the PHCNP role. Our results revealed that the best performing primary care teams were those that used a variety of organizational and individual strategies to carry out role clarification processes. From this study, we conclude that role clarification is both an organizational process to be developed and a competency that each member of the primary care team must mobilize to ensure effective interprofessional collaboration.
Highlights
High-performing primary care teams are one of the chief characteristics of healthcare systems that are responsive to population needs [1, 2]
Our objective is to examine the processes of role clarification among professionals in primary care teams when a new role is introduced into the team, that is, the primary healthcare nurse practitioner (PHCNP)
In the high-performing settings, this needs analysis preceded the arrival of the PHCNP and helped clarify the PHCNP’s role in the primary care team: Here in our organization, we met with the director of nursing to determine which would be the most appropriate sectors to receive a PHCNP, and what roles she might take on, while taking into account the regulations of the regional health agency. (Clinical nurse specialist)
Summary
High-performing primary care teams are one of the chief characteristics of healthcare systems that are responsive to population needs [1, 2]. The optimal development of such teams is a challenge for primary care systems. Optimizing each professional’s scope of practice is one suggested approach to reinforce team functioning and respond to patients’ needs [3]. This is difficult, because changes in professional roles can lead to power struggles [4]. Clarifying professional roles among members of a primary care team can be an effective approach to mitigate power struggles, facilitate the integration of new roles in teams, and foster interprofessional collaboration
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