Interprofessional Collaboration Research Articles

Collaboration in the midst of chaos: perspectives of inpatient occupational and physical therapists during the COVID-19 pandemic

ABSTRACT The COVID-19 pandemic has affected over 700 million people globally, straining healthcare systems and highlighting the need for interprofessional collaboration. The aim of this study was to describe interprofessional collaborative practice (IPCP) experiences from the perspectives of occupational therapists (OTs) and physical therapists (PTs) who were employed in a medical center both before and during the COVID-19 pandemic. This qualitative study, conducted from July 2020–November 2021, delved into the lived experiences of occupational and physical therapists in an inpatient setting during the pandemic through analysis of semi-structured interviews and journal entries. The pandemic prompted fear, uncertainty, and ethical dilemmas among therapists, affecting patient-centered care. Roles expanded, and teamwork challenges emerged in defining boundaries, while communication dynamics were transformed by virtual technologies. The pandemic affected therapists’ values and ethics, and evolving roles brought expanded tasks. The crisis showcased both collaboration potential and the need to address team disparities. This study highlights the significance of values, roles, teams, and communication for occupational and physical therapists during the COVID-19 pandemic providing valuable insights into interprofessional collaboration’s effect on healthcare delivery in times of crisis and beyond.

Bridging the evidence-to-practice gap: exploring dental professionals' perspectives on managing oral health during pregnancy in Tasmania, Australia.

Poor oral health is associated with adverse health, social and economic consequences for pregnant women. While dental professionals promote good oral health within the dental practice context, more broadly, women in the antenatal period face poor oral health outcomes. Therefore, this study explored dental professionals' perceptions of their role in managing the oral health of pregnant women and identified the barriers and facilitators to improving maternal oral health. This study employed a descriptive qualitative method utilizing semi-structured interviews. Convenience and snowball sampling were used to recruit 13 dental professionals from Tasmania, Australia, comprising dentists (n = 10), oral health therapists (n = 2) and dental therapist (n = 1). Interviews were audio-recorded, transcribed verbatim and analysed using inductive thematic analysis. Three major themes were constructed from the interviews: (1) dental professionals' oral health care of women during pregnancy; (2) perceived challenges to maternal oral health; and (3) proposed strategies to improve maternal oral health. Findings suggest dental professionals' competence in maternal oral health, but that several barriers, such as dental care access and maternal factors, hinder oral health outcomes. To address these barriers, oral health policies that support interprofessional collaboration, professional training and evaluation of existing community oral health programmes are needed. © 2024 Australian Dental Association.

Training students in interprofessional collaboration through a student-led activity.

Training students in interprofessional collaboration through a student-led activity.

Non-scripted role-playing with heritage speakers and second language learners in the medical interpreting classroom

Abstract This article examines dialogue interpreting in unscripted role-plays in the community interpreting classroom. In 2019, faculty members from several departments at Viterbo University (La Crosse, Wisconsin) coordinated an interprofessional education collaboration via role-playing in the institution’s Clinical Simulation Learning Center. Nursing, social work and pre-medical students were given the health-professional roles of caring for community members with limited English proficiency (who acted as ‘patients’). Interpreting students, both heritage speakers of Spanish and second language learners (L2) of both English and Spanish, facilitated language access for all parties involved. Recordings of these dialogues were then transcribed, annotated, and analyzed via mixed methods. This study examines overall and comparative findings of how heritage speakers and second language learners interpret dialogue, focusing on the textual aspects of their exchanges. While no language profile seemed to perform particularly better overall, certain indicators were more problematic for L2 Spanish speakers and/or heritage speakers. The presentation of these results and conclusions intend to foster improved teaching interventions for classrooms with students of varying English <> Spanish language backgrounds.

Patient experiences of interprofessional collaboration and intersectoral communication in rare disease healthcare in Germany – a mixed-methods study

BackgroundRare diseases are often complex, chronic and many of them life-shortening. In Germany, healthcare for rare diseases is organized in expert centers for rare diseases. Most patients additionally have regional general practicioners and specialists for basic medical care. Thus, collaboration and information exchange between sectors is highly relevant. Our study focuses on the patient and caregiver perspective on intersectoral and interdisciplinary care between local healthcare professionals (HCPs) and centers for rare diseases in Germany. The aims were (1) to investigate patients’ and caregivers’ general experience of healthcare, (2) to analyse patients’ and caregivers’ perception of collaboration and cooperation between local healthcare professionals and expert centers for rare diseases and (3) to investigate patients’ and caregivers’ satisfaction with healthcare in the expert centers for rare diseases.ResultsIn total 299 individuals of whom 176 were patients and 123 were caregivers to pediatric patients participated in a survey using a questionnaire comprising several instruments and constructs. Fifty participants were additionally interviewed using a semistructured guideline. Most patients reported to receive written information about their care, have a contact person for medical issues and experienced interdisciplinary exchange within the centers for rare diseases. Patients and caregivers in our sample were mainly satisfied with the healthcare in the centers for rare diseases. The qualitative interviews showed a rather mixed picture including experiences of uncoordinated care, low engagement and communication difficulties between professionals of different sectors. Patients reported several factors that influenced the organization and quality of healthcare e.g. engagement and health literacy in patients or engagement of HCPs.ConclusionsOur findings indicate the high relevance of transferring affected patients to specialized care as fast as possible to provide best medical treatment and increase patient satisfaction. Intersectoral collaboration should exceed written information exchange and should unburden patients of being and feeling responsible for communication between sectors and specialists. Results indicate a lack of inclusion of psychosocial aspects in routine care, which suggests opportunities for necessary improvements.

Competency analysis of health workers: Interprofessional collaboration practices in a tertiary referral hospital in Surabaya

Background: There is a rising need for high-quality, efficient healthcare. Implementing interprofessional cooperation (IPC) between healthcare professionals is one of the initiatives that has raised the standard of treatment in hospitals. The disparity in competence amongst health professionals is one of several elements that affect the requirements for the successful implementation of cooperation. Objective: To examine the attitudes, abilities, teamwork, and positive roles implemented by health workers in interprofessional collaboration practices. Method: Cross-sectional research methodology was used in this observational study. The Chiba Interprofessional Competency Scale (CICS29) instrument, which has 29 verified items, was used to evaluate the proficiency of health workers. The value of five (always) until one (never) was used to distinguish between the various categories. Result: A very good Cronbach alpha score of 0.921 was used to verify the questionnaire. Exactly 109 health professionals, including 21 physicians, 34 pharmacists, 50 nurses, and four nutritionists, participated in the study as respondents. Conclusion: Based on the study's findings, it was determined that health professionals, including physicians, pharmacists, nurses, and nutritionists, possess a high level of competence or capacity regarding interprofessional collaboration in hospitals.

Bias in team decision-making for advanced heart failure therapies: model application

ABSTRACT Bias in advanced heart failure therapy allocation results in inequitable outcomes for minoritized populations. The purpose of this study was to examine how bias is introduced during group decision-making with an interprofessional team using Breathett’s Model of Heart Failure Decision-Making. This was a secondary qualitative descriptive analysis from a study focused on bias in advanced heart failure therapy allocation. Team meetings were recorded and transcribed from four heart failure centers. Breathett’s Model was applied both deductively and inductively to transcripts (n = 12). Bias was identified during discussions about patient characteristics, clinical fragility, and prior clinical decision-making. Some patients were labeled as “good citizens” or as adherent/non-adherent while others benefited from strong advocacy from interprofessional team members. Social determinants of health also impacted therapy allocation. Interprofessional collaboration with advanced heart failure therapy allocation may be enhanced with the inclusion of patient advocates and limit of clinical decision-making using subjective data.

Interprofessional collaborations in child welfare: providers’ experiences

ABSTRACT This study investigated the experiences of providers collaborating with child welfare workers using the Quality of Collaboration with Child Welfare (Q-CCW) survey. The findings reveal a significant misalignment between the perceived importance of collaboration and providers’ actual satisfaction levels. Despite high valuations of collaboration, participants from a range of professions expressed dissatisfaction with the responsivity and professionalism of workers. They were slightly more satisfied with relational elements of the collaborations. Participants further indicated that their experiences led to poorer outcomes and decreased willingness to continue working on child welfare cases. Providers’ responses underscores the need for improvements in collaborative practices.

An Over-the-Counter Hearing Aid Clinical Trial in Rural Alabama: Project Design and Potential Implications for Pharmacy and Audiology Interprofessional Collaborations

An Over-the-Counter Hearing Aid Clinical Trial in Rural Alabama: Project Design and Potential Implications for Pharmacy and Audiology Interprofessional Collaborations

Perception of the compatibility of Quebec residency program characteristics with the advanced access model: a cross-sectional study

BackgroundThe advanced access (AA) model is among the most recommended innovations for improving timely access in primary care (PC). AA is based on core pillars such as comprehensive planning for care needs and supply, regularly adjusting supply to demand, optimizing appointment systems, and interprofessional collaborative practices. Exposure of family medicine residents to AA within university-affiliated family medicine groups (U-FMGs) is a promising strategy to widen its dissemination and improve access. Using four AA pillars as a conceptual model, this study aimed to determine the theoretical compatibility of Quebec’s university-affiliated clinics’ residency programs with the key principles of AA.MethodsA cross-sectional online survey was sent to the chief resident and academic director at each participating clinic. An overall response rate of 96% (44/46 U-FMGs) was obtained.ResultsNo local residency program was deemed compatible with all four considered pillars. On planning for needs and supply, only one quarter of the programs were compatible with the principles of AA, owing to residents in out-of-clinic rotations often being unavailable for extended periods. On regularly adjusting supply to demand, 54% of the programs were compatible. Most (82%) programs’ appointment systems were not very compatible with the AA principles, mostly because the proportion of the schedule reserved for urgent appointments was insufficient. Interprofessional collaboration opportunities in the first year of residency allowed 60% of the programs to be compatible with this pillar.ConclusionsOur study highlights the heterogeneity among local residency programs with respect to their theoretical compatibility with the key principles of AA. Future research to empirically test the hypotheses raised by this study is warranted.

The impact of video consultation on interprofessional collaboration and professional roles: a simulation-based study in prehospital stroke chain of care

ABSTRACT Healthcare is often conducted by interprofessional teams. Research has shown that diverse groups with their own terminology and culture greatly influence collaboration and patient safety. Previous studies have focused on interhospital teams, and very little attention has been paid to team collaboration between intrahospital and prehospital care. Addressing this gap, the current study simulated a common and time-critical event for ambulance nurses (AN) that also required contact with a stroke specialist in a hospital. Today such consultations are usually conducted over the phone, this simulation added a video stream from the ambulance to the neurologist on call. The aim of this study was to explore interprofessional collaboration between AN’s and neurologists when introducing video-support in the prehospital stroke chain of care. The study took place in Western Sweden. The simulated sessions were video recorded, and the participants were interviewed after the simulation. The results indicate that video has a significant impact on collaboration and can help to facilitate better understanding among different professional groups. The participants found the video to be a valuable complement to verbal information. The result also showed challenges in the form of a loss of patient focused care. Both ANs and neurologists saw the video as benefiting patient safety.

Collaborative Action Research As an Approach to School Improvement to Develop Inclusive Education in Pakistan

ABSTRACT Education in Pakistan continues to be underfunded and only one in three children complete primary education. Children with special needs face further barriers to access good quality education, with an estimated less than one in ten disabled children attending any school. In this situation, mainstream schools struggle to provide an inclusive education environment. Given these multiple challenges, Collaborative Action Research (CAR) was used to attempt to improve educational services, by facilitating teachers, school management, and families and parents to work together to promote inclusion. A research team consisting of occupational therapists and teachers worked with five local primary schools, using the Action Research cycles of plan-act-observe-reflect to develop practical strategies, materials, and inclusive lesson plans to facilitate the participation of all children in all school-based occupations. Support from school management as well as interdisciplinary collaboration were crucial factors for implementing Action Research and the innovations resulting from this process. Resulting strategies were found to benefit all children in class, leading to enhanced engagement and attainment of children with special needs as well as their peers. Both occupational therapists and teachers discovered the value of interprofessional collaboration through this process. A Resource Guide has been produced and is freely available.

A narrative review of risk mitigation strategies in the management of opioids for chronic pain and palliative care in older adults: interprofessional collaboration with the pharmacist.

The prevalence of chronic non-cancer pain (CNCP) in older adults is high. Opioids carry significant risk for harm in older adults. Yet, many older adults are established on long-term opioid therapy for the treatment of CNCP despite limited documented efficacy. Many of the non-opioid options to treat pain present challenges in this population. Since challenges with tapering patients off of opioids exist, older adults may remain established on long-term opioid therapy for CNCP. While opioid use is less scrutinized for older adults receiving palliative care, significant safety concerns exist. Therefore, efforts to mitigate risks for older adults receiving long-term opioids for CNCP and for palliative care are essential. Pharmacists as members of the interprofessional team are equipped to improve safety among older adults on chronic opioid therapy. Among patients receiving palliative care, collaboration with palliative care specialists is also key. The purpose of this narrative review is to describe risk mitigation strategies for opioid use among older adults with CNCP and those receiving palliative care. Data were identified by searching PubMed (January 1, 1990 to February 21, 2024) using the following search terms: older adults, opioids, chronic pain, palliative care, and pharmacist. The search was repeated using terms geriatric, elderly, opiates, narcotics, and controlled substances. Non-English articles and observational studies with fewer than 100 patients were excluded. Major North American and European guidelines were reviewed. Additional literature was obtained through review of relevant references of identified articles. A variety of risk mitigation strategies to improve safety for older adults using opioids exist. They include risk assessment, tapering opioids, reducing high-risk concomitant medications, utilizing non-opioid therapies, screening for and treatment of opioid use disorder (OUD), toxicology testing, co-prescribing naloxone, utilizing controlled substance agreements, reviewing prescription drug monitoring program data, prescriber and patient education, and collaboration with pharmacists and palliative care specialists. There are many opioid risk mitigation strategies for older adults. Collaboration with pharmacists and palliative care specialists can be an effective means for implementing strategies to optimize opioid safety for older adults with CNCP and those receiving palliative care.

Identifying Physician Public Health Competencies to Address Healthcare Needs in Underserved, Border, and Outer Island Areas of Indonesia: A Rapid Assessment

Phenomenon: Most medical schools in Indonesia have developed innovations to integrate public health content into the curricula. However, ensuring that all schools meet appropriate standards regarding the quality of subjects, content relevancy, and course delivery takes time and effort. Approach: This study employed a rapid assessment procedure to identify the current knowledge and competencies required to practice medicine effectively in underserved, border, and outer island areas of Indonesia. Ninety-three participants from six remote districts were involved in 12 focus group discussions. Qualitative data were analyzed using content analysis using the social determinants of health as a guiding framework. Findings: Under decentralized health system governance, the local socio-geographical context is critical to understanding the current public health landscape. Medical education with respect to public health must emphasize physicians’ ability to advocate and encourage the coordination of healthcare services in responding to disasters, as well as community-based surveillance and other relevant data for synergistic disease control. As part of a healthcare facility management team, prospective doctors should be able to apply systems thinking and provide critical input to improve service delivery at local health facilities. Also, recognizing underlying factors is essential to realizing effective interprofessional collaboration practices and aligning them with leadership skills. Insights: This study outlines recommendations for medical schools and relevant colleges in formulating compulsory block or integrated public health curricula. It also provides a public health learning topic that may aid medical schools in training their students to be competent for practice in underserved, border, and outer island areas. Medical schools should offer initiatives for students to acquire the necessary public health competencies merited by the population’s health needs.

“It Takes a Village”- A Conversation with the Interprofessional Diabetes Clinic at the ECU Health Family Medicine Center

Interprofessional collaboration and shared understanding positively impact both patients and providers. Current recommendations from the CDC and experts agree that collaboration between diverse professions is necessary to improve patient outcomes and empower patients to selfmanage their chronic conditions.

Assessing Interprofessional Collaboration at Clinical Learning Sites: Methodology on Developing the IP-CLEAR Tool

Interprofessional Clinical Learning Environment Assessment and Reflection (IP-CLEAR) tool was developed by a team of faculty from the schools of nursing, pharmacy, and medicine at University of North Carolina at Chapel Hill (UNC-CH), with the support of the North Carolina Area Health Education Consortium (NC AHEC) and the UNC-CH Office of Interprofessional Education and Practice (IPEP). The IP-CLEAR tool is intended for use by clinical sites that have or want to have clinical learners engaged and integrated into an excellent interprofessional CLE. The development of the IP-CLEAR and projections for future work are described here.

Interprofessional follow-up of patients with cancer in France (the SINPATIC study): a preliminary, qualitative study of the patient's perspective.

In 2020, 19.2 million people were diagnosed with cancer, and nearly 10 million cancer patients died worldwide. An effective cancer care pathway must be based on coordination, multidisciplinarity, a personalized approach, and collaboration between stakeholders. Follow-up can be improved by good collaboration and communication between GPs and the cancer care team at a common level of organization. To study patients with solid cancers and assess their perceptions of the care pathway, the roles of the healthcare professionals involved, and interprofessional collaboration. In a preliminary, qualitative study (part of the SINPATIC study of general practitioners, oncologists, nurses, and patients), adult patients with cancer in the Paris area of France were interviewed between January and April 2018. Using purposive sampling, 10 patients were recruited from hospital departments and primary care. An interview guide explored 3 themes: the care pathway, the stakeholders' roles in follow-up, and interprofessional collaboration. For patients, dealing with cancer is a complex process of awareness, care provision, decision-making, task assignment, a lack of clarification of professional roles, a piecemeal announcement of the diagnosis of cancer by several stakeholders, organizational and administrative difficulties, non-formal collaboration in inertia (tending towards collaboration under construction), and with cancer follow-up that was usually parallel, sometimes shared, rarely sequential. This SINPATIC substudy provided us a better understanding of the complexity of the patient care pathway. Looking forward, the present findings might stimulate thoughts on the design and development of interventional studies.

Provision and use of assistive products in patients after stroke and spinal cord injury in Germany: a qualitative interview study

Purpose Mobility impairments are a common consequence of stroke and spinal cord injury (SCI). Assistive products (APs) such as wheelchairs are often needed for activities and participation. The aim of the study was to explore the provision and use of APs in Germany and to identify associated factors underlying this practice. Materials and methods Semi-structured interviews were conducted with 19 professionals from outpatient neurorehabilitation services (three general practitioners, five physical therapists, five occupational therapists, one speech therapist, one neuropsychologist, two outpatient nurses, one rehab technician and one social worker), two patient advocates (long-term survivors, each stroke and SCI) and 20 patients (10 each after stroke and SCI with mobility impairment, and first-ever affected). Analysis was performed by qualitative content analysis. Results Reported experiences were mixed, varying from high satisfaction to unusable APs and unmet needs. Identified factors associated with these experiences were related to care pathways, care coordination, inter-professional collaboration, professionals’ knowledge and patient information, cost coverage, and approval procedures. Conclusion Overall, patients seem satisfied with the APs they receive, but patients with more severe mobility impairments in particular experience deficits in the provision and use of APs. Further research is needed to develop and test strategies for the provision and use of APs.

Proposing an Interprofessional Competency Framework for Person-Centered Care Connecting Interprofessional Education and Collaborative Practice

Introduction: The number of complex healthcare problems is increasing, the workforce is diminishing, and healthcare costs are rising. Interprofessional Education and Collaborative Practice is a promising solution, necessitating the cultivation of skills and competencies among health and social care professionals. The central question guiding this study revolves around the possibility of merging interprofessional collaboration, lifelong learning, the International Classification of Functioning, Disability and Health (ICF), and the Rehabilitation Competency Framework (RCF) into a unified competency framework that can be used in both education and in the work field. Method: In total, five modified Delphi rounds were executed during three phases specifically comprising the design, relevance, and report stages. The first contains a literature search, the second includes 11 pilots with surveys, and the last finalized the INPRO Competency Framework (INPRO CF). Results: The primary result is the INPRO CF that is readable, accurate, applicable, and accepted. It contains five domains, 17 competencies, and 200 learning outcomes or behaviors. It exists in four languages (Dutch, Finnish, English, German). Discussion: The INPRO CF is a relevant interprofessional competency framework designed to alleviate deficiencies between education and practice so it is suitable for a lifelong learning process. It demonstrates adaptability across various contexts. Implications for Practice The INPRO Competency Framework provides a structured overview of the learning journey in becoming an experienced interprofessional collaborator and is applicable in both practice and educational settings. The INPRO Competency Framework provides a comprehensive understanding of goals that an individual in a team can work on and structures those that it would like to achieve. The INPRO Competency Framework has the potential to positively impact person centered care by promoting collaboration among health and social care professionals. It simultaneously can contributes to transforming education by shaping curricula and preparing students for interprofessional teamwork in their future careers.

Japanese primary care physicians' postpartum mental health care: A cross‐sectional study

AbstractBackgroundPostpartum mental health care is a public health priority requiring interprofessional and interorganizational collaboration. Primary care physicians (PCPs) have the potential to play an essential role in facilitating access to health care and providing comprehensive and coordinated care for postpartum mental health problems. In Japan, however, there are no previous studies on the extent to which PCPs are involved in postpartum mental health care. Therefore, this study aimed to investigate the practices and experiences of Japanese PCPs in providing such care.MethodsThis study presents a subset of the findings from a cross‐sectional study using an online questionnaire on postpartum care among Japanese PCPs. We employed descriptive analysis to examine their practices and experiences in providing general and postpartum mental health care.ResultsWe received 339 valid responses from 5811 PCPs. The median proportion of the outpatients with mental health problems that PCPs regularly saw was 15%. Approximately two out of three PCPs (68.7%) reported routinely performing screening for depression and anxiety. Seventy‐six percent of PCPs had the opportunity to provide care for postpartum women. Approximately one in two PCPs (47.8%) had managed cases of postpartum mental health problems and collaborated with various professionals and resources to provide care.ConclusionsThe majority of Japanese PCP participants in the study provide mental health care and have managed cases of postpartum mental health problems, collaborating with various health professionals.