Interprofessional Collaborative Model Research Articles

Experiences of an interprofessional follow-up program in primary care practice

BackgroundAn integrative cooperation of different healthcare professional is a key component for high quality health services. With an aging population and many with long-term conditions, more health tasks and follow-up care are being transferred to primary care and locally where people live. Interprofessional collaboration among providers of different professional designations will be of increasing importance to optimizing primary care capacity in years to come. There is a call for further exploration of models of interprofessional collaboration that might be applicable in Norwegian primary care. The aim of this study was to explore experiences of interprofessional collaboration between primary care physicians and nurses working in primary care by applying an intervention for people with type 2 diabetes. Specifically, this study was designed to strengthen and gain deeper insight into interprofessional collaboration between primary care physicians and nurses in primary care settings.MethodsWe applied Interpretive Description as a research strategy. The participants within this study were primary care physicians and nurses from four different primary care practices in the western and eastern parts of Norway. We used semi-structured telephone interviews for collecting the data between January and September 2021.ResultsThe analysis revealed two key features of the primary care physicians and the nurses experience with interprofessional collaboration in primary care practices. The first involved managing the influence of discrepancies in their expectations of IPC and the second involved becoming aware of the competence they developed that allowed for better complementarity consultation.ConclusionsThis study indicates that interprofessional collaboration in primary care practice requires that primary care physicians and nurses clarify their expectations and, in turn, determine how flexible they can become in changing their usual primary care practices. Moreover, findings reveal that nurses and primary care physicians had discrepancies in expectations of how interprofessional collaboration should be carried out in primary care practice. However, both the nurses and primary care physicians appreciated the blending of complementary competencies and skills that facilitated a more collaborative care practice. They experienced that this interprofessional collaboration represented an essential quality improvement in the primary care services.Trial registrationThe trial is registered 03/09/2019 in ClinicalTrials.gov (ID: NCT04076384).

Influential factors affecting perceptions of interprofessional collaboration for advancing health outcomes: Insights and recommendations from an international fellowship program

ObjectivesThis study aims to examine the perception of health professions faculty towards interprofessional collaboration and to analyze how these perceptions are linked with their profession and prior professional experiences. MethodsThis study includes a convenience sample of 90 professionals who enrolled in a fellowship programme that focused on leadership competencies in interprofessional education. The perception of the Interprofessional Collaboration Model Questionnaire (PINCOM-Q) was used for data collection. The Chi-square test for independence was used to explore the relationship between profession and perception. One-way analysis of variance (ANOVA) was used to compare between the groups. ResultsThe response rate was 90%, with the majority of the participants being women (n = 49, 54.4%). The mean age was 42.16 ± 5.88 years (Range = 31–55 years). The most prominent constructs of collaboration perceived by the participants were: motivation, group leadership, and organisational culture. A difference in the perception based on age, years of experience, prior experience of working in interprofessional teams, and profession was observed. The Pearson correlation between construct averages was statistically significant (p ≤ 0.001) between: individuals and groups, r = 0.493; individuals and organisation, r = 0.418; and group and organisation, r = 0.683. ConclusionThe present study revealed that the perception of health professions faculty towards interprofessional collaboration differs in relation to their gender, age, professional qualification, working experience, professional background, and past experience with the interprofessional team. The study highlights the need to consider these factors while working with interprofessional teams.

Design of a service project that provides a model for interprofessional collaboration and layered learning within the refugee and asylum seeker community

Background: Development of an interprofessional service outreach within the refugee and asylum-seeker population gives pharmacy trainees the opportunity to develop healthcare skills and gain cultural awareness. Programme description: The interprofessional team prepared for the medical service trip through meetings, gathering supplies, and engaging in fundraising events. The team partnered with Siguiendo los Pasos de Jesús (SPJ) and Annunciation House while observing and partaking in service. A retrospective review of medical records was completed to develop the research project. Evaluation: A team of nine participated in a service project providing medical care and support for asylum-seekers. Layered learning and the importance of interdisciplinary communication were demonstrated within the team. The most common medical ailments for patients were respiratory, gastrointestinal diagnoses and headache/pain. Future plans: Service outreach offers the experience of caring for underserved populations and increases awareness of cross-cultural development, which is transferable in any clinical setting.

Physicians and nurses professional relationship with criminal investigation in dealing with survivors of sexual abuse: a scoping review

Survivors of sexual abuse and their families seek help from criminal law enforcement agencies and health professionals to obtain justice and health care. Many communities have implemented multi-professional collaborative models so that the victim’s well-being is assured and the truth is established. However, there is a general lack of evidence on how to best articulate these teams with the healthcare professionals caring for the survivors.Therefore, this Scoping Review was conducted in order to analyze and to map the barriers and facilitators of the relationship between health professionals and the criminal investigation team in the care of survivors of sexual abuse. The methodology proposed by the Joanna Briggs Institute for Scoping Reviews was used, and the Bronstein five dimension model of interprofessional collaboration served as the basis for the analysis of barriers and facilitators. Quantitative, qualitative and mixed studies, primary and secondary sources, text and opinion documents were included. Content analysis was performed on the main findings of the collected studies. Twelve articles were identified and analyzed. Collaboration, communication, hierarchy, skills, confidentiality, and leadership emerged as key themes. Multidisciplinary Sexual Assault Nurse Examiner (SANE) and Sexual Assault Response Teams (SARTs) were implemented to coordinate care, but conflicting goals and values among professionals posed challenges. Communication failures and inadequate information sharing hindered collaboration. Neutral leaders who coordinate teams, minimize groupthink, and improve decision-making were found to be valuable. Engaging across disciplinary boundaries and addressing power dynamics were challenging but could be addressed through facilitation and conflict resolution. This review highlights the importance of effective collaboration and interaction within teams and with other professionals in the care of sexual abuse survivors.

Breaking down barriers of interprofessional collaboration between social work and financial and employment service organizations

PurposeThe growing number of people with multiple problems in different areas of life means that cross-domain interprofessional collaboration is becoming increasingly important. This study aims to focus on interprofessional collaboration between professionals from social work and financial and employment service organizations in The Netherlands. This type of cross-domain collaboration is still mostly superficial, and limited empirical knowledge is available about its beneficial factors.Design/methodology/approachThe interprofessional collaboration model of Mulvale et al. (2016) was used as theoretical background for the research methodology and to reflect on the findings of our study. Data was collected through a qualitative study among professionals (N = 18) from social work and financial and employment service organizations in three different Dutch municipalities.FindingsSimilar team-level collaboration mechanisms of Mulvale et al.’s (2016) model were seen within this study. Joint client meetings were very beneficial for the interprofessional collaboration. Further beneficial factors include the decision-making process, team vision, client as an equal member, open communication and the appointment of a coordinator.Research limitations/implicationsFurther special attention is needed to determine how best to allocate co-ordinating tasks, and how organizational and policy contexts affect the functioning of interprofessional collaborative teams.Originality/valueThis study offers an empirical view on a cross-domain collaboration between social work and financial and employment service organizations, by using Mulvale et al.’s (2016) model. In addition, this study also offers special attention to the role of the client in interprofessional collaborative teams.

Perceptions of Interprofessional Collaboration for Children with Multiple and Complex Needs: Development and Psychometric Evaluation of a New Scale

ABSTRACT The quality of interprofessional collaboration is a key determinant of the success and effectiveness of integrative care for children with multiple and complex needs. This study reports on the development and first psychometric evaluation of a questionnaire that assesses professionals’ perceptions of interprofessional collaboration for child welfare-involved children with severe emotional and behavioural problems. We created the scale deductively using collaboration theory and inductively based on a large qualitative study examining interprofessional collaboration between residential care and mental health services in six European countries. Psychometric properties of the Perceptions of Interprofessional Scale for Children with Multiple and Complex Needs (PICOCC) were explored using exploratory and confirmatory factor analysis with two German samples of professionals working in child welfare and child and adolescent psychiatry (N = 360). Internal consistency was calculated using Cronbach’s alpha, known-groups validity was assessed, and convergent validity was established through examining the relationship with a widely used scale, the Perceptions of Interprofessional Collaboration Model - Questionnaire (PINCOM-Q). The 13-item scale had a one-factor solution, showed good internal consistency, and demonstrated known-groups validity. Strong correlations were reported for the PINCOM-Q entire scale and subscales coping, social support, communication, and organisational aims. These results support the theoretical conceptualisation of the construct underlying the scale and underline the potential of the scale in assessing and evaluating interprofessional collaboration in this field.

Personal and collective responsibility for health equity: An interprofessional education program around racism

Understanding the effects of racism on public health is necessary to stimulate structural and systemic change to improve the health outcomes of patients. As a healthcare team, racism is best addressed through interprofessional collaboration to develop equitable and sustainable solutions that transform the health and wellbeing of patients and communities. As a part of the collective effort to properly educate our health professional students about the declarations by local and county health departments that “racism as a public health crisis,” we sought to utilize an interprofessional collaboration model. A steering committee of faculty, staff, and students at The Ohio State University created a new longitudinal interprofessional education (IPE) exercise titled Personal and Collective Responsibility for Health Equity: Anti-Racism in Action (ARIA). The participating Colleges/Schools of Dentistry, Medicine, Nursing, Optometry, Pharmacy, Public Health, School of Health and Rehabilitation Sciences (SHRS), Social Work, and Veterinary Medicine worked with leaders from the University's Office of Interprofessional Practice and Education to develop this 5-week program to engage a cohort of approximately 1300 students in a virtual learning experience during the Spring of 2021, when COVID-19 restricted in-person instruction. Ultimately, 200-interprofessional teams of 5–7 students were involved in this learning experience. Students individually selected resources (readings or videos) from a comprehensive resource kit provided by the steering team, to learn about and reflect on the differential types of racism, how it impacts well-being, health care delivery, and how health professionals can collaborate to advance health equity. The 200 interprofessional teams met twice virtually during the 5-week module and were provided with discussion questions and short assignments. Each team then contextualized, designed and submitted a final poster of a project to describe how an interprofessional approach to racism could further racial equity in health and healthcare delivery as applied to a selected perceived health equity issue, problem or dilemma. Student survey data was used to describe the effect of this module on student learning and attitudes. Students generally agreed that the module helped them to achieve the learning objectives. A thematic analysis of open-ended responses revealed that students generally had a positive response to the content on racism and the opportunity to learn interprofessionally, and they had specific suggestions for how to improve the experience. The results were utilized to re-design the activity for the following year and may be useful to other institutions wishing to address racism through interprofessional education.

MoveMore: A model for interprofessional collaboration with nursing and physical therapy students in a community based walking class for people with stroke

Interprofessional education (IPE) opportunities that engage students with members of the community who have a chronic condition, like stroke, provide collaborative learning experiences. The purpose of this paper is to describe an IPE activity called MoveMore and its preliminary student learning outcomes. MoveMore is a community, evidence-based walking class, which engages physical therapy and nursing students together with participants with chronic stroke. Each session lasts 12 weeks with outcome measurements taken at weeks 1 and 12 and High Intensity Gait Training (HIGT) implemented during weeks 2–11. MoveMore occurred three times during 2022 and is scheduled to occur three times in 2023. Implementation of a community walking class for people with chronic stroke can be successfully implemented and sustained over time providing benefits to student learning as well as participants. Models of IPE provide the opportunity for other educational institutions to implement similar projects.

Technology-based interprofessional collaboration in primary care for home rehabilitation of the older adults: A dutch exploratory study.

Primary healthcare professionals face an increasing number of geriatrics patients, and patient care often involves different disciplines. eHealth offers opportunities to support interprofessional collaboration (IPC). This exploratory study aimed to gain insight in 1) IPC in community-based rehabilitation, 2) facilitators and barriers for technology-based IPC and 3) technological IPC solutions envisioned by the primary healthcare professionals An focus group with six primary healthcare professionals and a design thinking session with four participants were conducted. Data analysis was based upon an IPC model. Results indicate that facilitators and barriers for IPC can be clustered in three categories: human, organization and technology, and provide some requirements to develop suitable IPC technological solutions Primary healthcare professionals recognise the urgency of working collaboratively. Current barriers are understanding each other's professional vocabulary, engaging the older adults, and using technology within the patient's environment. Further research is needed to integrate IPC components in a technological solution.

Perceptions of interprofessional collaboration at the intersection of child welfare and child and adolescent psychiatry in Germany

In Germany (and other countries) a significant proportion of children and young people in contact with the child welfare system do not receive adequate mental health care. Fragmented service delivery has been partially attributed to a lack of interprofessional collaboration between the child welfare system and providers of child mental health services. Child and adolescent psychiatric (CAP) clinics provide the majority of child mental health care for the child welfare population in Germany. In this paper, we present the first wave of data collected in a nonrandomized pretest–posttest intervention study, in which we examined the collaboration between child welfare services and CAP clinics in Northern Germany with a sample of N = 204 professionals in total, from both organizations. We used two standardized measurements. The general quality of collaboration was measured using an established tool, the “Perceptions of Interprofessional Collaboration Model – Questionnaire” (PINCOM-Q). Perceptions of collaboration around children with complex care needs were measured with a newly developed scale, the “Perceptions of Interprofessional Collaboration Scale for Children with Multiple and Complex Needs” (PICOCC). The results show that perceptions of interprofessional collaboration differed based on organizational and professional affiliation. Frontline workers employed in the child welfare system compared to those working in CAP clinics had a more negative perception of collaboration in general, and felt their organization provided less support for collaboration. Social workers in both CAP and child welfare services perceived less organizational support for collaboration compared to mental health professionals. In the overall group of social workers, those working in the child welfare system felt their organization supported collaboration the least. Mental health professionals working in CAP clinics, however, had a more negative perception of collaboration around children with complex needs. This suggests that attention should be paid to perceptions of interprofessional collaboration as an important process variable, which may impact on frontline workers’ responsiveness to organizational change.

Improving interprofessional collaboration in schools: A cluster-randomized study evaluating the effectiveness of the LOG model on collaboration practices

ABSTRACT Although interprofessional collaboration is emphasized as important in schools, little is known about how it should be organized. We analyzed the effects of an organizational model of interprofessional collaboration, the LOG model. The model aims to improve interprofessional collaboration by identifying and improving various meeting places for collaboration, involving municipal school leaders, principals, staff, and interprofessional collaborators, and by increasing feedback from meeting places in and around schools. In a cluster-randomized design including 35 Norwegian primary schools, 19 schools were randomized to the experimental group and implemented the LOG model, and 16 were randomized to a control group. A total of 142 interprofessional collaborators (e.g., school nurses, social workers, and principals) received a questionnaire prior to randomization, with one- and two-year follow-up. Using a validated scale to measure interprofessional team collaboration, we evaluated the effects of the model on collaborators’ perceptions in four dimensions: (a) Reflection on process, (b) Professional flexibility, (c) Newly created professional activities, and (d) Role interdependence. During the first, but not the second year of follow-up, the results demonstrated positive and statistically significant effects of the LOG model on the dimensions Reflection on process (p< .001) and Newly created professional activities (p= .016). Our findings demonstrate the potential of interventions addressing interprofessional collaboration at the organizational level.

Lessons Learned from the Implementation of a Person-Centred Digital Health Platform in Cancer Care.

The SARS-CoV-2 (COVID-19) pandemic has accelerated the development and use of digital health platforms to support individuals with health-related challenges. This is even more frequent in the field of cancer care as the global burden of the disease continues to increase every year. However, optimal implementation of these platforms into the clinical setting requires careful planning and collaboration. An implementation project was launched between the Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Centre-Ouest-de-I’Île-de-Montreal and BELONG—Beating Cancer Together—a person-centred cancer navigation and support digital health platform. The goal of the project was to implement content and features specific to the CIUSSS, to be made available exclusively for individuals with cancer (and their caregivers) treated at the institution. Guided by Structural Model of Interprofessional Collaboration, we report on implementation processes involving diverse stakeholders including clinicians, hospital administrators, researchers and local community/patient representatives. Lessons learned include earlier identification of shared goals and clear expectations, more consistent reliance on virtual means to communicate among all involved, and patient/caregiver involvement in each step to ensure informed and shared decision making.

Designing an interprofessional dementia specialty clinic: Conceptualization and evaluation of a patient-centered model

ABSTRACT The need for blueprints to design specialty care interprofessional collaboration (IPC) models is urgent, given the expanding aging population and current challenges in dementia diagnosis and treatment. We describe key steps creating an interprofessional outpatient dementia specialty clinic, efforts to sustain the model, and evaluation of interprofessional effectiveness and clinician satisfaction. The conception for the Comprehensive Memory Center was informed by qualitative research methodologies including focus groups, interviews, and literature reviews. Quantitative evaluation included satisfaction surveys and team effectiveness measures. The IPC model diverges from typical dementia practices through its interprofessional team, visit structure, approach to decision-making, in-house services, and community collaborations. Team retreats and workshops helped build clinician knowledge of interprofessional values and practices to sustain the IPC model. In the first 3.5 years, we served nearly 750 patients and their caregivers. Team evaluation results revealed that increased access to consultation and sharing the workload and emotional burden were beneficial. The majority of team members preferred the IPC model to traditional models of clinical care.

"White code protocol": model of interprofessional collaboration in the emergency room

Acute agitation is a frequent cause of emergency department's consultation. Managing an agitated patient is complex due to many factors and require from healthcare teams a close interdisciplinary collaboration. Scope of this article is to describe the management of agitated patients in an emergency department and to present an interprofessional medical care protocol (white code protocol), giving also the opinion of principal actors of this healthcare interdisciplinary model.

Factors that Influence Co-production among Student Interns, Consumers, and Providers of Social and Public Health Services: Implications for Interprofessional Collaboration and Training

ABSTRACT Providers of public health and social services (“providers”) develop and deliver services by engaging in interprofessional collaboration (IPC), from seeking external advice to making referrals and linkages to various social and public health services. Providers collaborate with consumers of social and public health services (“consumers”) and student interns (e.g., social work, public health) to explore, determine, and deliver relevant services through a process referred to as co-production. Both IPC and co-production are widespread strategies with the potential to improve service accessibility and quality. However, the intersection of co-production and IPC remains understudied. This study examines factors that influence co-production in IPC among service providers, consumers, and student interns. We used cross-sectional survey data from an NIMH-funded study, including 379 providers in 36 HIV-service organizations in New York City. We examined the relationships between providers’ perspectives on co-production in IPC and multiple provider- and organization-level variables using random-effects logistic regression. Most respondents said that consumers and students in their agency participate in IPC on the issues that concern them. Providers who perceive greater flexibility in the IPC process were more likely to agree that their organizations’ providers co-produced IPC. Organizational service offerings (i.e., multilingual services, a comprehensive range of services), job positions, and full-time employment status were strong predictors of co-production. Our findings indicate that intentional and inclusive models of flexible IPC are needed. Fostering co-production in the HIV service field requires more institutional support and incentives for organizations, providers, and student interns. Implications for research and practice are discussed.

Interprofessional Collaboration in School-Based Settings Part 1: Definition and the Role of the School Nurse.

Interprofessional collaboration is an important approach in providing quality care to patients by healthcare professionals. Interprofessional collaboration is common in healthcare organizations such as hospitals and long-term healthcare facilities where each professional of the healthcare team contributes to the overall healthcare plan for the patient. But, little research or discussion how interprofessional collaboration is implemented within the school systems exist. This article looks at interprofessional collaboration within the schools and how the school nurse can facilitate collaboration among healthcare and education professionals to ultimately benefit students. This first article, in a series of three, will define and discuss frameworks and models of interprofessional collaboration.

"It's Not Just About Getting Along": Exploring Learning Through the Discourse and Practice of Interprofessional Collaboration.

Interprofessional collaboration (IPC) is a necessary competency for all professionals. However, IPC can be fraught with politics leading to variable uptake and execution. The authors set out to understand how trainees come to appreciate the value of the "team" in their learning and to describe the type of learning related to IPC afforded to trainees in a highly collaborative complex care context. The authors conducted 72 hours of observations of pediatric rheumatology settings at a large pediatric hospital across 18 months. They interviewed 10 health professionals and analyzed an archive of texts to ascertain how the field of pediatric rheumatology conceptualizes the role of IPC. They used the concept of governmentality and critical discourse analysis to describe how values of collaboration enabled learning and theories of expertise to understand how learning was enacted and perceived. Collaboration was perceived to be a product of providing good rheumatological care, which in this case, aligned well with hospital model of IPC. This alignment afforded trainees learning opportunities beyond preparing them to get along with other health professionals. IPC, when role modeled during problem solving, created the conditions for learning "why" collaboration is important for clinical expertise. By critically examining the relationship between discourse, practice, and learning, the authors have described how practices that underpin collaboration as a clinical competency are distinct from collaboration as cultural work contributing to civility within teams and across the organization.

Interprofessional collaboration practice: Are you doing it well? Individual perceptions within Sexual Assault Response Team (SART)

Abstract Purpose The purposes of this study were 1) to describe the individual member, group and organizational perception of collaboration of the Sexual Assault Response Team (SART) and 2) to focus on the individual levels of Interprofessional Collaboration (motivation, role expectations, personality style, professional power). Methods A cross sectional exploratory descriptive design. Data was collected from an online Qualtric© survey that incorporated the Perception of INterprofessional Collaboration Model Questionnaire (PINCOM) with some open ended questions. A convenience sample of SART members (n = 159) from the United States. Results The constructs for the individual level on interprofessional collaboration and the themes were categorized for the Sexual Assault Nurse Examiner, Advocate, Law Enforcement and Attorney. Three of four disciplines had a strong connection with individual motivation. Two disciplines had scores that reflected an unfavorable perception of collaboration. Scores on personality styles hindered interprofessional collaboration in all four disciplines. Conclusion Curriculum development based on the IPEC competencies may be a viable to unique groups such as the SART.

Empowering the team: A social work model of interprofessional collaboration in hospitals

Abstract Healthcare is increasingly delivered through interprofessional collaborations (IPC). The social work perspective of IPC is important to understand, as the profession has contributed to other interprofessional models, yet less is known about social workers’ actions within interprofessional teams. Using a grounded theory approach, this study examines the functioning of interprofessional teams through seven focus groups with social workers (n = 46) at six urban hospitals. Specifically, this study identifies the particular contributions of social work to collaborative healthcare teams and proposes a model of social work in interprofessional teams. The key finding was that social workers are Empowering Collaboration by Actively Communicating (building relationships, holding information, and filling gaps), Proactively Educating (training the team, advocating for patients, and teaching about systems) and Managing Risk (troubleshooting discharge and avoiding liability). Implications for research and practice with interprofessional teams are provided.

Interprofessional collaboration in hospitals: a critical, broad-based review of the literature

ABSTRACT Interprofessional collaboration (IPC) is a common term applied in the healthcare literature, with suggestions it contributes to improved quality and safety of patient care across the globe. Despite worldwide implementation of models of IPC, past systematic or meta-reviews on this topic have concluded that the evidence is mixed. However, these reviews are yet to adequately consider the qualitative and mixed-methods literature on this topic. In this critical review, we synthesize the outcomes and key findings of IPC in hospitals, taking a broader approach by including diverse study designs. A total of 4,776 abstracts were screened from three major databases (Medline, CINAHL, Embase). Thirty-four studies fulfilled inclusion criteria. Although outcomes and key findings (e.g., staff turnover, error rates) were mostly positive, there were inconsistencies in the results. The included studies reflected a variety of study designs and different methodological approaches. Overall, our review revealed moderate evidence that IPC can positively influence patient, staff and organizational factors in hospitals, and that inconsistent findings may be due to variation in context (e.g., the cohort of patients). Recommendations from the review are to incorporate qualitative- and mixed-methods approaches to studying IPC in healthcare and tailor evaluations of IPC outcomes specific to the context.