A four-year, systems-wide intervention promoting interprofessional collaboration

Abstract

BackgroundA four-year action research study was conducted across the Australian Capital Territory health system to strengthen interprofessional collaboration (IPC) though multiple intervention activities.MethodsWe developed 272 substantial IPC intervention activities involving 2,407 face-to-face encounters with health system personnel. Staff attitudes toward IPC were surveyed yearly using Heinemann et al's Attitudes toward Health Care Teams and Parsell and Bligh's Readiness for Interprofessional Learning scales (RIPLS). At study's end staff assessed whether project goals were achieved.ResultsOf the improvement projects, 76 exhibited progress, and 57 made considerable gains in IPC. Educational workshops and feedback sessions were well received and stimulated interprofessional activities. Over time staff scores on Heinemann's Quality of Interprofessional Care subscale did not change significantly and scores on the Doctor Centrality subscale increased, contrary to predictions. Scores on the RIPLS subscales of Teamwork & Collaboration and Professional Identity did not alter. On average for the assessment items 33% of staff agreed that goals had been achieved, 10% disagreed, and 57% checked neutral. There was most agreement that the study had resulted in increased sharing of knowledge between professions and improved quality of patient care, and least agreement that between-professional rivalries had lessened and communication and trust between professions improved.ConclusionsOur longitudinal interventional study of IPC involving multiple activities supporting increased IPC achieved many project-specific goals. However, improvements in attitudes over time were not demonstrated and neutral assessments predominated, highlighting the difficulties faced by studies targeting change at the systems level and over extended periods.

Teamwork Assessment in Internal Medicine: A Systematic Review of Validity Evidence and Outcomes

“…The Attitudes Toward Health Care Teams Scale (ATHCTS) has been used in ten studies measuring attitudes towards interprofessional collaboration in a variety of settings, most commonly interprofessional education. [58][59][60][61][62][63][64][65][66][67] It consists of three subscales assessing attitudes about team value, team efficiency and the physician's shared role on the team. ATHCTS 65 The Ottawa Global Rating Scale has been used in multi-specialty education as an objective measurement of an individual's crisis resource management skills in simulated scenarios.…”

Health and social care professionals’ attitudes to interprofessional working and interprofessional education: A literature review

“…• previous experience of IPE on attitudes to IPW and IPE In addition, Braithwaite et al, (2012;2013) found that allied health professionals (AHPs) had more positive attitudes to IPW and IPE than physicians and nurses.…”

“…Time pressures, limited resources, lack of understanding of roles and responsibilities, competing priorities, and access to other professionals prevent effective IPW between professional groups (Bailey, Jones, & Way, 2006;Braithwaite et al, 2012;Hughes & McCann, 2003;Kvarnström, 2008;Larkin & Callaghan, 2005;Snelgrove & Hughes, 2000). Healthcare teams are capable of improvising and developing strategies to work around such barriers (Baxter & Brumfit, 2008;Lingard et al, 2012).…”

A realist analysis of hospital patient safety in Wales: applied learning for alternative contexts from a multisite case study

“…As outlined in Chapter 1, health-care quality and patient safety demand effective and co-ordinated leadership from politicians, 448,449 executive-level managers 81,450 and their subordinate staff -whether corporate or clinical professionals 451 -who interact with patients, directly or indirectly, 4,88,204,452,453 in the coproduction of their care. 146,155,454 Health-care leadership is, therefore, inherently distributed 30,36,455,456 and complex, 457 and necessitates active followership.…”