Collaboration processes, outcomes, challenges and enablers of distributed clinical communities of practice

Abstract

Modern healthcare's need for knowledge sharing and bridging the researchpractice-gap requires new forms of collaboration, in which clinicians of varying clinical and research expertise work together over geographical and organisational borders. To support such distributed communities of practice (CoPs), an understanding of their collaboration processes, outcomes, challenges, and enablers is needed. The paper examines these issues through a case study of a long-running CoP, the Swedish Oral Medicine Network (SOMNet). SOMNet's main form of collaboration is monthly telephone conference meetings centred on case consultations. Cases are submitted by the clinicians via a Web-based system. The methods used were interviews, observations, and a questionnaire.The work adds to previous research by studying a distributed CoP explicitly focused on supporting the transfer of scientific results from researchers to practitioners.We found that the regular meetings give a rhythm to the community. The centrality of cases means an immediate benefit for the submitter while the share an overarching goal of general improvement and harmonisation of patient care.However, the present study focuses on distributed collaboration where there are more than two types of participants, which sets it apart from the common format of teleconsultations. The studied distributed CoP makes the case discussions available to a larger group of clinicians, while adding challenges related to handling a larger and heterogeneous group. This study also has commonalities with the format of the MDTM, but without the emphasis on the coordination between the different roles and disciplines involved in caring for a specific patient, and with more loosely coupled participants.Within the studied collaboration, there is little variation with respect to the discipline, but much variation in the other aspects, such as degree of specialisation, experience, focus on clinical work or on research, access to external evidence, location, and level of partici- 2004). Third, given that the single previously studied CoP aimed at sharing knowledge among researchers and practitioners is based on the sending of emails between com-

Communities of Practice and Situated Learning in Health Care

“…In addition to overcoming professional and geographical boundaries, virtual CoPs can also help to overcome the institutional boundary between researchers in universities and practitioners in the health care system. One example of a virtual CoP being developed to span this research-practice boundary is provided by Friberger and Falkman (2013), who investigated the workings of a geographically dispersed "oral care" CoP that included both practitioners and academics. The CoP was established to give practitioners access to cases of low prevalence by combining data from various facilities and providing learning opportunities beyond the scope of one clinic's operation.…”

“…Participating physicians presented cases via a virtual submission system in order to receive opinions regarding diagnosis, pose a general question, or educate other CoP members. In this situation, participants often became immediate beneficiaries of sharing by obtaining feedback on their cases, and the community as a whole benefitted by gaining access to authentic data and aligning their models of treatment with others present in the discipline (Friberger and Falkman, 2013).…”

Enhancing client welfare through better communication of private mental health data between rural service providers

“…As a result, information sharing between agencies becomes complicated. There is therefore no question of the importance of designing usable processes and technologies for interagency communication, an argument that has been documented previously (Asan & Montague, 2013;Friberger & Falkman, 2011). What is unique to this article is that it uses qualitative interviews with mental health service users and professionals to inform a model of communication that integrates privacy legislative changes into designs for communication between rural service providers.…”

The use of the PARIHS framework in implementation research and practice—a citation analysis of the literature

“…▪ 92 intervention studies where PARIHS did not guide the development of an intervention [ 149 , 152 , 153 , 155 , 156 , 158 , 160 , 162 , 167 , 168 , 171 , 176 , 178 , 179 , 182 – 185 , 194 , 201 – 203 , 205 – 209 , 211 , 212 , 214 , 217 , 219 – 223 , 225 , 234 – 236 , 243 – 245 , 249 – 252 , 254 , 255 , 258 – 261 , 263 , 265 , 266 , 268 – 270 , 273 , 274 , 276 – 285 , 287 – 292 , 296 , 297 , 299 – 301 , 303 – 312 ],…”