Developing interprofessional collaboration: A longitudinal case of secondary prevention for patients with osteoporosis

Abstract

The aim of this study was to explore the development of interprofessional collaboration aiming to improve secondary prevention of osteoporosis by studying this topic expansively from the perspectives of different stakeholders. The method used was a longitudinal single case study with both qualitative and quantitative data sources. The findings elucidate that the bottom-up structure used triggers a freedom to act for the professionals and a changed leadership. Such an approach seems to make managers aware of the need for a horizontal organizational focus that, in this case, was crucial for developing interprofessional collaboration. Furthermore, the study shows that continuous feedback was central to motivate professionals to collaborate. Constructive feedback was created by interprofessional and patient-centered interaction skills, facilitated by confirming leadership promoting ability to recognize the efficacy of joint collaboration. The interprofessional collaboration resulted in an improved chain of care with increased transparency and collective control with benefits for both patients and providers. Outcomes at the system level showed an appreciable increase in patients investigated for osteoporosis: 88% were followed up in primary care and nearly half had improved their health behavior. The implementation of a bottom-up structure where leaders and professionals are developing interdependency, measuring collective performance and using feedback loops generated, in this case, motivational forces for interprofessional collaboration. It is reasonable to assume that these findings could be transferable to similar healthcare settings.

Observation of interprofessional collaborative practice in primary care teams: An integrative literature review

“…Three studies (Hjalmarson et al, 2013;Kislov et al, 2012;Nadeau et al, 2012) also investigated interprofessional collaboration between or across multiple sites or organisations.…”

“…All 11 studies had a primary focus on aspects of interprofessional collaboration in primary care teams including: impact of time, physical space and design, impact of system change; influence of organisational boundaries; health professional roles; collective learning in teams, and new knowledge creation. Four studies further identified the study context as a particular area of care: palliative care (Munday et al, 2007); child and youth mental health (Nadeau et al, 2012); chronic kidney disease (Kislov et al, 2012) and osteoporosis (Hjalmarson et al, 2013). All 11 studies reported detailed process findings (influences known or considered to facilitate interprofessional collaboration, interprofessional collaborative practice and team functioning as well as characteristics of well performing teams).…”

“…All 11 studies reported detailed process findings (influences known or considered to facilitate interprofessional collaboration, interprofessional collaborative practice and team functioning as well as characteristics of well performing teams). Two of the 11 studies went further and also attempted to link process findings with clinical outcome measures in a specific area of care (Hjalmarson et al, 2013;Munday et al, 2007).…”

“…Participant observation was used in three studies (Hjalmarson et al, 2013;Nadeau et al, 2012;Welch et al, 2013). Approaches to both data collection and analysis were most often referred to as inductive, interpretive and/ or iterative.…”

“…In 5 of the 11 studies (Gum et al, 2012;Hjalmarson et al, 2013;Kislov et al, 2012;Oandasan et al, 2009;Quinlan, 2009) it was possible to ascertain that observation data was initially collected independently from other data, and that the initial analysis stemmed from the observation data.…”