Effective interprofessional collaboration in rural contexts: a research protocol

Mitchell, Rebecca; Paliadelis, Penny; McNeil, Karen; Parker, Vicki; Giles, Michelle; Higgins, Isabel; Parmenter, Glenda; Ahrens, Yvonne

doi:10.1111/jan.12083

Cited by 21 publications

(23 citation statements)

References 58 publications

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“…Our results are in line with the limited research on interprofessional learning in primary care and reviews on interprofessional education [14,31,32]. …”

Section: Conclusion and Discussionsupporting

confidence: 89%

Interprofessional education in primary care for the elderly: a pilot study

et al. 2013

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BackgroundThe Dutch health care system faces huge challenges with regard to the demand on elderly care and the competencies of nurses and physicians required to meet this demand.At present, the main focus of health care in the Netherlands lies on illness and treatment. However, (frail) elderly need care and support that takes their daily functioning and well-being into consideration as well. Therefore, health care professionals, especially those professionals working in primary care such as GPs and practice nurses, will be challenged to a paradigm shift in emphasis from treating illness to promoting health (healthy ageing). Interprofessional education is necessary to realise this shift in professional behaviour. Evidence indicates that interprofessional education (IPE) can play a pivotal role in enhancing the competencies of professionals in order to provide elderly care that is both effectively, integrated and well-coordinated. At present, however, IPE in primary care is rarely utilised in the Netherlands. Therefore, the aim of this pilot study was to develop an IPE program for GPs and practice nurses and to evaluate the feasibility of an IPE program for professionals with different educational backgrounds and its effect on the division of professionals’ tasks and responsibilities.MethodsTen GPs and 10 practice nurses from eight primary care practices in two provinces in the north of the Netherlands, Groningen and Drenthe (total population about 1.1 million people), participated in the pilot IPE program. A mixed methods design including quantitative and qualitative methods was used to evaluate the IPE program.ResultsDuring the program, tasks and responsibilities, in particular those related to the care plan, shifted from GP to practice nurse. The participants’ attitude toward elderly (care) changed and the triage instrument, the practical tool for prioritising preferences of the elderly and discussing their medication use, was considered to have an added value to the development of the care plan.ConclusionsThe results of this pilot study show that an interprofessional education program for professionals with different educational backgrounds (GPs and practice nurses) is feasible and has an added value to the redefining of tasks and responsibilities among GPs and practice nurses.

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“…Our results are in line with the limited research on interprofessional learning in primary care and reviews on interprofessional education [14,31,32]. …”

Section: Conclusion and Discussionsupporting

confidence: 89%

Interprofessional education in primary care for the elderly: a pilot study

et al. 2013

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“…One of the primary factors shaping APRNs as PCPs is the role of the collaborating physician within the healthcare team. Collaboration that comes from primary care teams, which include supervising physicians, can be beneficial for primary care APRNs, resulting in support and availability for consult, particularly of more complex patients (Mitchell et al., ). Research suggests good working relationships, collaboration with physicians, and trust in the team contribute to both autonomy and informal empowerment (Almost & Laschinger, ; Maylone, Ranieri, Quinn‐Griffin, McNulty, & Fitzpatrick, ).…”

Section: Introductionmentioning

confidence: 99%

The role of physician oversight on advanced practice nurses’ professional autonomy and empowerment

Petersen

Way

2017

Journal of the American Association of Nurse Practitioners

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Background and purpose Little is known about the effects of physician oversight on advanced practice registered nurses (APRNs). Examination of these relationships provides insight into the strength of independent practice. The purpose of this study was to examine whether APRNs’ perceptions of autonomy and empowerment varied according to type of physician oversight, whether facilitative or restrictive. Data sources A cross‐sectional survey design was used to examine whether APRNs’ perceptions of autonomy and empowerment varied according to physician oversight, geographical location, and practice setting. Five hundred questionnaires were mailed in March 2013 with 274 returned. Participants were asked about autonomy, empowerment, demographics, physician oversight, geographical location, and practice setting. Conclusions Among surveyed respondents, physician oversight was related to increased empowerment, regardless of whether the oversight was defined in facilitative or restrictive terms; both had similar positive effects on empowerment. Implications for practice If APRNs are to be part of the solution to the growing problem of healthcare access, it is important to study factors that contribute to their success. We speculate that increasing opportunities for collaboration and interaction with physicians, and possibly other healthcare professionals, could facilitate APRN empowerment, optimizing their contribution.

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“…Organisational information and communication technology and practicesIntegration of interprofessional approaches at institutional levels Integration of interprofessional approaches at organisational level Geographic proximity including models of co-location Shared interprofessional protocols and tools Source: Mitchell et al(9).…”

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confidence: 99%

The paradoxical effects of workforce shortages on rural interprofessional practice

McNeil

Mitchell

Parker

2014

Scandinavian Caring Sciences

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We found that clinicians often invested in interprofessional practice because of the need to manage intense workloads and this necessitated sharing of responsibilities across disciplines and blurring of role boundaries. Paradoxically, participants noted that workload pressures hampered interprofessional working if there were long-term skill shortages. Sharing workload and responsibility is an important motivator for rural practitioners to engage in interprofessional practice; however, this driver is only effective under circumstances where there are sufficient resources to facilitate collaboration. In the context of intransient resource challenges, rural health service managers would be best to focus on enabling IPP through facilitating role understanding and respect between clinicians. This is most feasible via informal workplace learning and allowing time for teams to reflect on collaborative processes.

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Effective interprofessional collaboration in rural contexts: a research protocol

Cited by 21 publications

References 58 publications

Interprofessional education in primary care for the elderly: a pilot study

Interprofessional education in primary care for the elderly: a pilot study

The role of physician oversight on advanced practice nurses’ professional autonomy and empowerment

The paradoxical effects of workforce shortages on rural interprofessional practice

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