Exploring the Team Climate of Health and Social Care Professionals Implementing Integrated Care for Older People in Europe

Abstract

Background and problem statement: Team climate describes shared perceptions of organisational policies, practices and procedures. A positive team climate has been linked to better interprofessional collaboration and quality of care. Most studies examine team climate within health or social care organisations. This study uniquely explores the team climate of integrated health and social care teams implementing integrated care initiatives for older people in thirteen sites across seven European countries, and examines the factors which contribute to the development of team climate. Theory and methods: In a multiple case study design, data collected as part of the European SUSTAIN (Sustainable Tailored Integrated Care for Older People in Europe) project were analysed. The short-form Team Climate Inventory (TCI-14) was administered before and after implementation of the integrated care initiatives. Qualitative data was used to explain the changes in TCI-14 scores over time. Results and discussion: Overall, team climate was found to be high and increased over time in eight of the thirteen sites. The development of a shared vision was associated with a strong belief in the value and feasibility of the initiative, clear roles and responsibilities, and a reflective approach. Strong inter-personal relationships, shared decision-making, and high levels of commitment and motivation contributed to the development of participative safety. Support for innovation increased when staff had the ‘space’ and time to work together. Conclusion: This mixed methods study offers significant insights into the development and maintenance of team climate in complex, integrated care systems in Europe.

Professionals´ readiness for change to knowledge-based palliative care at nursing homes: a qualitative follow-up study after an educational intervention

“…The broad questions were followed with probing follow-up questions. The six focus group interviews had an average duration of 43 min (34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53). The digitally recorded interviews were transcribed verbatim.…”

“…The participants experienced that after completing their education, they had an increased awareness of the importance of a good interprofessional climate compared to before, where they called for better communication and a consensus on the team. Team climate has been described as the professionals' shared perception of practices and procedures among the organization and describes the team members' attitudes and behaviours [40][41][42]. Previous research [42] has highlighted the importance of a positive team climate to promote interprofessional collaboration.…”

“…Team climate has been described as the professionals' shared perception of practices and procedures among the organization and describes the team members' attitudes and behaviours [40][41][42]. Previous research [42] has highlighted the importance of a positive team climate to promote interprofessional collaboration. To endorse teambuilding, an understanding of the different roles among the professionals on the team was found to be valuable [43].…”

“…This is in line with the finding that the participants shared that taking care of each other within the team was an important part of achieving positive team results. Thus, it is important that time be given to support professionals in improving the team climate and collaboration over time [42]. The participants hoped to improve the interprofessional climate when the education should continue and be spread in the workplaces.…”

Validation of the Novel Interprofessional Shared Decision-Making Questionnaire to Facilitate Multidisciplinary Team Building in Patient-Centered Care

“…Previous reports proposed the use of SDM by a team [ 9 ], and it has been proven that multidisciplinary professionals’ provision of ongoing support for decision-making regarding palliative, transitional, and primary care on a routine basis as a team enhances patient participation [ 6 , 10 , 11 ]. Especially for patients who have had strokes who need continuous decision-making support over an extended period—from the acute phase to the convalescence stage and during the home healthcare stage—there is a need for treatment as well as support by an interdisciplinary team, which includes a home healthcare team, daily care team, and nursing professionals [ 12 , 13 , 14 ]. In Japan, where the elderly population is increasing, the promotion of SDM by a team that supports various types of difficult decision-making processes is required.…”