Ingroup identity as an obstacle to effective multiprofessional and interprofessional teamwork: findings from an ethnographic study of healthcare assistants in dementia care

Abstract

Rising dementia incidence is likely to increase pressures on healthcare services, making effective well coordinated care imperative. Yet, barriers to this care approach exist which, we argue, might be understood by focussing on identity dynamics at the frontlines of care. In this article, we draw upon findings from an ethnographic study of healthcare assistants (HCAs) from three dementia wards across one National Health Service mental health trust. Data revealed that the HCAs are a close-knit 'in-group' who share low group status and norms and, often highlight their own expertise in order to promote self worth. HCAs' social identity is considered as a barrier to effective teamwork with strong ingroup behaviour suggested as a consequence of their marginalisation. We explore these findings with reference to social identity theory (Tajfel, 1974; Turner, 1978 ) and discuss implications for delivering multiprofessional and interprofessional care.

Healthcare professionals’ evaluation of interprofessional teamwork and job satisfaction / Evaluation der Teamarbeit und der Arbeitszufriedenheit von Gesundheitsfachberufen

“…This result for Germany corresponds with the international literature on healthcare "professional silos" (Braithwaite, 2010;Delva et al, 2008;Hall, 2005;Margalit et al, 2009;Pecukonis et al, 2008;World Health Organization, 2010) or in-group identity as a barrier to effective interprofessional teamwork (Lloyd, Schneider, Scales, Bailey, & Jones, 2011;Sinclair et al, 2009). The physicians showed the highest values for interprofessional teamwork as well as for job satisfaction, which can be explained by the highest status and power of this profession in the healthcare system (Chang et al, 2009;Farrell, Schmitt, & Heinemann, 2001;Gair & Hartery, 2001).…”

Decision-making Processes for a Do-not-resuscitate Poisoned Pediatric Patient Admitted to the Department of Emergency and Medical Services — A Case Study

“…The decision was hence, detrimental to the patient. Therefore, in order to demonstrate a comprehensive range of sound judgment, the decision-maker must be in control emotionally, psychologically and intellectually (Lloyd et al 2011) without rushing into a decision using clinical guidelines.…”

Evaluation of the impact on audiences of Inside Out of Mind, research-based theatre for dementia carers

“…Three postgraduate researchers worked as health care assistants in separate dementia wards for several months in 2009. The enquiry sought to understand this little-researched workforce and it produced the expected academic outputs (Bailey, Scales, Lloyd, Schneider, & Jones, 2015;Lloyd, Schneider, Scales, Bailey, & Jones, 2011;Schneider et al, 2014). More than half a million words of field notes were subsequently entrusted to the writer, Tanya Myers, whose personal experience of dementia and extensive reading around the subject together with her professional skills shaped the script.…”