Shared care requires a shared vision: communities of clinical practice in a primary care setting

Abstract

A shared vision of care is an aspirational concept which is difficult to articulate but with attentiveness, sustained authentic engagement and being driven by values, it should evolve amongst the core participants of a 'Community of Clinical Practice'.

Does functional diversity increase effectiveness of community care teams? The moderating role of shared vision, interaction frequency, and team reflexivity

“…Within the context of health and social care, Fay and colleagues (2006) argue that having a shared vision provides the "glue" that holds an interprofessional team together. Other studies also confirm that problems that arise from the categorization path of the CEM (Van Young et al, 2017). Furthermore, in a team which consists of members with different professions, team goals may be more diffused, due to the different functional frameworks within which the team members operate (Peltokorpi & Yamao, 2017).…”

“…Within the context of health and social care, Fay and colleagues () argue that having a shared vision provides the “glue” that holds an interprofessional team together. Other studies also confirm that problems that arise from the categorization path of the CEM (Van Knippenberg et al, ) may be circumvented by creating a shared mental model of how the team should provide care to their clients (see also Young et al, ).…”

Moral Economy and Moral Capital in the Community of Clinical Practice

“…In our study, these judgments are made by members of the CoCP on one another, and those with whom they interact on the peripheries of the CoCP such as secondary care specialists and district nurses. From the LTCMP nurses’ perspective, health care professionals who fail to “come on board,” or “are not on the same page” (Young, Egan, et al, 2017) are likely to be sidelined in favor of others who are more sympathetic to the patient’s needs (and the management plan favored by the patient’s nurses). This reflects processes of alignment and marginalization within the CoCP, remembering that one defining characteristic of a successful CoCP is the sharing of a common vision oriented around patient goals, and alignment between the values of the CoCP’s core members (Young, Egan, et al, 2017).…”

“…From the LTCMP nurses’ perspective, health care professionals who fail to “come on board,” or “are not on the same page” (Young, Egan, et al, 2017) are likely to be sidelined in favor of others who are more sympathetic to the patient’s needs (and the management plan favored by the patient’s nurses). This reflects processes of alignment and marginalization within the CoCP, remembering that one defining characteristic of a successful CoCP is the sharing of a common vision oriented around patient goals, and alignment between the values of the CoCP’s core members (Young, Egan, et al, 2017). From the patient’s perspective, assessments of moral capital are highly influential in decisions involving who they are prepared to trust and accept care from.…”

“…The concept of CoCP, derived from Wenger’s (1998) community of practice model, encompasses various modes of effective engagement between health professionals and the patients they care for (Egan & Jaye, 2009). A defining characteristic of the effective CoCP is the centrality of the patient (Aiguier, Oboeuf, Cobbaut, & Vanpee, 2015; Carlson & Bengtsson, 2014; Lutfey, Campbell, Marceau, Roland, & McKinlay, 2012), and a common goal supported by a moral imperative of care (Young, Egan, et al, 2017). The other defining attributes of CoCP include membership defined by participation in the care of individual patients, legitimation of key lay supports, a vision of care based on each patient’s preferences and goals and shared among the core members, a distinctive praxis, and boundary markers that differentiate one CoCP from another such as membership and patient-specific goals (Egan & Jaye, 2009).…”