Abstract
Objective: To understand the factors that enable/inhibit Interprofessional Collaboration (IPC) using a theoretical framework.
Background: IPC improves patient care and outcomes; the assumption is that interprofessional education (IPE) leads to IPC. The literature however shows that atheoretical IPE models focusing only on educational activities may not engender IPC due to IPC-inhibiting factors. We selected Bronfenbrenner’s ecological systems theory for its multi-system approach to understanding IPC enablers/inhibitors.
Design/Methods: Our ongoing study at National Neuroscience Institute (NNI) using a qualitative research design began in May 2019. We observed healthcare professionals’ (HCP) interactions; we interviewed some of them using purposive sampling. All interviews were audio-recorded and transcribed. Thematic analysis was conducted and findings triangulated with observation memos and notes. Ethics approval was obtained.
Results: We observed 52 hours of interactions among patient service associates (PSA,n=4), allied health professionals (AHP,n=7), nurses (n=10) and doctors (n=39) in inpatient and outpatient settings. We interviewed 16 participants (PSAs,n=2; nurses,n=5; doctors,n=9) totaling 19.5 hours. To describe the ecology that enables healthcare professionals to engage in IPC, we applied Bronfenbrenner’s ecological systems theory. Analysis showed that a crucial factor for IPC efforts was leadership. For doctor-led teams, when doctors were respectful and collegial with their non-medical HCP team members, patients and their family trusted the non-medical HCP more. Non-medical HCPs thus contributed more actively to patient care. For the Institution, leadership support providing structure was crucial. Examples included institutional policies giving prescribing rights to non-medical HCPs, or policies providing protected time for non-medical HCPs to participate in IPC activities. Using Bronfenbrenner’s theory, we identified factors at the meso- and macrosystem levels which influenced IPC.
Conclusions: Bronfenbrenner’s ecological system theory is a useful framework that allows a comprehensive theoretically-grounded understanding of factors that enable/inhibit IPC.
Disclosure: Dr. Tan has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Novartis, Merck, UCB, Sanofi Genzyme and Eisai.Dr. Tan has nothing to disclose. Dr. Rao has nothing to disclose. Dr. Foo has nothing to disclose.
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