‘Trying to patch a broken system’: Exploring institutional work among care professions for interprofessional collaboration

IF 2 Q3 MANAGEMENT Journal of Professions and Organization Pub Date : 2024-01-18 DOI:10.1093/jpo/joad027
Andreas Nielsen Hald, Mickael Bech, Ulrika Enemark, Jay Shaw, Viola Burau
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Abstract

There is a growing interest in understanding when and why interprofessional collaborations are well functioning, especially within healthcare systems. However, more knowledge is needed about how professionals affect and contribute to these collaborations when they engage in them. To address this shortcoming, this study aims to contribute to professional and organizational studies of interprofessional collaboration by providing novel insights into how professionals engage in and contribute to interprofessional collaborations. It builds on a theoretical perspective of examining professionals’ everyday collaboration practices through the interplay between temporal-oriented agency and institutional work. It applies this perspective to a case study of interprofessional collaboration between personal workers (PWs), nurses, and therapists in the home care sector in Denmark. Overall, the findings show that the professionals engaged in and contributed to the interprofessional collaboration by ‘trying to patch a broken system’. All three professional groups did this primarily by ‘adopting new practices to deal with inept institutionalized practices’ to maintain collaboration. Additionally, some PWs ‘failed to enact institutionalized practices’ to disrupt the collaboration, and some nurses and therapists ‘invented and established mechanisms’ to create new arrangements for the collaboration. Based on the findings, the study demonstrates that certain dimensions of agency are associated with certain types of institutional work. Furthermore, the study suggests that the interplay between agency and institutional work varies between professional groups, influenced by their relative autonomy.
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试图修补破损的系统":探索护理专业之间的机构工作,促进专业间合作
人们越来越有兴趣了解跨专业合作何时以及为何能够良好运作,尤其是在医疗保健系统内。然而,对于专业人员在参与合作时如何影响和促进这些合作,我们还需要更多的了解。为了弥补这一不足,本研究旨在通过对专业人员如何参与和促进跨专业合作提供新的见解,为跨专业合作的专业和组织研究做出贡献。本研究基于一种理论视角,即通过时间导向的代理和机构工作之间的相互作用来研究专业人员的日常合作实践。它将这一视角应用于丹麦家庭护理行业中个人工作者(PW)、护士和治疗师之间跨专业合作的案例研究。总体而言,研究结果表明,专业人员通过 "努力修补破损的系统 "参与并促进了跨专业合作。所有三个专业群体都主要通过'采用新的做法来应对无能的制度化做法'来维持合作。此外,一些公共工程人员 "没有采用制度化的做法 "来破坏合作,而一些护士和治疗师则 "发明并建立了机制 "来为合作做出新的安排。研究结果表明,代理的某些方面与某些类型的机构工作有关。此外,研究还表明,代理与机构工作之间的相互作用因专业群体的相对自主性而异。
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来源期刊
CiteScore
4.80
自引率
36.40%
发文量
14
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