Journal of Interprofessional Care最新文献

SBAR (Situation, Background, Assessment and Recommendation) is a structured method developed for communicating critical information that requires immediate action. In 2016 the SBAR tool was introduced at the Amalia Children's Hospital in the Netherlands to improve communication between healthcare workers. Despite formal training and the introduction of aids to facilitate implementation, observed adherence to the tool was low. A qualitative study was undertaken to study the use of SBAR by pediatric residents and nurses in the non-acute clinical care setting of an academic children's hospital. Semi-structured focus group sessions were conducted and qualitatively analyzed using a constructed coding template to search for facilitators and barriers in the use of SBAR by different professionals. We found professionals' use of SBAR was influenced by departmental, cultural, and individual factors. Important themes for effective implementation and use of SBAR in an interprofessional setting, like situation dependency, learning climate and professional identity had not been addressed during the initial implementation. To facilitate SBAR's use it is important to identify professionals' needs to use the tool effectively, to take into account how tasks and responsibilities are perceived by different professions, and to stimulate interprofessional feedback and role modeling.

Interprofessional care coordinators informally collaborate across sectors to facilitate care of patients with multimorbidity and social complexity, such as in the case of ill-housed persons at hospital discharge. The complexity of homeless patients demands research on cross-sector collaborative interventions like medical respite, a cross-sector transitional care model. Relational Coordination (RC) and exploratory social network analysis were used to assess the cross-sector collaboration of a medical respite network (N = 15 organizations), by comparing administrative (n = 20) and frontline care coordinator (n = 41) behavior. Five elements of cross-sector collaboration were measured: collaboration frequency, communication, relationships, coordinating mechanisms, and role attributes. Data were collected by semi-structured interviews and surveys; analyzed with UCINet and RC indexing. Collaboration across sectors was evident in all network organizations. Administrative representatives were more connected than frontline (cohesion 0.95; 0.77). Both showed weak RC scores (<3.5 out of 5.0), value on accurate communication, problem-solving communication, and shared goals. Organizations with coordinating mechanisms (shared meetings, contracts, etc.) showed higher centrality and RC scores. Our study suggests ties between administrative and frontline workers and coordinating mechanisms optimize cross-sector collaboration in interprofessional teams. Intraorganizational behavioral differences between administrators and frontline care coordination professionals denote the need for further research individual provider attribute (sector, role, education, licensure) impact.

National and international organizations are increasingly focused on interprofessional education in health-related fields to address complex and emerging health issues. One public health concern is the impact of adverse childhood experiences (ACEs). At one public university in Appalachia, faculty of nursing, public health, and social work collaborated to develop an interprofessional course at the undergraduate and graduate levels that focus on ACEs, trauma, and resiliency literature as well as interprofessional collaboration and evidence-based prevention and treatment. In this paper, the faculty detail the approach undertaken to develop this interprofessional course, lessons learnt and key resources.

Interprofessional collaboration among health professionals is increasingly recognized as best practice in assessing and supporting autistic children, however limited research has explored whether this collaboration is being practiced. This study explored parents' experiences of interprofessional collaboration between health professionals involved with the assessment and support of their autistic children. Seventeen parents of autistic children participated in semi-structured interviews exploring their unique experiences of health professional collaboration. Six themes were developed inductively using reflexive thematic analysis. Parents suggested that health professionals are taking a siloed and staggered approach to the assessment of autistic children. When providing support to autistic children, parents reported health professionals had variable understanding of others' roles, with minimal direct communication across practices, often limited by time and funding. The parents identified the importance of collaboration between the health professionals and school teachers, but identified several barriers to the implementation of supports in the school setting recommended by the health professionals. Overall, parents perceived themselves as their child's case manager, facilitating professionals' collaboration. This study's findings suggest the need for a review of systems and processes to better support interprofessional collaboration between health professionals, along with schools, in the assessment and support of autistic children.

Interprofessional collaboration is vital in the context of service delivery for children with physical disabilities. Despite the established importance of interprofessional collaboration and an increasing focus on research on this topic, there is no overview of the research. A scoping review was conducted to explore current knowledge on interprofessional collaboration for children with physical disabilities from the point of view of the actors involved. The steps of this review included identifying a research question, developing a protocol, identifying relevant research, selecting studies, summarizing and analyzing the data, and reporting and discussing the results. Through databases and studies from hand-searches, 4,688 records were screened. A total of 29 studies were included. We found that four themes: communication, knowledge, roles, and culture in interprofessional collaboration illustrate current knowledge on the topic. Interprofessional collaboration for children with physical disabilities is shown to be composed of these four themes, depending on the actors involved. Interprofessional collaboration is affected by how these four themes appear; they mainly act as barriers and, to a lesser extent, as facilitators for interprofessional collaboration. Whether and how the themes appear as facilitators need further exploration to support innovation of interprofessional collaboration.

Primary health care services are responsible for preventive measures to optimize child development in the first years of life. In Denmark, these services are shared between general practitioners and municipality health visitors. National guidelines mandate collaboration between these professionals but in reality, they work in parallel. We aimed to explore how professionals experience collaboration and communication regarding children with professional concern about their wellbeing. Seventeen semi-structured interviews were conducted with general practitioners, and health visitors. Both professions considered closer collaboration to be important in meeting children's needs. Barriers to collaboration and communication included differing legal obligations, Information Technology-systems (IT), lack of financial incentives, lack of mutual professional acknowledgment and respect, and absence of routines for sharing knowledge. The traditional division of responsibilities between physicians and nurses in which all professionals involved in preventive child health care are acculturated seems to impede collaboration based on unequal professional status. IT infrastructure needs to support information sharing and structures to support informal meetings between professionals are warranted to support more collaborative practice.

Interprofessional trust is essential for effective team-based care. Medical students are transient members of clinical teams during clerkship rotations and there may be limited focus on developing competency in interprofessional collaboration. Within a pediatric clerkship rotation, we developed a novel simulation activity involving an interprofessional conflict, aiming to foster trusting interprofessional relationships. Active participants included a nurse educator and a medical student participant, with additional students using a checklist to actively observe. The debrief focused on teaching points related to interprofessional competencies and conflict resolution. Students completed a written evaluation immediately following the simulation. Descriptive statistics were used to analyze Likert-type scale questions. Conventional content analysis was used to analyze open-ended responses. Two hundred and fourteen students participated in the simulation between June 2018-June 2019. Most students indicated that the simulation was effective (86%) and improved their confidence to constructively manage disagreements about patient care (88%). Students described anticipated changes in practice including developing their role on the interprofessional team as a medical student, developing a shared mental model, and establishing a shared goal. Our findings suggest that simulation-based learning may present an opportunity for developing interprofessional trust in academic health centers.

Healthcare services are accountable to their clients, communities, governments and funding sources to clearly demonstrate the effectiveness of interventions. A First Australian children's therapy service delivering culturally responsive, interprofessional collaborative practice aimed to evaluate their service. However, this process was constrained by available outcome measures which lacked the flexibility necessary for meaningful use within the dynamic and relational nature of their service delivery. This paper outlines an action research process in three cycles which was used to develop the Australian Therapies Outcome Measure for Indigenous Clients (ATOMIC) with the aim of evaluating therapy outcomes for urban First Australian children engaged in culturally responsive interprofessional therapy. Interrater reliability values of 0.995 and 0.982 were established for ATOMIC pre- and post-therapy measures, respectively, during a pilot phase involving 16 participants. Participants in the main study were 80 First Australian children aged two to 16 years who attended between two and nine interprofessional therapy sessions with occupational therapists and speech pathologists. Pre- and post-therapy ATOMIC scores confirmed progress on pre-determined functional goals across a range of skill domains. Outcomes of this study demonstrated that real gains are being made in urban First Australian children's lives following interprofessional collaborative service provision.

Early childhood caries (tooth decays) is a severe oral health condition that develops under the age of six. In many countries, oral health (including cavity treatment) is provided solely by dentists, who work independently. This organizational structure results in missed opportunities to prevent illnesses that occur throughout the child's health pathway, from birth and even before. The article aims to describe existing strategies for interprofessionality in pediatric oral health, as well as the obstacles and facilitators to their implementation. A scoping review was conducted on PubMed, Web of Science, Embase and Google Scholar between 2013 and 2025 to identify existing interprofessional collaboration strategies. Articles had to present a model of interprofessionality (oral health professional and other professionals), without being associated with a specific disease. Books, conferences or case reports were not included. The 10 articles included propose 3 major strategies such as the integration of dental hygienists into primary care. Others models focus on collaborative practice, with oral health training for healthcare professionals, recommendations or shared assessment tools. These collaborations sometimes go as far as the delegation of skills, if legislative support allow. Finally, new technologies can be used, such as telehealth and dental applications for assessing the risk of caries. The results were discussed in the light of D'Amour's interprofessional model of care, to identify the obstacles and facilitators of the different strategies with an operational aim (creation of a model applicable in France). Results highlight the need to set up a pediatric oral health network, that is sufficiently structured and focused on patients' interests to reduce social and territorial inequalities in oral health.

Meeting the needs of patients with substance use disorders (SUDs), complex comorbidity, and social determinants of poor health is challenging in traditional primary care environments. Interprofessional primary care (IPC) can better address these needs and may reduce acute care utilization and healthcare costs. We used a retrospective cohort study design (n = 994 patients) to compare healthcare utilization and costs 2 years before and after patients enrolled in an IPC model in the US Veterans Health Administration. Patients were grouped based on histories of high emergency department (ED) use, SUDs, homelessness, and combinations of these vulnerabilities. Generalized estimating equations (GEE) tested for differences in utilization and costs across groups. Following IPC enrollment, primary care visits and costs increased overall (adjusted increase = 2.90-7.24 visits/person-year; $1,032-$2,817/person-year). Among patients with prior high ED use, acute care costs declined; among patients without prior high ED use, acute care costs were mixed and ED use increased. Total costs decreased, were neutral, and increased for patients with 3, 1-2, and no vulnerabilities, respectively. Primary care engagement, reduced acute care, and limited cost increases suggest high value in this IPC model and highlight the need to further study IPC in addressing addiction and social determinants of poor health.