Journal of Interprofessional Care最新文献

The challenges to sustaining interprofessional education (IPE) are numerous and well-documented. These challenges include crowded curricula, scheduling conflicts, lack of physical space, faculty availability, and financial considerations. In turn, IPE is often viewed and treated as an add-on rather than an integral part of healthcare education, leading to sporadic implementation and vulnerability to institutional changes. The concept of eLearning, utilizing electronic technologies for education, emerges as a potential solution to these challenges and could serve as the "next frontier" for IPE. eLearning offers a flexible and scalable platform to deliver IPE, transcending geographical and time constraints. Recent research highlights the benefits of eLearning-based IPE, including enhanced collaboration, learner satisfaction, and clinical application. eLearning allows learners to engage in virtual simulations, reflexive exercises, and collaborative problem-solving, fostering essential skills for future healthcare teams. Interprofessional eLearning courses can seamlessly integrate into existing health professions curricula, catering to busy professionals and students. Most importantly, eLearning promotes consistent and purposeful embedding of interprofessional values and competencies throughout education, training, and professional development. In this Short Report, we utilize the Center for Advancing Interprofessional Practice, Education, and Research (CAIPER) at Arizona State University as a rudimentary "critical instance" case study for advancing and sustaining IPE through eLearning program development. CAIPER exemplifies this approach by constructing engaging evidence-based eLearning IPE courses ranging from examining and applying interprofessionalism in primary care to empathy and humility team-based training. CAIPER's eLearning courses have reached a global audience of over 65,000 learners highlighting the reach, impact, and viability of eLearning for sustainable IPE. Although further research is needed, eLearning presents a promising solution to the systemic challenges of IPE, and by embracing eLearning and embedding interprofessional eLearning courses in existing curricula, institutions can ensure the consistent, accessible, and sustainable delivery of high-quality IPE experiences.

In many healthcare settings, teams change composition regularly, so healthcare students must be trained to function effectively in dynamic teams before entering the workforce. Interprofessional clinical rotations provide an ideal venue for learners to practice these skills, but little is known about how student teams interact in such settings. In this qualitative observational evaluation, learners from multiple health professions at a single institution participated in scheduled clinics in low-income housing communities for older adults. Interprofessional student teams met with program participants for care coordination, health and wellness assessments, and assistance in setting and achieving health goals; team composition changed from week-to-week. A purposive sample was selected from video-recorded encounters between student teams and their program participants. The aim of this study was to explore team interactions and document learner behaviors. Two researchers independently reviewed discrete segments of each video, recorded their observations and reflections, and then the team discussed, categorized, and identified relevant examples of both effective and ineffective behaviors. Four major themes were observed: inclusiveness, leadership, joy of practice, and sharing of clinical knowledge. Students demonstrated both positive and negative examples of behaviors that aligned with each theme. Understanding how students behave on teams in dynamic settings where patient care is taking place can help educators establish practice-based interprofessional education models that better prepare learners to function effectively and strategies that may improve team interactions.

Effective interprofessional team function is integral to high-quality care in the intensive care unit (ICU). However, little is known about how familiarity develops among teams, which may be an important antecedent to effective team function and quality care. To examine team familiarity and how it impacts ICU team function and care, we conducted an ethnographic study in four ICUs (two medical ICUs, one mixed medical-surgical ICU, and one surgical ICU) in two community hospitals and one academic medical center. We conducted 57.5 h of observation, 26 shadowing experiences, and 26 interviews across the four ICUs sequentially. We used thematic analysis to examine familiarity among the team. We found that ICU team members become familiar with their team through interpersonal, relational interactions, which involved communication, time working together, social interactions, trust, and respect. Our findings underscore the relational aspect of effective teams and demonstrate that time working together, social interactions, communication, developing trust, and respect are pathways to familiarity and optimal team function. Leveraging unique and creative ways to enhance the relational aspects of ICU teams could be an area for future research and lead to improved ICU outcomes.

Improving teamwork among mental health practitioners is crucial. However, there have been few intervention studies on teamwork enhancement among community mental health practitioners in South Korea. We aimed to determine the effectiveness of the Team Building Circle program (TBC) based on the restorative justice paradigm, which sought to promote integration and cohesion. The TBC was developed to improve conflict interpretation mind-set, interpersonal skills, and teamwork among practitioners in community mental health centers. We conducted a quasi-experimental study using a pre and posttest design with a non-equivalent control group. The participants were 44 practitioners from four community mental health centers. Data were collected before the implementation TBC (pretest), just after (posttest), and 3 months after TBC (follow-up test). A generalized estimating equation model was used for analysis. Our findings indicate that the intervention group had improved scores in the ability to cope with interpersonal stress in a constructive way, interpersonal relationship skills, and teamwork compared to the control group. To improve teamwork among community mental health practitioners, managers are encouraged to consider providing TBC intervention.

Collaboration among healthcare providers is regarded as a promising method to improve care quality and patient outcomes with limited human and financial resources. In Norway, "hospital-at-home" refers to care given by teams from the hospital pediatric wards who provide treatment and care in the family's home. When children need home visits multiple times daily, the hospital-at-home often reaches out to municipality healthcare providers, asking them to share this task. We aimed to explore the collaboration between stakeholders to gain knowledge on matters concerning the transfer of pediatric competence between hospital and home-based care, and to gain insight into how to set up the service for children in the future. We conducted three focus group interviews. The results showed that managing hospital-at-home collaboratively came with various challenges concerning unclear responsibilities between hospitals and homecare services and several obstacles to setting up cooperation across service levels. Thus, positive collaboration experiences between hospital and homecare settings were shared. Formalizing this collaboration was considered important for future collaboration. Building competence and learning from and with each other ensures better conditions for success if the collaboration is organized and facilitated through agreements between the hospital and the municipalities.

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.

Team climate and attributes of primary healthcare (PHC) are key elements for collaborative practice. Few researchers have explored the relationship between team climate and patients' perceptions of PHC. This study aimed to assess the association between team climate and patients' perceptions of primary healthcare attributes. A quantitative approach was adopted. In Stage 1, Team climate was assessed using Team Climate Inventory in 118 Family Health Strategy (FHS) teams at a PHC setting. In Stage 2, Patients' perceptions of PHC attributes were assessed using the Primary Care Assessment Tool (PCATool) in a sample of 844 patients enrolled in teams studied in Stage 1. Cluster analysis was used to identify team climate groups. The analysis used multilevel linear regression models. Patients assigned to teams with the highest team climate scores had the highest PHC attributes scores. Patients who reported affiliation at the team level had the highest PCATool scores overall. They also scored higher on the attributes of comprehensiveness and coordinated care compared to patients with affiliation to the health unit. In conclusion, patients under the care of FHS teams exhibiting a more favorable team climate had more positive patient perceptions of PHC attributes.

Poor communication within healthcare teams occurs commonly, contributing to inefficiency, medical errors, conflict, and other adverse outcomes. Interprofessional bedside rounds (IBR) are a promising model that brings two or more health professions together with patients and families as part of a consistent, team-based routine to share information and collaboratively arrive at a daily plan of care. The purpose of this systematic scoping review was to investigate the breadth and quality of IBR literature to identify and describe gaps and opportunities for future research. We followed an adapted Arksey and O'Malley Framework and PRISMA scoping review guidelines. PubMed, CINAHL, PsycINFO, and Embase were systematically searched for key IBR words and concepts through June 2020. Seventy-nine articles met inclusion criteria and underwent data abstraction. Study quality was assessed using the Mixed Methods Assessment Tool. Publications in this field have increased since 2014, and the majority of studies reported positive impacts of IBR implementation across an array of team, patient, and care quality/delivery outcomes. Despite the preponderance of positive findings, great heterogeneity, and a reliance on quantitative non-randomized study designs remain in the extant research. A growing number of interventions to improve safety, quality, and care experiences in hospital settings focus on redesigning daily inpatient rounds. Limited information on IBR characteristics and implementation strategies coupled with widespread variation in terminology, study quality, and design create challenges in assessing the effectiveness of models of rounds and optimal implementation strategies. This scoping review highlights the need for additional studies of rounding models, implementation strategies, and outcomes that facilitate comparative research.

The lack of a proper system for ongoing open interprofessional communication among care providers increases miscommunications and medical errors. Seamless access to patient information is important for care providers to prevent miscommunication and improve patient safety. A shared understanding of the information needs of different care providers in an interprofessional team is lacking. Our purpose is to identify care providers' information needs from the perspective of different professions for communication, shared understanding about the patient, and decision-making. We conducted semi-structured interviews with 10 subject matter experts representing eight professions, including dentistry, dietetics, medicine, nursing, occupational therapy, pharmacy, physical therapy, and social work in a 465-bed academic hospital at a large urban Midwestern city. We used an in-house rounding tool presenting physicians' information needs and a hypothetical patient scenario to collect participants' feedback. Interview notes were coded using direct content analysis. We identified 22 additional essential data elements for an interprofessional rounding tool. We categorized those into six domains: discharge-related, social determinants of health, hospital safety, nutrition, interprofessional situation awareness, and patient history. A well-designed validated rounding tool that includes an interprofessional team of care providers' information needs could improve communication, care planning, and decision-making among them.