Journal of Interprofessional Care最新文献

In response to the growing opioid epidemic in Fresno County, Central California, a virtual interprofessional workshop focusing on opioid misuse and overdose was developed and implemented for health professional providers and students in the local community. The purpose of the research was to evaluate if a four-hour virtual, synchronous interprofessional workshop influenced participants' knowledge and attitudes toward opioid overdose. A quantitative, quasi-experimental pre-post approach was used to evaluate the workshop. Participants attended a 4-hour online synchronous workshop focused on effectively responding to, engaging with, and educating individuals struggling with opioid misuse. The workshop significantly improved knowledge of and attitudes toward opioid overdose among health professional providers and students. The findings inform future curriculum development and enhancement of future virtual programs on how to efficiently train health professionals to approach an opioid overdose.

Despite the growing global emphasis on interprofessional education and collaborative practice (IPECP) in healthcare, ethical competence development remains underexplored. This article presents initial findings from an ongoing scoping review aimed at addressing two key questions: How does the existing literature describe the precursors of ethical conflict resolution in IPECP? What gaps in knowledge persist in this area? A search across eight electronic databases selected 27 eligible articles, which underwent thematic content analysis. The analysis identified eleven primary themes concerning the factors influencing interprofessional ethical conflict resolution and revealed a notable gap: insufficient strategies for integrating ethical competence and conflict resolution into the daily practices of healthcare professionals. While the literature stresses the importance of ethics education and training for students and professionals alike, there is a clear need for further exploration of effective frameworks tailored to IPECP contexts.

Partnerships are required in health and social care services to meet the increasingly complex needs of vulnerable populations. It is essential to assess these partnerships to ensure partners are supported as they strive to improve their practices. This qualitative study assessed the quality and development of the partnership of an integrated service centre for pregnant women and substance-abusing parents and their young children aged 5 and under. The data were gathered over a period of three years, by means of group and individual interviews. Twenty respondents (practitioners and managers) shared their perceptions of the interagency collaboration at the beginning, the midpoint and the end of the project funding period. Their responses were examined by means of thematic analysis. Conditions facilitating or hindering implementation of the partnership included (a) partners' participation and engagement; (b) nature of the project and its functioning (aspects of governance); (c) partners' joint work with families; and (d) social and political issues. The study highlights critical elements to consider for the development and success of a partnership project. Participants reported a number of barriers to effective collaboration; the main ones, the importance of thorough planning of project implementation, as well as the challenges relating to communication and shared leadership, are discussed.

There are many ways to account for the return on investment (ROI) in healthcare: improved communication, teamwork, culture, patient satisfaction, staff satisfaction, and clinical outcomes are but a few. Some of these are easier to quantify and associate to an intervention than others. What if the outcomes listed were not just independent results, but beget one another? In 2001, the Society of Obstetricians and Gynaecologists of Canada created the Managing Obstetrical Risk Efficiently (MORE^OB) programme, to improve healthcare culture and patient outcomes in obstetrics by leveraging front-line ownership. Our study provides evidence that MORE^OB lowers the frequency and cost of reportable events in maternity units. We sought to review the impact of this intervention on the frequency and cost of reportable events at the insurer level of a clinically focused, three-year interprofessional culture change intervention applied to the maternity unit. We compared the impact of reportable events both in the obstetrical and in the non-obstetrical areas of the same hospitals during the same time periods. We analysed these data using an interrupted time series (ITS) design, among 34 Ontario Canada hospitals. The ITS design assessed changes in the frequency and cost of reportable events before and after the implementation of the intervention. The method was ideally suited as the various maternity units had differing programme commencement and completion dates. The frequency of reportable events showed little change during the three-year intervention. As culture change grew, the changes in behaviour and processes that impact patient outcomes took longer to accrue. A large reduction in the frequency of reportable events occurred in the following three-year (14% reduction) and six-year (25% reduction) tranches. Our results show statistically significant reductions in the frequency and costs associated with reportable events at the level of an insurer. The results also give insight as to the investment of time required to achieve a level of sustainability.

Interprofessional collaboration optimizes maternal-newborn outcomes and satisfaction with care. Since 2002, midwives have provided an increasing proportion of maternity care in British Columbia (BC). Midwives often collaborate with and/or refer to physicians; but no study to date has explored Canadian medical trainees' exposure to, knowledge of, and attitudes towards midwifery practice.We designed an online cross-sectional questionnaire that included a scale to measure attitudes towards midwifery (13 items) and residents' knowledge of midwifery (94 items across 5 domains). A multi-disciplinary expert panel rated each item for importance, relevance, and clarity. The survey was distributed to family medicine (n = 338) and obstetric (n = 40) residents in BC.We analyzed responses from 114 residents. Residents with more favourable exposures to midwifery during their education had significantly more positive attitudes towards midwives (r_s = 0.32, p = 0.007). We also found a significant positive correlation between residents' attitudes towards midwifery and four of five knowledge domains: scope of practice (r_s = 0.41, p < 0.001); content of education (r_s = 0.30, p = 0.002), equipment midwives carry to home births (r_s = 0.30, p = 0.004) and tests that midwives can order (r_s = 0.39, p < 0.001). The most unfavourable exposures were observing interprofessional conversations (66.2%), and providing inpatient consultations for midwives (61.4%). Findings suggest increased interprofessional education may foster improved midwife-physician collaboration.Abbreviations: BC - British Columbia; UBC - University of British Columbia.

Shared leadership improves team performance in many domains and is present in some interprofessional healthcare teams. Despite the dominant paradigm of a singular obstetrician leader in maternity emergencies, co-leadership, a specific form of shared leadership, has been identified as a potentially beneficial to clinical care. This qualitative interview study addresses the gaps in knowledge regarding clinician attitudes toward co-leadership and how a co-leadership structure might be implemented within a maternity care setting. Twenty-five clinicians (midwives, obstetricians and anaesthetists) working in the birthing units of two tertiary maternity units were interviewed and a conventional content analysis conducted. Clinicians viewed co-leadership as potentially beneficial to patient care through improved leadership performance and co-leader back up behavior. Implementation of co-leadership was thought to require a supportive organizational culture, agreed patient management protocols and the participation in simulation training. Enacting co-leadership required adaptable leadership sharing practices, effective communication, and high levels of trust between the co-leaders. These findings inform the future implementation strategies for co-leadership in interprofessional healthcare teams.

Maternity policy in England has recommended the establishment of Community Hubs, where health-care professionals who care for women during and after pregnancy are co-located and can provide care collaboratively. The aim this paper is to explore midwives,' health visitors' and postnatal women's experiences and views of co-location of midwifery and health visiting services and collaborative practice. In total 15 midwives, 17 health visitors, and 29 mothers participated in a semi-structured interview, either via phone or face-to-face. Transcripts were analyzed thematically. Participants reported how care is currently provided in numerous settings, with home visits especially well liked. Co-location was perceived to be of benefit, however some mothers were not convinced of its necessity, suggesting that integrated services are more important than co-located services. Health-care professionals recognized that co-location aids but does not automatically improve interprofessional collaboration. These findings highlight the need for careful consideration before implementing co-located maternity services. Community Hubs may be apromising strategy to improve care for women and their families but to provide interprofessional care and collaboration appropriate managerial and organizational support is needed. With this support, midwives and health visitors have the potential to deliver the best care possible for women and their families.

'Vulnerable' is a term often used for pregnant women in need of extended antenatal care, although the term is not well defined. This study focuses on healthcare professionals' interpretations and understanding of vulnerability in pregnancy, including their own role, to understand the practices of interprofessional and intersectoral collaboration in antenatal care for vulnerable pregnant women. Intrepretive Description informed the methodology of the study and the theoretical framework was inspired by Symbolic Interactionism. It was found that definitions of vulnerability in pregnancy are fluid, being based on the healthcare professional's individual assessment of the pregnant woman´s personal resources, personal characteristics and psychological factors, and that these definitions also depend on the healthcare professional's role in relation to the pregnant woman. The different interprofessional teams' identification of what constitutes vulnerability in a pregnant woman was complex and relied on different components. Interprofessional collaboration was influenced by the relationships between professionals and sectors involved in antenatal care for pregnant women and was thereby influenced by the settings and structures in place for interprofessional and intersectoral collaboration. Insight into the healthcare professionals' perspectives of vulnerability in pregnancy can help develop and improve the interprofessional and intersectoral collaboration in antenatal care of vulnerable pregnant women and their unborn babies.

Interprofessional collaboration (IPC) is crucial for the safe provision of maternity care. However, IPC is poorly understood in the maternity care context, and the role of the childbearing woman within this collaboration remains unclear. The Labouring Together study used a mixed method, multi-site case study design to explore IPC and decision-making with women from the perspectives of maternity health care professionals (HCP). Case studies included a range of maternity models of care in metropolitan and regional settings in Australia. Cross-sectional surveys were used to investigate organizational context and HCPs' attitudes toward collaboration. Experiences and perceptions of collaboration and decision-making were explored using in-depth semi-structured interviews. A conceptual framework "Experience of collaboration: Working together to get the best outcomes" was formed from the interview findings, with major themes of "Organisation of care: working together for the organisation" and "Partnering in care: working together with women." Individual-level behaviors were employed by HCP to transcend interprofessional tensions relating to IPC. Entrenched organizational and policy-level barriers to effective IPC were identified; and whilst participants agreed that women should have autonomy with decision-making, most identified barriers at multiple levels to achieving this ideal.