What's so great about rehabilitation teams? An ethnographic study of interprofessional collaboration in a rehabilitation unit.

OBJECTIVE

To explore team structures, team relationships, and organizational culture constituting interprofessional collaboration (IPC) in a particular rehabilitation setting; to develop a description of IPC practice that may be translated, adapted, and operationalized in other clinical environments.

DESIGN

An ethnographic study involving: Field observations: 40 hours, over 4 weeks, daily activities, 7 interprofessional meetings, 3 care planning meetings, 1 business meeting, and 3 family meetings; Individual observations: a physiotherapist, an occupational therapist, and a social worker individually observed for 45 minutes to an hour; and Interviews: 19 participants, 11 professions, 27 informal, 5 formal interviews. Data analysis consisted of an iterative process involving coding field notes for themes by 3 members of the research team by qualitative analysis software.

SETTING

Single inpatient spinal cord rehabilitation care unit in a Canadian urban academic rehabilitation hospital.

PARTICIPANTS

Purposive convenience sample of core team, more than 40 professionals: physiatrist, over 21 nurses, 3 physiotherapists, 3 occupational therapists, 2 social workers, chaplain, psychologist, therapeutic recreationist, program assistant, program manager, pharmacist, advanced practice leader, 6 students (1 pharmacy, 4 registered nurse, and 1 psychology), and on-site community organizations. After university and hospital ethical approvals, all staff members were recruited to participate in the study.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Not applicable.

RESULTS

Recurrent examples of IPC fit 2 dominant themes: team culture (divided into leadership, care philosophy, relationships, and the context of practice) and communication structures (both formal and informal).

CONCLUSIONS

IPC practice in rehabilitation care is supported by clinical, cultural, and organizational factors. This understanding of daily IPC work may guide initiatives to promote IPC in other clinical team settings.