Karam Marlène, Tricas-Sauras Sandra, Darras Elisabeth, Macq Jean
Catholic University of Louvain, BE.
Int J Integr Care. 2017 Oct 2;17(4):9. doi: 10.5334/ijic.2520.
This study aimed to assess interprofessional collaboration between general physicians and emergency departments in the French speaking regions of Belgium. Eight group interviews were conducted both in rural and urban areas, including in Brussels. Findings showed that the relational components of collaboration, which are highly valued by individuals involved, comprise mutual acquaintanceship and trust, shared power and objectives. The organizational components of collaboration included out-of-hours services, role clarification, leadership and overall environment. Communication and patient's role were also found to be key elements in enhancing or hindering collaboration across these two levels of care. Relationships between general physicians and emergency departments' teams were tightly linked to organizational factors and the general macro-environment. Health system regulation did not appear to play a significant role in promoting collaboration between actors. A better role clarification is needed in order to foster multidisciplinary team coordination for a more efficient patient management. Finally, economic power and private practice impeded interprofessional collaboration between the care teams. In conclusion, many challenges need to be addressed for achievement of a better collaboration and more efficient integration. Not only should integration policies aim at reinforcing the role of general physicians as gatekeepers, also they should target patients' awareness and empowerment.
本研究旨在评估比利时法语区全科医生与急诊科之间的跨专业协作。在农村和城市地区（包括布鲁塞尔）进行了八次小组访谈。研究结果表明，协作的关系要素受到相关人员的高度重视，包括相互认识和信任、共享权力和目标。协作的组织要素包括非工作时间服务、角色明确、领导力和整体环境。沟通和患者的角色也是影响这两个护理层面协作加强或受阻的关键因素。全科医生与急诊科团队之间的关系与组织因素和总体宏观环境紧密相连。卫生系统监管似乎在促进行为主体之间的协作方面未发挥重要作用。为了促进多学科团队协调以实现更高效的患者管理，需要更好地明确角色。最后，经济实力和私人执业阻碍了护理团队之间的跨专业协作。总之，要实现更好的协作和更高效的整合，需要应对许多挑战。整合政策不仅应旨在加强全科医生作为守门人的作用，还应提高患者的意识并增强其能力。
