Wener Pamela, Leclair Leanne, Fricke Moni, Brown Cara
Department of Occupational Therapy, College of Rehabilitation Sciences, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
Department of Physical Therapy, College of Rehabilitation Sciences, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
Front Rehabil Sci. 2022 May 31;3:890001. doi: 10.3389/fresc.2022.890001. eCollection 2022.
Team-based care has been integrated into primary care (PC) across Canada because it improves patient safety, effectiveness, efficiency, person-centredness, and equity. However, this integration in and of itself may not lead to improved patient care without effective interpersonal relationships amongst team members. Currently, teams have few tools to guide the development of collaborative relationships. The Interprofessional Collaborative Relationship-building Model (ICRB) was developed to be a tool for understanding the stages of development of the interprofessional team's relationship-building.
This qualitative secondary data analysis illuminates a PC team's experiences of their developing interprofessional relationships with occupational therapists and physical therapists who joined the PC team.
Eleven team member interviews of one primary care team from a family medicine teaching clinic affiliated with a training university and the health region in central Canada were analyzed using secondary data analysis. The team included family physicians ( = 4), nurses ( = 2), a social worker ( = 1), a mental health counselor ( = 1), occupational therapists ( = 2), and a physical therapist ( = 1). We used the ICRB for directed content analysis using the phased approach that includes the three main steps of data preparation, data organization and data presentation.
This team experienced the ICRB stages of Looking For Help, Fitting-In, and Growing Reciprocity thereby learning about one another to better understand what OT and PT may bring to the PC setting. However, contrary to the ICRB, co-location, was the context within which the collaborative relationship-building took place rather than a distinct developmental stage. Although team members did experience some level of Growing Reciprocity, this developing team had not yet established collaborative leadership processes. As the ICRB originally posited, communication and patient focus facilitated all stages of the relationship-building process and helped the team develop shared values and role clarity that establish how different team members contribute to improving quality care.
The context of co-location with a patient focus and open communication facilitated the team's development with the occupational therapists and physical therapist. Collaborative leadership is a worthy goal for future research and clinical focus as it has implications for improving overall patient quality care and team member work satisfaction.
团队式护理已融入加拿大各地的初级保健(PC)中,因为它能提高患者安全性、有效性、效率、以患者为中心的程度和公平性。然而,若团队成员之间缺乏有效的人际关系,这种整合本身可能无法带来更好的患者护理。目前,团队几乎没有工具来指导合作关系的发展。跨专业合作关系建立模型(ICRB)旨在成为一种工具,用于理解跨专业团队关系建立的发展阶段。
这项定性二次数据分析阐明了一个初级保健团队与加入该初级保健团队的职业治疗师和物理治疗师发展跨专业关系的经历。
对来自加拿大中部一所与培训大学及健康区域相关联的家庭医学教学诊所的一个初级保健团队的11名团队成员访谈进行二次数据分析。该团队包括家庭医生(n = 4)、护士(n = 2)、一名社会工作者(n = 1)、一名心理健康顾问(n = 1)、职业治疗师(n = 2)和一名物理治疗师(n = 1)。我们使用ICRB通过分阶段方法进行定向内容分析,该方法包括数据准备、数据组织和数据呈现三个主要步骤。
该团队经历了ICRB的寻求帮助、融入和增强互惠阶段,从而相互了解,以便更好地理解职业治疗师和物理治疗师可能为初级保健环境带来什么。然而,与ICRB不同的是,同地办公是合作关系建立的背景,而不是一个独特的发展阶段。尽管团队成员确实经历了一定程度的增强互惠,但这个发展中的团队尚未建立合作领导流程。正如ICRB最初所假定的,沟通和以患者为重点促进了关系建立过程的所有阶段,并帮助团队形成了共同价值观和角色清晰度,从而确定了不同团队成员如何为提高护理质量做出贡献。
以患者为重点且开放沟通的同地办公环境促进了该团队与职业治疗师和物理治疗师的发展。合作领导是未来研究和临床关注的一个有价值的目标,因为它对提高整体患者护理质量和团队成员工作满意度有影响。