Jungdal Anni, Tousig Charlotte Gad, Christiansen Tanja Kjærgaard, Birkelund Lisbeth, Sørensen Anette Nissen, Roskilde Jesper, Birkelund Regner
Department of Cardiology, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark.
Odense University Hospital - University of Southern Denmark, Odense, Denmark.
Scand J Caring Sci. 2024 Jun;38(2):378-386. doi: 10.1111/scs.13238. Epub 2024 Feb 4.
In health policy, much attention has been paid to collaboration between the primary and secondary health care sectors, especially in relation to hospitalisation and discharge. Despite ideal plans for collaboration, the research literature shows that inadequate communication is a well-known problem that can be a barrier to a safe trajectory for the citizen. Based on the assumption that better knowledge of each other's work will lead to better collaboration, a cross-sectoral exchange program with nurses was initiated.
The aim was to investigate which barriers to good patient trajectories the involved nurses attributed to cross-sectoral collaboration and what impact the exchange to the opposite sector had for them.
Twenty-eight nurses were exchanged: 14 from a cardiology department and 14 from municipal home care. The nurses shadowed a colleague from the opposite sector in their daily work. Subsequently, six focus group interviews were conducted. The transcribed material was analysed based on Ricoeur's interpretation theory.
Two main themes, including sub-themes emerged: (1) Challenging communicative conditions: (a) Inadequate digital communication, (b) Inadequate care plans and discharge reports, (c) Conversation promotes understanding, and (d) Challenging collaboration and communication with the discharge coordinators. (2) Perceived importance of the exchange: (a) Cross-sectoral relationship, prejudice and gaining respect for each other and (b) Working in two different worlds.
Electronic communication is inadequate, and the IT systems do not support sufficient cross-sectoral communication. The organisational model in the municipal care sector is inflexible in terms of allocations for the current needs of citizens, and professionals feel that their professional judgements are not recognised. The nurses gained insight into each other's work and working conditions and respect for each other's professionalism. The exchange has the potential to both improve the relationship and communication between the sectors for the benefit of a better and more coherent patient course.
在卫生政策中，初级和二级卫生保健部门之间的合作备受关注，尤其是在住院和出院方面。尽管有理想的合作计划，但研究文献表明，沟通不足是一个众所周知的问题，可能成为公民安全就医轨迹的障碍。基于相互更好地了解对方工作将带来更好合作的假设，启动了一项与护士开展的跨部门交流计划。
旨在调查参与的护士认为跨部门合作对良好患者就医轨迹存在哪些障碍，以及到对方部门交流对他们有何影响。
交换了28名护士：14名来自心脏病科，14名来自市政家庭护理机构。护士们在日常工作中跟随对方部门的一位同事进行观察。随后进行了六次焦点小组访谈。根据利科的解释理论对转录材料进行了分析。
出现了两个主要主题及子主题：（1）具有挑战性的沟通条件：（a）数字通信不足，（b）护理计划和出院报告不完善，（c）对话促进理解，（d）与出院协调员的合作及沟通具有挑战性。（2）交流的感知重要性：（a）跨部门关系、偏见以及相互尊重，（b）在两个不同的世界工作。
电子通信不足，信息系统不支持充分的跨部门沟通。市政护理部门的组织模式在满足公民当前需求的资源分配方面缺乏灵活性，专业人员觉得他们的专业判断未得到认可。护士们深入了解了彼此的工作和工作条件，并相互尊重对方的专业素养。这种交流有潜力改善部门之间的关系和沟通，以实现更好、更连贯的患者就医过程。
