Institute for Education and Training, Amsterdam Universities Medical Centres location University of Amsterdam, Meibergdreef 15, 1105 AZ, Amsterdam, The Netherlands.
Emma Children's Hospital, Amsterdam Universities Medical Centres location University of Amsterdam, Meibergdreef 15, 1105 AZ, Amsterdam, The Netherlands.
BMC Med Educ. 2024 Mar 25;24(1):334. doi: 10.1186/s12909-024-05304-6.
In the context of increasingly intricate healthcare systems, professionals are compelled to collaborate within dynamically changing interprofessional teams. Moreover, they must adapt these collaborative processes to effectively and efficiently manage the evolving complexity of care needs. It remains unclear how professionals determine care complexity and relate this complexity to their preferences for interprofessional collaboration (IPC). This study investigated the relationships between care complexity, professionals' perceived complexity and IPC preferences, and examined the variation in individual and team characteristics of IPC-practices across different levels of complexity in paediatric care.
In an online questionnaire, 123 healthcare professionals working at an academic tertiary children's hospital scored their perceptions of complexity and preferences for IPC. They also selected family and various professions as members of the interprofessional (IP-) team based on thirteen patient cases. We employed conjoint analysis to systematically model the complexity of case descriptions across the five domains of the International Classification of Functioning, Disability and Health (ICF). Additionally, we applied social network analysis to identify important professions, crucial connectors and influential professions in the IP-team, and to describe the cohesiveness of IP-teams.
Modelled case complexity, professionals' perceived complexity and IPC preferences were positively associated. We found large inter-individual variations in the degree of these associations. Social network analysis revealed that the importance and influence of professions was more equally distributed when case complexity increased. Depending on the context and complexity of the case, different professions (e.g. medical doctors, social professionals, extramural professionals) were considered to be more crucial connectors within the IP-team. Furthermore, team cohesion was positively associated with modelled and perceived care complexity.
In conclusion, our study contributes to the existing knowledge by integrating task-specific insights and broadening the use of conjoint and social network analysis in the context of IPC. The findings substantiate the contingency theory that relates characteristics of IPC to care complexity, offering quantified insights into how IP-teams adapt to situational needs. This understanding of relationships and variations within IPC holds crucial implications for designing targeted interventions in both clinical and health profession education contexts. Consequently, it contributes to advancements in healthcare systems.
在日益复杂的医疗保健系统中，专业人员必须在动态变化的跨专业团队中协作。此外，他们必须调整这些协作流程，以有效和高效地管理不断变化的护理需求的复杂性。目前尚不清楚专业人员如何确定护理复杂性，并将这种复杂性与他们对跨专业协作（IPC）的偏好联系起来。本研究调查了护理复杂性、专业人员感知的复杂性和 IPC 偏好之间的关系，并研究了在儿科护理的不同复杂性水平下，个体和团队 IPC 实践特征的变化。
在一项在线问卷调查中，123 名在学术性三级儿童医院工作的医疗保健专业人员对他们对复杂性的感知和对 IPC 的偏好进行了评分。他们还根据 13 个患者病例选择了家庭和各种专业人员作为跨专业（IP）团队的成员。我们采用联合分析系统地对国际功能、残疾和健康分类（ICF）五个领域的病例描述的复杂性进行建模。此外，我们应用社会网络分析来确定 IP 团队中重要的专业人员、关键的连接器和有影响力的专业人员，并描述 IP 团队的凝聚力。
建模后的病例复杂性、专业人员感知的复杂性和 IPC 偏好呈正相关。我们发现这些关联的个体间差异很大。社会网络分析表明，当病例复杂性增加时，专业人员的重要性和影响力分布更加均衡。根据情况和病例的复杂性，不同的专业人员（例如医生、社会专业人员、校外专业人员）被认为是 IP 团队中更关键的连接器。此外，团队凝聚力与建模后的护理复杂性和感知的护理复杂性呈正相关。
总之，我们的研究通过整合特定任务的见解并拓宽联合分析和社会网络分析在 IPC 背景下的应用，为现有知识做出了贡献。研究结果证实了与护理复杂性相关的 IPC 特征的权变理论，为如何使 IP 团队适应情境需求提供了量化的见解。对 IPC 中关系和变化的这种理解对设计临床和卫生专业教育背景下的有针对性的干预措施具有重要意义。因此，它为医疗保健系统的发展做出了贡献。
