Organisation of Care and Services, HAN University of Applied Sciences, Nijmegen, The Netherlands
Organisation of Care and Services, HAN University of Applied Sciences, Nijmegen, The Netherlands.
BMJ Open. 2024 Sep 20;14(9):e085096. doi: 10.1136/bmjopen-2024-085096.
Insights about what actions contributed to the development of an interprofessional learning and working culture were lacking for nursing homes. This study aimed to provide insight into the context and actions that trigger mechanisms for the development of an interprofessional learning and working culture in nursing homes.
Realist evaluation action research was conducted from 2019 to 2023.
11 teams in 6 Dutch nursing homes.
Questionnaires, focus group interviews and observations were used to identify actions, context factors and mechanisms. We used retroductive analysis to discuss how actions were related to the development of the culture. Actions were evaluated in terms of context and manner in which they contribute to the development.
21 actions were identified and clustered into two themes. Theme 1: improving person-centred care. Actions activated the mechanisms of critical reflective behaviour and collective ownership in a context of, among other things, clear roles and tasks, a stable and competent team, the presence of case managers and facilitating organisational factors such as time for reflection. Theme 2: getting to know and understand each other's expertise. Actions activated respectful relationships, collective ownership of goals and feeling appreciated for your work in a context of, among other things, team members who meet regularly and management supporting interprofessional working.
This research sheds light on how and in what manner-specific actions contribute to the development of an interprofessional learning and working culture in nursing homes. Depending on the context, the actions triggered the following mechanisms: critical reflective behaviour, collective ownership of goals, respectful/caring relationships and feeling appreciated for your work. These mechanisms are the underlying drivers of an interprofessional learning and working culture. This study provides valuable guidance for fostering collaborative and effective interprofessional dynamics in nursing homes.
对于养老院而言，缺乏关于哪些行动有助于形成跨专业学习和工作文化的深入了解。本研究旨在深入了解触发养老院形成跨专业学习和工作文化的机制的背景和行动。
从 2019 年至 2023 年开展了真实评估行动研究。
6 家荷兰养老院的 11 个团队。
使用问卷、焦点小组访谈和观察来识别行动、背景因素和机制。我们使用回溯分析来讨论行动与文化发展之间的关系。根据对背景的影响和对发展的贡献程度来评估行动。
确定并聚类了 21 项行动，分为两个主题。主题 1：改善以患者为中心的护理。行动在明确的角色和任务、稳定且有能力的团队、病例经理的存在以及促进反思时间等因素的背景下，激活了关键反思行为和集体所有权的机制。主题 2：了解和理解彼此的专业知识。行动在团队成员定期开会和管理层支持跨专业工作等因素的背景下，激活了相互尊重的关系、共同的目标所有权和对工作的赞赏感。
本研究揭示了特定行动如何以及在何种程度上有助于养老院形成跨专业学习和工作文化。根据背景，行动触发了以下机制：关键反思行为、目标的集体所有权、相互尊重/关怀的关系和对工作的赞赏感。这些机制是跨专业学习和工作文化的潜在驱动力。本研究为促进养老院中协作和有效的跨专业动态提供了有价值的指导。
