Christophers Lauren, Torok Zsofia, Trayer Aine, Hong George Chao-Chi, Carroll Aine
University College Dublin, Dublin, Ireland.
National Rehabilitation University Hospital, Dublin, Ireland.
BMC Health Serv Res. 2025 May 7;25(1):651. doi: 10.1186/s12913-025-12795-6.
This study aimed to qualitatively explore the experiences of healthcare professionals implementing changes (as change initiators) and operationalizing interdisciplinary teamwork in a rehabilitation service within the Irish healthcare system.
Data for this study were collected through focus group discussions with change initiators involved in interdisciplinary team initiatives at a rehabilitation service in Ireland.
A reflexive thematic analysis was employed to analyse the focus group data, which involved identifying patterns and themes within the narratives provided by participants.
Three overarching themes emerged from the analysis: 1. "Nature of the Battle for Change", 2. "Characteristics of the 'Status Quo' and Contradictions to IDT Working," and 3. "Power and Identity: Threats to Hierarchy and Status". These themes shed light on the challenges faced in implementing interdisciplinary teamwork, particularly the perceived threats to individual power and professional identity within hierarchical healthcare structures.
Implementing healthcare changes, especially in historically hierarchical healthcare systems is complex. Interdisciplinary team rehabilitation can challenge the status quo, posing adoption barriers. A nuanced, bottom-up approach is recommended, emphasizing long-term coalition building, continuous professional development, and early discussions about hierarchy and status. These recommendations offer practical guidance for stakeholders seeking to implement interdisciplinary, person-oriented approaches in rehabilitation practices, facilitating better anticipation and resolution of challenges, and ultimately improving care delivery and patient outcomes.
本研究旨在定性探索医疗保健专业人员在爱尔兰医疗系统内的康复服务中实施变革(作为变革发起者)和开展跨学科团队合作的经历。
本研究的数据通过与爱尔兰一家康复服务机构中参与跨学科团队倡议的变革发起者进行焦点小组讨论收集。
采用反思性主题分析法分析焦点小组数据,包括识别参与者叙述中的模式和主题。
分析得出三个总体主题:1. “变革斗争的本质”,2. “‘现状’的特征以及与跨学科团队工作的矛盾”,3. “权力与身份:对等级制度和地位的威胁”。这些主题揭示了实施跨学科团队合作所面临的挑战,尤其是在等级制医疗结构中对个人权力和职业身份的感知威胁。
实施医疗保健变革,尤其是在历史上等级分明的医疗系统中,是复杂的。跨学科团队康复可能会挑战现状,造成采用障碍。建议采用细致入微的自下而上的方法,强调长期联盟建设、持续专业发展以及关于等级制度和地位的早期讨论。这些建议为寻求在康复实践中实施跨学科、以人为本方法的利益相关者提供了实用指导,有助于更好地预见和解决挑战,并最终改善护理服务和患者结局。