Koldeweij Roeyel J F, Lovink Marleen H, Persoon Anke
Department of Quality Improvement, Streekziekenhuis Koningin Beatrix, Winterswijk, The Netherlands.
Department of Primary Care, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
BMJ Open Qual. 2025 Jun 15;14(2):e003147. doi: 10.1136/bmjoq-2024-003147.
Interprofessional collaboration became more firmly positioned after the WHO highlighted its importance for better healthcare outcomes. In nursing homes, interprofessional collaboration refers to collaboration between teams of physicians/allied health professionals and care teams. Collaboration within care teams is known as intraprofessional collaboration. Determinants of interprofessional and intraprofessional collaboration have yet to be explored within the nursing-home context. Our exploratory qualitative study focused on the determinants considered important by professionals in seven nursing homes. We conducted 14 one-on-one, semistructured interviews with nurses and collaborating physicians/allied health professionals from seven teams of one care organisation. Data were analysed on thematic analysis, proceeding from an inductive approach. Five interacting determinants were identified. The core determinant was 'investing in each other', followed by 'roles, functions and responsibilities within care teams'; 'written policies for individual residents'; 'verbal coordination meetings'; and 'organisational influences'. One notable finding is the influence of intraprofessional collaboration within the care team on all determinants of interprofessional collaboration, including the role of the coordinating nurse. Future ethnographic and action research on intraprofessional collaboration is needed, including the perspective of nurse assistants, as well as on interventions aimed at improving interprofessional collaboration. We recommend training professionals to invest in each other as a skill that encourages relationships.
在世卫组织强调跨专业协作对改善医疗保健结果的重要性之后，它的地位变得更加稳固。在养老院中，跨专业协作是指医生/专职医疗专业人员团队与护理团队之间的协作。护理团队内部的协作被称为专业内协作。在养老院环境中，跨专业和专业内协作的决定因素尚未得到探索。我们的探索性定性研究聚焦于七家养老院中专业人员认为重要的决定因素。我们对来自一个护理机构的七个团队的护士以及协作医生/专职医疗专业人员进行了14次一对一的半结构化访谈。数据采用归纳法进行主题分析。确定了五个相互作用的决定因素。核心决定因素是“相互投入”，其次是“护理团队中的角色、职能和职责”；“针对个体居民的书面政策”；“口头协调会议”；以及“组织影响”。一个值得注意的发现是护理团队内部的专业内协作对跨专业协作的所有决定因素的影响，包括协调护士的角色。未来需要对专业内协作进行人种志和行动研究，包括护士助理的视角，以及针对改善跨专业协作的干预措施。我们建议培训专业人员将相互投入作为一种促进关系的技能。
