Professional differences in interprofessional working

Academic Unit of Child Health, University of Sheffield, PGME Stephenson Unit, Western Bank, Sheffield, UK.
Journal of Interprofessional Care (Impact Factor: 1.4). 07/2008; 22(3):239-51. DOI: 10.1080/13561820802054655
Source: PubMed

ABSTRACT UK government policy is encouraging healthcare staff to blur traditional roles, in the drive to increase joint working between practitioners. However, there is currently a lack of clarity regarding the impact that changes to traditional working practice might have on staff delivering the services, or on patient care. In this article, we report findings from three qualitative case studies examining interprofessional practice in stroke care, in which the influence of professional differences emerged as a significant theme. We draw on findings from individual semi-structured interviews, as well as fieldwork observations, to describe the influence of professional knowledge and skills, role and identity, and power and status considerations in interprofessional working. The insights that were gained contribute to the understanding of how professional differences impact on healthcare staff joint working, and suggest that the elements identified need to be fully considered in drives towards changed working practice.

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Available from: Shelagh M Brumfitt, Jul 22, 2014
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    • "219). Interprofessional collaboration is affected by factors including limited time for teambuilding, confused team roles, the effects of professional socialization, differences in professional authority and vertical management of professionals (Baxter & Brumfitt, 2008; Engestrom, Engestrom, & Vahaaho, 1999; Reeves & Lewin, 2004). Much of the literature on these issues stems from core concepts within the sociology of professions, such as clinical autonomy, which serve to explain the way in which the division of labour within healthcare has been created and operates through a set of complex historical, cultural and structural processes (Freidson, 1970; Willis, 1983). "
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    ABSTRACT: The rapid response system (RRS) is a patient safety initiative instituted to enable healthcare professionals to promptly access help when a patient’s status deteriorates. Despite patients meeting the criteria, up to one-third of the RRS cases that should be activated are not called, constituting a ‘‘missed RRS call’’. Using a case study approach, 10 focus groups of senior and junior nurses and physicians across four hospitals in Australia were conducted to gain greater insight into the social, professional and cultural factors that mediate the usage of the RRS. Participants’ experiences with the RRS were explored from an interprofessional and collective competence perspective. Health professionals’ reasons for not activating the RRS included: distinct intraprofessional clinical decision-making pathways; a highly hierarchical pathway in nursing, and a more autonomous pathway in medicine; and interprofessional communication barriers between nursing and medicine when deciding to make and actually making a RRS call. Participants also characterized the RRS as a work-around tool that is utilized when health professionals encounter problematic interprofessional communication. The results can be conceptualized as a form of collective incompetence that have important implications for the design and implementation of interprofessional patient safety initiatives, such as the RRS.
    Journal of Interprofessional Care 11/2014; Early Online: 1–7(4). DOI:10.3109/13561820.2014.984021 · 1.40 Impact Factor
    • "Hammick, Freeth, Koppel, Reeves and Barr (2007) report that although IPE is generally well received and facilitates collaborative working from a theoretical perspective, it does not always have a positive influence on attitudes towards and perceptions of other team members in the clinical environment. Both professional tribalism and individual philosophies may negatively influence collaborative team practice (Freeman et al., 2000; Baxter and Brumfitt, 2008). Professional tribalism, whereby different health professions may hold differing values and attitudes, has developed as professions have evolved separately from each other. "
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    ABSTRACT: Globally it has been suggested that interprofessional education can lead to improvements in patient safety as well as increased job satisfaction and understanding of professional roles and responsibilities. In many health care facilities staff report being committed to working collaboratively, however their practice does not always reflect their voiced ideologies. The inability to work effectively together can, in some measure, be attributed to a lack of knowledge and respect for others’ professional roles, status and boundaries. In this paper, we will report on the findings of an interpretative study undertaken in Australia, focusing specifically on the experiences of new graduate nurses, doctors and pharmacists in relation to ‘knowing about’ and ‘working with’ other health care professionals. Findings indicated there was little understanding of the roles of other health professionals and this impacted negatively on communication and collaboration between and within disciplines. Furthermore, most new graduates recall interprofessional education as intermittent, largely optional, non-assessable, and of little value in relation to their roles, responsibilities and practice as graduate health professionals. Interprofessional education needs to be integrated into undergraduate health programs with an underlying philosophy of reciprocity, respect and role valuing, in order to achieve the proposed benefits for staff and patients.
    Nurse Education in Practice 06/2014; 14(5). DOI:10.1016/j.nepr.2014.06.005
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    • "Although some researchers share their application of particular methodologies such as case study (Baxter & Brumfitt, 2008; McDonald et al., 2012), ethnography (Reeves et al., 2009b) or grounded theory (Baggs & Schmitt, 1997), the vast majority of studies are descriptive, lack conceptual or thematic renderings of data and do not identify a particular qualitative approach. Adding to the lack of clarity about methodology, some authors use the terms methods and methodology interchangeably. "
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    ABSTRACT: Increasingly, researchers are using qualitative methodology to study interprofessional collaboration (IPC). With this increase in use, there seems to be an appreciation for how qualitative studies allow us to understand the unique individual or group experience in more detail and form a basis for policy change and innovative interventions. Furthermore, there is an increased understanding of the potential of studying new or emerging phenomena qualitatively to inform further large-scale studies. Although there is a current trend toward greater acceptance of the value of qualitative studies describing the experiences of IPC, these studies are mostly descriptive in nature. Applying a process suggested by Crotty (1998) may encourage researchers to consider the value in situating research questions within a broader theoretical framework that will inform the overall research approach including methodology and methods. This paper describes the application of a process to a research project and then illustrates how this process encouraged iterative cycles of thinking and doing. The authors describe each step of the process, shares decision-making points, as well as suggests an additional step to the process. Applying this approach to selecting data collection methods may serve to guide and support the qualitative researcher in creating a well-designed study approach.
    Journal of Interprofessional Care 02/2013; 27(4). DOI:10.3109/13561820.2013.763775 · 1.40 Impact Factor
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