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01.12.2012 | Research article | Ausgabe 1/2012 Open Access

BMC Health Services Research 1/2012

A four-year, systems-wide intervention promoting interprofessional collaboration

Zeitschrift:
BMC Health Services Research > Ausgabe 1/2012
Autoren:
Jeffrey Braithwaite, Mary Westbrook, Peter Nugus, David Greenfield, Joanne Travaglia, William Runciman, A Ruth Foxwell, Rosalie A Boyce, Timothy Devinney, Johanna Westbrook
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1472-6963-12-99) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors' contributions

JB is principal chief investigator on the project, conceptualised and led the research project and co-developed the first draft of the manuscript. MW conducted the quantitative data analysis and developed the first draft of the manuscript. PN contributed field work data and co-wrote the manuscript. DG contributed field data and co-wrote the manuscript. JT contributed field data and co-wrote the manuscript. BR is a chief investigator on the project, contributed clinical expertise and co-wrote the manuscript. ARF is a chief investigator on the project, contributed methodological expertise and co-wrote the manuscript. RAB is a chief investigator on the project, contributed clinical expertise and co-wrote the manuscript. TD is a chief investigator on the project, contributed organisational expertise and co-wrote the manuscript. JW is a chief investigator on the project, contributed methodological and statistical expertise and co-wrote the manuscript. All authors read and approved the final manuscript.

Abstract

Background

A four-year action research study was conducted across the Australian Capital Territory health system to strengthen interprofessional collaboration (IPC) though multiple intervention activities.

Methods

We developed 272 substantial IPC intervention activities involving 2,407 face-to-face encounters with health system personnel. Staff attitudes toward IPC were surveyed yearly using Heinemann et al's Attitudes toward Health Care Teams and Parsell and Bligh's Readiness for Interprofessional Learning scales (RIPLS). At study's end staff assessed whether project goals were achieved.

Results

Of the improvement projects, 76 exhibited progress, and 57 made considerable gains in IPC. Educational workshops and feedback sessions were well received and stimulated interprofessional activities. Over time staff scores on Heinemann's Quality of Interprofessional Care subscale did not change significantly and scores on the Doctor Centrality subscale increased, contrary to predictions. Scores on the RIPLS subscales of Teamwork & Collaboration and Professional Identity did not alter. On average for the assessment items 33% of staff agreed that goals had been achieved, 10% disagreed, and 57% checked neutral. There was most agreement that the study had resulted in increased sharing of knowledge between professions and improved quality of patient care, and least agreement that between-professional rivalries had lessened and communication and trust between professions improved.

Conclusions

Our longitudinal interventional study of IPC involving multiple activities supporting increased IPC achieved many project-specific goals. However, improvements in attitudes over time were not demonstrated and neutral assessments predominated, highlighting the difficulties faced by studies targeting change at the systems level and over extended periods.
Zusatzmaterial
Authors’ original file for figure 1
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Authors’ original file for figure 2
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Authors’ original file for figure 3
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