Year: 2012
Type: dissertation
Abstract: Summary In recent years, the world of work has changed in many ways. Organisations have become team-based and their structures are flatter than before. Customer-driven, flexible teams are quite independent in evaluating and improving their own work. The development of information technology enables the required transfer and gathering of information across boundaries between experts and organisations. Thus, the work of experts has become more collective and customer-driven. In the social services and health care sector, team-based, customer-oriented collective expertise is called interprofessional collaboration. Applying the ideal of interprofessional collaboration in practice has proved challenging. This doctoral thesis studied the challenges and phenomena faced by various experts when their organisation starts to develop interprofessional collaboration. The study mainly focused on a large hospital that provides acute treatment. Most of the hospital s patients are elderly people. This was a qualitative study. The research data was collected in focus group interviews. They were carried out with separate groups of various experts and with five teams that worked together. In the focus groups, interviews were conducted with doctors, registered nurses, enrolled nurses, occupational therapists, physiotherapists and social workers. In addition, focus groups of nursing officers and medical directors were included in the study as representatives of the management. Interviews were conducted with a total of 81 experts; 41 in the expert groups and 40 in the teams. The analysis of the data was based on dialogue between theory, earlier research data and the present data. According to the study, the main challenges were seen in roles involving agreed flexibility, the specification of responsibilities, the practices of developing shared knowledge, as well as learning teamwork and interaction skills. Organisational structures constituted the fifth challenge. They do not always support the development of shared knowledge and a joint operating model. Despite the opportunities provided by modern technology, the organisation constituted a border that was difficult to cross when aiming for patient-driven work. On the basis of the results of the analysis, a theoretical model was created that describes the challenges and requirements of the development of interprofessional collaboration in the social services and health care sector. Because work and training in the sector is regulated by legislation, genuine and more extensive cultural change in the operations of organisations and the training of experts requires decisions also from social and political decision-makers. The organisation and its entire management need a common understanding, joint goals and continuous support in order to implement such changes that enable a patient-driven approach to break the organisation s old operating culture, structures and limits. The social and health care sector includes many strongly established professions. The contribution of these professions and trade unions is required for the development of the work community. Without these background elements, it will not be possible to change the entire organisational culture. At the individual level, the model discloses challenges related to experts' collective work skills and shortcomings in the required communicative skills. Skilful debate and dialogue and reflective assessment were found to be important interaction skills when developing interprofessional collaboration. A positive finding in the study was the mutual support and trust between experts in smoothly functioning interprofessional teams. The team members appreciated working in such teams. These teams developed social capital, which promoted well-being at work.
Source: Työväentutkimus Vuosikirja
Author: Kaarina Isoherranen
Language: Finnish
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2143164358