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Strengthening Healthcare Systems and Services through Intersectoral and Interprofessional Partnerships

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences & Services".

Deadline for manuscript submissions: closed (31 January 2023) | Viewed by 26007

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Special Issue Editors

Dr. Priya Martin

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Guest Editor

Faculty of Medicine, The University of Queensland, Rural Clinical School, Locked Bag 9009, Toowoomba DC, QLD 4350, Australia
Interests: clinical supervision; rural health workforce; professional support for healthcare workers; interprofessional education and collaborative practice; program evaluation

Dr. Michael Palapal Sy

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Guest Editor

National Teacher Training Center for the Health Professions, University of the Philippines Manila, Manila 1000, Philippines
Interests: occupational therapy; interprofessional education; occupational science; substance addiction; health professions education

Special Issue Information

Dear Colleagues,

Building partnerships across sectors and professions can strengthen the safety and quality of healthcare. Working in silos cannot meet the growing complexities of healthcare needs of populations. There are repeated calls for sectors (e.g., primary and secondary care; academia and industry) to work together closely to not only enhance health outcomes but also bridge the evidence–practice gap. Integrated care transcends boundaries to bring about the best care for clients. Similarly, interprofessional education and collaborative practice is a promising solution to bring professions together right from the pre-registration phase, through to the practitioner phase, to maximise efficiencies, improve teamwork and enable better, client-centred outcomes. Co-designing research with service users or consumers has been much talked about in recent times. While these concepts are all being advocated for, there are many barriers in reality that hinder their uptake in current research practices. We are interested in contributions that will showcase examples of research partnerships that are beyond sectoral, professional or other traditional boundaries, and that have resulted in better outcomes for health systems and services. We are particularly interested in lessons researchers and practitioners have learnt while implementing such research work.
Topics and Scope (including, but not limited to): evaluation research on the impact of interprofessional education on healthcare practice, policy making, systems and governance; multi-site, multi-method, longitudinal research designs that address critical issues of interprofessional education, collaborative practice and integrated care across sectors and systems; review papers including high-quality meta-analysis and meta-synthesis that can inform healthcare practices across sectors and systems; discussion of open, conceptual and engaging approaches to interprofessional research, drawing on innovative approaches that include citizens, learners and service users in informing research questions, research designs, data analysis and translation strategies; case studies that demonstrate evidence for aspects of interprofessional collaborative practice that result in desired positive changes for service users, populations, service providers, learners, communities and systems.

Dr. Priya Martin
Dr. Michael Palapal Sy
Guest Editors

Manuscript Submission Information

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Keywords

interprofessional education
collaborative practice
integrated care
co-design
healthcare systems

Published Papers (10 papers)

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Research

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11 pages, 1832 KiB

Open AccessArticle

The Contribution of Cultural Heritage Owned by Local Health Authorities in the Humanization of Care: The Point of View of Top Management

by Martina Giusti, Claudia Cosma, Stefania Simoni and Niccolò Persiani

Int. J. Environ. Res. Public Health 2022, 19(24), 16632; https://doi.org/10.3390/ijerph192416632 - 11 Dec 2022

Cited by 2 | Viewed by 1040

Abstract

After the COVID-19 pandemic, reforms in healthcare systems have the purpose to fully recover the relationship of healthcare organizations with their patients. For centuries, art was used throughout Europe in the healthcare context for its power to engage and support patients in their illnesses. This approach can be rediscovered by utilizing the cultural heritage owned by Local Health Authorities. In this context, tradition, art, innovation, and care coexist. This study aims to investigate the interest in developing projects for the humanization of care by the top management of Italian Local Health Authorities, in particular exploiting their cultural heritage. The evaluation of the proposal was conducted using semi-structured interviews with the top management of two Local Health Authorities, in which the Santa Maria Nuova hospital in Florence and the Santo Spirito in Sassia Hospital in Rome are located, as the two selected cases for this study. The interviewees welcomed the proposal to develop humanization of care projects involving the use of their cultural heritage. Moreover, they expressed their desire to invest human, economic, and structural resources in the development of these initiatives. The implementation of humanization of care projects using cultural heritage owned by Local Health Authorities is useful to apply specific policies to enhance the governance of the cultural heritage according to the health mission. On the other hand, it permits the search for additional or ad hoc resources. Finally, it is possible to humanize and improve patients’ experience while increasing awareness among the health workforce and trainees. Full article

(This article belongs to the Special Issue Strengthening Healthcare Systems and Services through Intersectoral and Interprofessional Partnerships)

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17 pages, 1099 KiB

Open AccessArticle

Older Adults’ Demand for Community-Based Adult Services (CBAS) Integrated with Medical Care and Its Influencing Factors: A Pilot Qualitative Study in China

by Zhenyu Wang, Hanchun Wei and Zhihan Liu

Int. J. Environ. Res. Public Health 2022, 19(22), 14869; https://doi.org/10.3390/ijerph192214869 - 11 Nov 2022

Cited by 4 | Viewed by 1711

Abstract

Introduction: The number of older people in China who require formal care is increasing. In response, China is creating a service delivery mode of health and social care combination for older people—community-based adult services (CBAS) integrated with medical care—in some provincial capital cities, such as Changsha. However, the needs of most older people for this service delivery mode are not well understood. Aim: To assess older people’s awareness of and demand for CBAS integrated with medical care and to determine influencing factors. Methods: Semi-structured guideline interviews were conducted with 20 older people (aged 65+ years) from two communities at different economic development levels and from a nursing home in Changsha, China. Interviews were analyzed using qualitative content analysis. Results: The specific needs that older adults expect from CBAS integrated with medical care involve daily care, primary care, self-management guidance, rehabilitation therapy services, and mental health services. Contrary to expectations, most interviewees showed low awareness of and demand for CBAS integrated with medical care. Individual, family, and community factors influence older people’s demand, as do exogenous variables such as gender and number of children. Discussion: The influencing mechanism of older people’s demand for CBAS integrated with medical care is complex and multifaceted. To implement and promote CBAS integrated with medical care, attention should be given to older people’s individual needs, family backgrounds and community environment improvement. Furthermore, improving awareness of integrated care and increasing ageing-in-place opportunities for more older adults is essential and urgent. Full article

(This article belongs to the Special Issue Strengthening Healthcare Systems and Services through Intersectoral and Interprofessional Partnerships)

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15 pages, 352 KiB

Open AccessArticle

Cooperation between Public Primary Health Care and Occupational Health Care Professionals in Work Ability-Related Health Issues

by Lauri Vähätalo, Anna Siukola, Salla Atkins, Tiia Reho, Markku Sumanen, Mervi Viljamaa and Riitta Sauni

Int. J. Environ. Res. Public Health 2022, 19(19), 11916; https://doi.org/10.3390/ijerph191911916 - 21 Sep 2022

Cited by 2 | Viewed by 1848

Abstract

Work disability creates significant expenses for nations and causes human suffering by limiting patients’ lives. International studies show that to enhance recognition of and support for work disability, cooperation, mutual trust, and information exchange between public primary health care and occupational health care must be strengthened. However, little is known of how health care professionals experience this cooperation. The aim of this study was to understand how professionals experience the cooperation between public primary health care and occupational health services regarding patients’ work ability. Semi-structured interviews were conducted with 29 health care professionals working in five small cities (<10,000 inhabitants) in Finland. Interviews were audio and video recorded, transcribed verbatim, and analyzed through inductive thematic analysis. Three key themes were identified from the interviews: attitudes toward the other health care sector, the exchange of information, and resources for cooperation. Professionals seem to have poor knowledge about the services available and how care is given in the other sector, appearing to lead to weak mutual trust. The public primary health care professionals especially emphasized the benefits of cooperation, but several issues were mentioned as barriers to cooperation. These results can be used when planning effective patient paths and service provisioning models. Full article

(This article belongs to the Special Issue Strengthening Healthcare Systems and Services through Intersectoral and Interprofessional Partnerships)

12 pages, 318 KiB

Open AccessArticle

A Novel Interprofessional Education and Supervision Student Placement Model: Student and Clinical Educator Perspectives and Experiences

by Priya Martin, Anne Hill, Martelle Ford, Tessa Barnett, Nicky Graham and Geoff Argus

Int. J. Environ. Res. Public Health 2022, 19(17), 10734; https://doi.org/10.3390/ijerph191710734 - 29 Aug 2022

Cited by 6 | Viewed by 2008

Abstract

Interprofessional student placements can not only cater to the added pressures on student placement numbers but can also enhance the work readiness of new graduates. For rural areas, there is a potential for interprofessional student placements to attract the future healthcare workforce. However, tried and tested models of interprofessional placements in rural areas backed up by rigorous evaluation, remain scarce. The Rural Interprofessional Education and Supervision (RIPES) model was developed, implemented, and evaluated across four rural health services in Queensland to address this gap. Students from two or more professions undertook concurrent placements at RIPES sites, with a placement overlap period of at least five weeks. Eleven focus groups (n = 58) with clinical educators (CEs) and students were conducted to explore student and clinical educator experiences and perspectives. Content analysis of focus group data resulted in the development of the following categories: value of the RIPES placement model, unintended benefits to CEs, work units and rural areas, tension between uni-professional and IPE components, and sustainability considerations. Students and CEs alike valued the learning which arose from participation in the model and the positive flow-on effects to both patient care and work units. This unique study was undertaken in response to previous calls to address a gap in interprofessional education models in rural areas. It involved students from multiple professions and universities, explored perspectives and experiences from multiple stakeholders, and followed international best practice interprofessional education research recommendations. Findings can inform the future use and sustainability of the RIPES model. Full article

(This article belongs to the Special Issue Strengthening Healthcare Systems and Services through Intersectoral and Interprofessional Partnerships)

13 pages, 314 KiB

Open AccessArticle

Impact of the COVID-19 Pandemic on Clinical Supervision of Healthcare Students in Rural Settings: A Qualitative Study

by Priya Martin, Lucylynn Lizarondo, Geoff Argus, Saravana Kumar and Srinivas Kondalsamy-Chennakesavan

Int. J. Environ. Res. Public Health 2022, 19(9), 5555; https://doi.org/10.3390/ijerph19095555 - 3 May 2022

Cited by 10 | Viewed by 2615

Abstract

The COVID-19 pandemic has caused significant disruptions to healthcare student placements worldwide, including already challenged rural areas in Australia. While accounts are emerging of student experiences in larger centers and from a student perspective, there is a need for in-depth exploration of student supervisor experiences in rural areas at the onset of the pandemic. This study aims to address this gap through 23 individual, semi-structured interviews with healthcare workers from ten health professions who were either direct student supervisors or in roles supporting student supervisors A reflexive thematic analysis approach was used to develop four themes, namely compounding stress, negative impacts on student learning, opportunity to flex and innovate, and targeted transitioning support strategies. The findings indicate that healthcare workers with student supervision responsibilities at the onset of the pandemic experienced high levels of stress and wellbeing concerns. This study sheds light on the importance of supporting student supervisors in rural areas, and the need for implementing targeted support strategies for new graduates whose placements were impacted by the pandemic. This is not only essential for supporting the rural healthcare workforce but is also imperative for addressing inequalities to healthcare access experienced in rural communities. Full article

(This article belongs to the Special Issue Strengthening Healthcare Systems and Services through Intersectoral and Interprofessional Partnerships)

Review

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13 pages, 696 KiB

Open AccessReview

A Rapid Review of the Factors That Influence Service User Involvement in Interprofessional Education, Practice, and Research

by Michael Palapal Sy, Arden Panotes, Daniella Cho, Roi Charles Pineda and Priya Martin

Int. J. Environ. Res. Public Health 2022, 19(24), 16826; https://doi.org/10.3390/ijerph192416826 - 15 Dec 2022

Cited by 4 | Viewed by 2549

Abstract

Service user involvement in interprofessional education and collaborative practice remains limited despite the increasing push for this by governments and grant funding bodies. This rapid review investigated service user involvement in interprofessional education, practice, and research to determine factors that enable or hinder such involvement. Following the Cochrane and the World Health Organization’s rapid review guidelines, a targeted search was undertaken in four databases. Subsequent to the screening processes, included papers were critically appraised, and extracted data were synthesized narratively. Sixteen studies met inclusion criteria. Most studies were related to interprofessional collaborative practice, as opposed to education and research. Service user involvement was more in the form of consultation and collaboration, as opposed to consumer-led partnerships. Enablers and barriers to service user involvement in IPECP were identified. Enablers included structure, the valuing of different perspectives, and relationships. Barriers included time and resources, undesirable characteristics, and relationships. This rapid review has added evidence to a swiftly expanding field, providing timely guidance. Healthcare workers can benefit from targeted training. Policy makers, healthcare organizations, and governments can investigate strategies to mitigate the time and resource challenges that impede service user involvement in IPECP. Full article

(This article belongs to the Special Issue Strengthening Healthcare Systems and Services through Intersectoral and Interprofessional Partnerships)

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16 pages, 573 KiB

Open AccessReview

Understanding Feedback for Learners in Interprofessional Settings: A Scoping Review

by Varun Coelho, Andrew Scott, Elif Bilgic, Amy Keuhl and Matthew Sibbald

Int. J. Environ. Res. Public Health 2022, 19(17), 10732; https://doi.org/10.3390/ijerph191710732 - 29 Aug 2022

Cited by 1 | Viewed by 2078

Abstract

Background: Interprofessional feedback is becoming increasingly emphasized within health professions’ training programs. The objective of this scoping review is to determine what is known about how learners perceive and interact with feedback in an interprofessional context for learning. Methods: A search strategy was developed and conducted in Ovid MEDLINE. Title and abstract screening were performed by two reviewers independently. Next, full texts of selected articles were reviewed by one reviewer to determine the articles included in the review. Data extraction was performed to determine the articles’ study population, methodologies and outcomes relevant to the research objective. Results: Our analysis of the relevant outcomes yielded four key concepts: (1) issues with the feedback process and the need for training; (2) the perception of feedback providers, affecting how the feedback is utilized; (3) professions of the feedback providers, affecting the feedback process; and (4) learners’ own attitude toward feedback, affecting the feedback process. Conclusions: The learner’s perception of interprofessional feedback can be an obstacle in the feedback process. Training around interprofessional feedback should be included as part of interprofessional programs. Research is needed to explore how to address barriers in feedback interaction that stem from misguided perceptions of feedback providers’ professions. Full article

(This article belongs to the Special Issue Strengthening Healthcare Systems and Services through Intersectoral and Interprofessional Partnerships)

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13 pages, 602 KiB

Open AccessReview

Implementation of Virtual Communities of Practice in Healthcare to Improve Capability and Capacity: A 10-Year Scoping Review

by Louise Shaw, Dana Jazayeri, Debra Kiegaldie and Meg E. Morris

Int. J. Environ. Res. Public Health 2022, 19(13), 7994; https://doi.org/10.3390/ijerph19137994 - 29 Jun 2022

Cited by 18 | Viewed by 4226

Abstract

Virtual communities of practice consist of individuals who use a common online platform to share professional expertise and experiences. In healthcare settings a virtual community of practice (VCoP) can optimise knowledge, skills, and the implementation of evidence-based practice. To ensure effective knowledge synthesis and translation into practice, it is essential to clarify the best methods for designing and implementing VCoPs within healthcare organisations. This scoping review aimed to identify the methods used to establish and facilitate online or digitally enabled communities of practice within healthcare organisations across the globe. Six online databases identified papers published from January 2010 to October 2020. Papers were independently screened by two reviewers using Covidence. Data were captured and analysed using a data extraction chart in Covidence. Twenty-four publications that detail methods for establishing a VCoP in healthcare were included. Few studies used a framework to establish a VCoP. It was difficult to identify details regarding methods of development and key elements such as roles, how they were coordinated, and types of technology used. Healthcare organisations can benefit from using a standardised framework for the establishment, implementation and evaluation of VCoPs to improve practice, staff engagement, and knowledge sharing. Full article

(This article belongs to the Special Issue Strengthening Healthcare Systems and Services through Intersectoral and Interprofessional Partnerships)

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Other

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10 pages, 776 KiB

Open AccessStudy Protocol

Measuring Interprofessional Collaboration’s Impact on Healthcare Services Using the Quadruple Aim Framework: A Protocol Paper

by Yang Yann Foo, Xiaohui Xin, Jai Rao, Nigel C. K. Tan, Qianhui Cheng, Elaine Lum, Hwee Kuan Ong, Sok Mui Lim, Kirsty J. Freeman and Kevin Tan

Int. J. Environ. Res. Public Health 2023, 20(9), 5704; https://doi.org/10.3390/ijerph20095704 - 1 May 2023

Viewed by 2890

Abstract

Despite decades of research on the impact of interprofessional collaboration (IPC), we still lack definitive proof that team-based care can lead to a tangible effect on healthcare outcomes. Without return on investment (ROI) evidence, healthcare leaders cannot justifiably throw their weight behind IPC, and the institutional push for healthcare manpower reforms crucial for facilitating IPC will remain variable and fragmentary. The lack of proof for the ROI of IPC is likely due to a lack of a unifying conceptual framework and the over-reliance on the single-method study design. To address the gaps, this paper describes a protocol which uses as a framework the Quadruple Aim which examines the ROI of IPC using four dimensions: patient outcomes, patient experience, provider well-being, and cost of care. A multimethod approach is proposed whereby patient outcomes are measured using quantitative methods, and patient experience and provider well-being are assessed using qualitative methods. Healthcare costs will be calculated using the time-driven activity-based costing methodology. The study is set in a Singapore-based national and regional center that takes care of patients with neurological issues. Full article

(This article belongs to the Special Issue Strengthening Healthcare Systems and Services through Intersectoral and Interprofessional Partnerships)

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29 pages, 1382 KiB

Open AccessSystematic Review

Interprofessional Identity in Health and Social Care: Analysis and Synthesis of the Assumptions and Conceptions in the Literature

by Gabriël Rafaël Cantaert, Peter Pype, Martin Valcke and Emelien Lauwerier

Int. J. Environ. Res. Public Health 2022, 19(22), 14799; https://doi.org/10.3390/ijerph192214799 - 10 Nov 2022

Cited by 7 | Viewed by 3292

Abstract

Interprofessional identity (IPI) development is considered essential in reducing incongruency and improving interprofessional collaboration. However, noticeable differences in conceptualizations are being put forward in the literature, hindering interpretation of research findings and translation into practice. Therefore, a Concept Analysis and Critical Interpretative Synthesis of empirical research articles were conducted to explore the assumptions and conceptions of IPI. Independent literature screening by two researchers led to the inclusion and extraction of 39 out of 1334 articles. Through critical analysis, higher order themes were constructed and translated to a synthesizing argument and a conceptual framework depicting what constitutes IPI (attributes), the boundary conditions (antecedents) and the outcomes (consequences) of its development. The attributes refer to both IPI’s structural properties and the core beliefs indicative of an interprofessional orientation. The antecedents inform us on the importance of IPI-fitting constructivist learning environments and intergroup leadership in enabling its development. This development may lead to several consequences with regard to professional wellbeing, team effectiveness and the quintuple aim. Given the educational orientation of this study, ways for facilitating and assessing the development of IPI among learners across the professional continuum have been proposed, although empirical research is needed to further validate links and mediating and moderating variables. Full article

(This article belongs to the Special Issue Strengthening Healthcare Systems and Services through Intersectoral and Interprofessional Partnerships)

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