Developing interprofessional collaborative practice competencies in rural primary health care teams

The impact of remuneration, extrinsic and intrinsic incentives on interprofessional primary care teams: results from a rapid scoping review

BACKGROUND

High-performing primary care relies on effective interprofessional teams and provider payment arrangements. This study aims to examine the impact of provider remuneration mechanisms and intrinsic and extrinsic incentives in team-based primary care.

METHODS

This rapid scoping review assessed various provider payment models and incentives in team-based primary care. Statistical tests were not applicable in this review.

RESULTS

Fee-for-service models hindered team collaboration, while salaried and quality-based compensation models enhanced collaboration. Extrinsic incentives, such as pay-for-performance programs for physicians, showed mixed impacts on outcomes. Strong organizational cultures and leadership, resources, team meetings, training, clear protocols, and professional development opportunities facilitated teamwork. Intrinsic incentives like autonomy, mastery, and social purpose improved team performance and satisfaction.

CONCLUSIONS

This study underscores the importance of a holistic approach to designing interprofessional primary care teams. It highlights the need for implementing non-fee-for-service provider payment models and team-based pay-for-performance incentives. Investments in teams should include health human resources and leadership, training, guidelines, and professional development opportunities. Implementing a performance measurement framework for teams and regular public reporting can foster mastery. Continuous research and evaluation are crucial to optimizing teamwork and healthcare delivery in primary care settings.

Strengthening collaboration for interprofessional primary care teams: Insights and key learnings from six disciplinary perspectives

We provide a case example of the collaborative process required to plan and implement initiatives to enhance team-based primary care, drawing on experiences of six disciplines working together to create new curricula as part of Team Primary Care. Recommendations to strengthen collaboration from our team include building capacity requires an understanding of unique disciplinary roles and understanding of unique elements of primary care; competencies have to be specifically articulated and demonstrated within a primary care context; interprofessional education within and across disciplines is needed; establishing primary care competencies would provide a common set of skills, knowledge, values, and attitudes to form a foundation in which to build the capacity of the interprofessional primary care workforce; and interprofessional collaboration is needed in implementing team-based primary care in practice and in preparing an interprofessional workforce prepared to leverage the expertise of the entire team.

Gap analysis of strategies for promoting interprofessional teams in healthcare units

PURPOSE

A healthcare unit's effectiveness largely depends on how well its interprofessional teams work together. Unfortunately, the strategies used to improve these teams often lack substance. This study analyzed these strategies and found a performance gap.

DESIGN/METHODOLOGY/APPROACH

This study took a unique mixed-method approach, systematically reviewing both qualitative and quantitative studies that identified strategies to enhance interprofessional teams in healthcare units. To gauge the effectiveness of these strategies, the researcher utilized an Importance-Performance Analysis (IPA) in four specialized clinical training centers in Hamadan province, Iran. The analysis of the IPA involved 35 experts from these centers as the statistical population.

FINDINGS

Based on a systematic review, there are seven categories: contextual, strategic, communication, organizational, individual, Human Resources Management (HRM), and environmental for promoting interprofessional teams with a total of 36 sub-indicator. Based on the IPA, the HRM aspect shows the most extensive performance gap. The individual and organizational aspects fall under resource wastage, and the environmental aspect is within the indifferent zone. Also, some critical sub-indicators, such as incentives/rewards, roles and responsibilities, financial resources, team-initiated innovation, the culture of respect, partner resources, humility, data availability, set expectations, and team availability, are in the weak areas.

PRACTICAL IMPLICATIONS

This research has identified critical areas for improvement in promoting teamwork in clinical training centers through a comprehensive gap analysis. It also presents practical policy solutions to address these weak points, providing a clear roadmap for enhancing interprofessional teams in healthcare units.

ORIGINALITY/VALUE

Improving teamwork in healthcare can be challenging, but it is possible with proper strategies and tools. One of the highlights of the recent study was the combination of systematic review studies with IPA to identify areas for improving interprofessional teamwork in clinical training centers.

Relationship between nurses' perceptions of the benefits/challenges of nursing and degree of interprofessional and intraprofessional collaboration in all-inclusive services combining day services, overnight stays and home-visit nursing for the older people living at home

Background

Many countries are experiencing rapid population aging, and the provision of support for older adults with diseases or disabilities to continue living in their communities is a major global challenge. Japan has established multifunctional long-term care in small group homes and home-visit nursing (MLSH) as a service category that integrates medical and care services. These services focus on nursing functions to support continuous, long-term home, and end-of-life care for older adults with high levels of medical care dependency. This study aimed to clarify the relationship between nurses' perceptions of nursing benefits/challenges and the degree of interprofessional collaboration in the context of MLSH.

Methods

We conducted a mail questionnaire survey of MLSH facilities throughout Japan. All facilities in Japan that had been operating for at least 1 year were included. We analyzed 182 responses (response rate: 36.0%; valid response rate: 98.3%).

Results

Comparison of scores representing the degree of interprofessional collaboration perceived by nurses showed the highest score was for colleague nurses (3.9 ± 0.5) and the lowest was for external care managers (2.5 ± 0.9). Compared with the weak collaboration group, the strong collaboration group had higher perceptions of the benefits of nursing and lower perceptions of the challenges.

Conclusions

The results of this study suggest that strong collaboration allows teams to achieve sufficient effects of care while reducing related challenges. It may be necessary to promote collaboration with external professionals to appropriately manage service users' worsened conditions and improve the quality of care.

FITRI's four steps in developing primary health cares' interprofessional collaborative: an intervention for fostering IPCP competencies

It is important to fill the gaps in collaborative practice due to the lack of the healthcare professionals' ability to work in collaboration with other disciplines. However, the current team training does not routinely address this important issue. This study aimed to identify how interactive interprofessional collaborative practice (IPCP) learning materials in a virtual course and community implementation called FITRI's four steps in developing primary health cares' interprofessional collaborative practice can be used in primary healthcare settings to address IPCP competencies of healthcare providers. This research was a quasi-experimental study with an untreated control group design using a dependent pretest and posttest sample. A purposive sample of 50 primary healthcare providers consisting of general physicians, dentists, nurses, dietitians, and pharmacists were nonrandomly divided into the control and intervention groups. This study showed that IPCP competencies measured by the Interprofessional Collaborator Assessment Rubric (ICAR) in the intervention group were significantly higher after the training and implementation than before. The Mann-Whitney tests indicated that IPCP competencies were better in the intervention group than the control group. Based on effect size analysis, the intervention had a very strong impact and could significantly improve the participants' competencies, especially in the collaborative patient/client-family centered approach domain. The FITRI's four steps in developing primary health cares' interprofessional collaborative practice can be implemented and provide positive impacts in primary healthcare settings to improve and foster competencies of IPCP in primary healthcare.

Prática colaborativa na Estratégia Saúde da Família

Objetivo: compreender a configuração da Prática Colaborativa no contexto da Estratégia Saúde da Família. Método: trata-se de um estudo de caso único, de natureza qualitativa, realizado com trinta e cinco profissionais das equipes de saúde da família. A coleta de dados ocorreu por meio de entrevistas, guiadas por roteiro semiestruturado e observação não participante. Os dados foram analisados por meio de Análise de Conteúdo Temática. Resultados: os resultados evidenciaram potencialidades da prática colaborativa para a qualificação das práticas profissionais e dos resultados de saúde, no contexto da ESF. Entretanto observou-se insuficiência de dispositivos organizacionais para apoiar o trabalho compartilhado na ESF, desafio a ser superado, inclusive no que tange às políticas públicas, revelando o chamamento para a educação interprofissional no contexto dos serviços de saúde para estimular a colaboração. Conclusão: a configuração da Prática Colaborativa interprofissional no contexto da Estratégica Saúde da Família é desafiadora e requer processos interacionais e da organização do trabalho.