Role understanding and modes of cooperation in inter-professional collaboration at two municipal rehabilitation units.

Transkript

1 NIPNET OCTOBER 2014 Role understanding and modes of cooperation in inter-professional collaboration at two municipal rehabilitation units. Dorte Lyby Norenberg, Assisent Professor, Department of Occ.Therapy Nora Hagstrøm, Assistent Professor, Department of Physiotherapy Inger Taasen, Associated Professor, Derpartment of Nursing Kjellaug Kildal Hansen, Assistent Professor, Department of Nursing Bjørg Christiansen, Associated Professor, Derpartment of nursing Faculty of Health Sciences Oslo and Akershus University College of Applied Sciences, Presentation of the project: Background Health policy guidelines The context Methodology approaches Limitations Tentative categories Question to the audience Disposition: 1

2 Guvernement guidelines National curriculum Quality demands Why this project? Students' collaborative learning Learning in interprofessional settings are required Small-scale projects What happens in practice? How do the professions interact cooperate? Rehabilitation Unit A: Relative newly established (2011/2012) Patients come from several urban districts The therapist group is located in the unit The therapist group goes in shifts The context Rehabilitation Unit B: Rehabilitation unit is linked to a larger nursing home with many departments Patients come from one urban districts The therapist group is located in a separate department - several floors from the rehabilitation unit The therapist group does not goes the shifts 2

3 Methodology approaches ethnographic design Observation: Participating in interprofessional meetings Network Meetings Meetings with the district service award office together with the unit Observation in the unit Report meetings Qualitative Interview Nurses (5) Nursing assistants (4) Physiotherapists (3) Occupational therapists (4) Doctors (3) Professional Development Nurse (1) Department nurses (2) Document Revision: Job descriptions Templates forms and guidelines from health and nursing home agency Excerpts from records Analysis so far Meaning condensation and categorization (Kvale 2004) The presentation of to day : Delineation three professions nurse, OT and PT Only from the interviews Look at the two institutions together Excerpts from the interview guide Tentative categories 3

4 Forms of collaboration three categories Core area Border area Greyzone area Core area: Defined tasks and responsibility Nurse : medicine, wound care spider OT: homevisit, assements, ADL,looking at the patient's resources PT : displacement, training The profession s distinctive knowledge, skills and competences Referring to multi-professional interaction and role perceptions Concepts/ tribal language- morning care / PADL 4

5 Border area Interprofessional cooperation/ interation situation Role perception is overlapping Procedure, documentation Meetings initiating inter-professional collaboration form Coordinator for the patient Goalsetting talks / Network mettings Interprofesionel meetings Informal meetings Greyzone area Undefined tasks Multi professional with the potential for interprofessional collaboration forms «Follow the patient to PT» «Follow the patient to the dinningroom» «Common activation Play aunt «Answaring the bells» «Caring subject in the reports» 5

6 How the three profesions talk about their roles and code of cooperation Grey = dots Border = hatching Core =circles Question to the audience What are your reflections giving this three categories? Might these categories shed light on task allocation? Might these categories clarify the profession's roles and core tasks? 6

7 References Axelsson, Runo og Axelson, Susanne B (2014) Organisering av samverkan modeller, svårigheter og möjligheter.i Willumsen og Ødegård(red). Tverrprofesjonelt samarbeid et samfunnsoppdrag. Universitetsforlaget Jacobsen, Flemming(2014) Læring med, af og om hinanden, resultater fra et tværfaglig kliniks studieafsnit. I Willumsen og Ødegård(red). Tverrprofesjonelt samarbeid et samfunnsoppdrag Universitetsforlaget Kvale, Steinar (2004) Interview En introduktion til det kvalitative forskningsinterview. Hans Reitzels Forlag Kvärnstrøm, Sussanne (2009) Samarbeid og læring i det tverrprofesjonelle teamet i Willumnsen, Elisabeth (red); Tverrprofesjonelt samarbeid i praskis og utdanning. Universitetsforlaget Meld. St. 13 ( ) Utdanning for velferd Samspill i Praksis Sirnes,Tore (2014) Fra politikk til praksis i helse og velferdstjenestene.i Willumsen og Ødegård(red). Tverrprofesjonelt samarbeid et samfunnsoppdrag Universitetsforlaget. Coming together is the beginning Keeping together is progress Working together is success Henry Ford 7