Interdisciplinary Team Based Pastoral Care: A Potentially Adaptable Model for Estonian Healthcare

This article aims to build a potentially adaptable model of clinical pastoral care for Estonia’s healthcare institutions. To help the development of spiritual support provision in Estonian healthcare institutions, we are currently working on creating a model of clinical pastoral care that would be in accordance with the local circumstances. Preparatory research in the matter has addressed the socio-cultural and institutional context that shows the great need for interdisciplinary teamwork. The current article offers concrete proposals in the following main points: a) presentation of the pastoral caregiver; b) main actors; c) forms of cooperation; and c) education and internal trainings. The model construction draws information from international research and considers it in Estonia’s local context. Spiritual support provision in Estonia’s healthcare has not yet been taken for granted and the concept is not fully understood. Secularity and religious diversity also set complex frames. Therefore, the model is suggested in guiding proposals, not in a rigorous structure. As such, the model could also be useful for healthcare spiritual support developments in other countries with similar characteristics. The article also poses possible questions of the implementation potential of the model

Curriculum renewal for interprofessional education in health

In this preface we comment on four matters that we think bode well for the future of interprofessional education in Australia. First, there is a growing articulation, nationally and globally, as to the importance of interprofessional education and its contribution to the development of interprofessional and collaborative health practices. These practices are increasingly recognised as central to delivering effective, efficient, safe and sustainable health services. Second, there is a rapidly growing interest and institutional engagement with interprofessional education as part of pre-registration health professional education. This has changed substantially in recent years. Whilst beyond the scope of our current studies, the need for similar developments in continuing professional development (CPD) for health professionals was a consistent topic in our stakeholder consultations. Third, we observe what might be termed a threshold effect occurring in the area of interprofessional education. Projects that address matters relating to IPE are now far more numerous, visible and discussed in terms of their aggregate outcomes. The impact of this momentum is visible across the higher education sector. Finally, we believe that effective collaboration is a critical mediating process through which the rich resources of disciplinary knowledge and capability are joined to add value to existing health service provision. We trust the conceptual and practical contributions and resources presented and discussed in this report contribute to these developments.Office of Learning and Teaching Australi

Therapists’ experiences and perceptions of teamwork in neurological rehabilitation: Critical happenings in effective and ineffective teamwork

This article reports the second part of an exploratory study into occupational therapists` and physiotherapists` perceptions and experiences of team-work in neurological rehabilitation: the factors that were thought to influence effective and ineffective team-work, and the meaning behind effective and ineffective team work in neurological rehabilitation. The study was undertaken through semi-structured interviews of 10 therapists from three different neurological rehabilitation teams based in the United Kingdom, and used the critical incident technique. Through analysis of the data, several main themes emerged regarding the perceived critical happenings in effective and ineffective team work. These were: team events and characteristics, team members` characteristics, shared and collaborative working practices, communication, specific organisational structures, environmental, external, and patient and family related factors. Effective and ineffective team-work was perceived to impact on a number of levels: having implications for the team, the patient, individual team members, and the neurological rehabilitation service. The study supported the perceived value of team work within neurological rehabilitation. It also indicated the extensive and variable factors that may influence the team working process as well as the complex and diverse nature of the process

Inter-professional education and primary care : EFPC position paper

Inter-professional education (IPE) can support professionals in developing their ability to work collaboratively. This position paper from the European Forum for Primary Care considers the design and implementation of IPE within primary care. This paper is based on workshops and is an evidence review of good practice. Enablers of IPE programmes are involving patients in the design and delivery, providing a holistic focus, focussing on practical actions, deploying multi-modal learning formats and activities, including more than two professions, evaluating formative and summative aspects, and encouraging team-based working. Guidance for the successful implementation of IPE is set out with examples from qualifying and continuing professional development programmes

Enhancing Care Transitions for Older People through Interprofessional Simulation: A Mixed Method Evaluation

Introduction: The educational needs of the health and social care workforce for delivering effective integrated care are important. This paper reports on the development, pilot and evaluation of an interprofessional simulation course, which aimed to support integrated care models for care transitions for older people from hospital to home. Theory and methods: The course development was informed by a literature review and a scoping exercise with the health and social care workforce. The course ran six times and was attended by health and social care professionals from hospital and community (n=49). The evaluation aimed to elicit staff perceptions of their learning about care transfers of older people and to explore application of learning into practice and perceived outcomes. The study used a sequential mixed method design with questionnaires completed pre (n=44) and post (n=47) course and interviews (n=9) 2-5 months later. Results:Participants evaluated interprofessional simulation as a successful strategy. Post-course, participants identified learning points and at the interviews, similar themes with examples of application in practice were: Understanding individual needs and empathy; Communicating with patients and families; Interprofessional working; Working across settings to achieve effective care transitions. Conclusions and discussion:An interprofessional simulation course successfully brought together health and social care professionals across settings to develop integrated care skills and improve care transitions for older people with complex needs from hospital to home

Unlocking medical leadership’s potential:a multilevel virtuous circle?

Background and aim: Medical leadership (ML) has been introduced in many countries, promising to support healthcare services improvement and help further system reform through effective leadership behaviours. Despite some evidence of its success, such lofty promises remain unfulfilled. Method: Couched in extant international literature, this paper provides a conceptual framework to analyse ML's potential in the context of healthcare's complex, multifaceted setting. Results: We identify four interrelated levels of analysis, or domains, that influence ML's potential to transform healthcare delivery. These are the healthcare ecosystem domain, the professional domain, the organisational domain and the individual doctor domain. We discuss the tensions between the various actors working in and across these domains and argue that greater multilevel and multistakeholder collaborative working in healthcare is necessary to reprofessionalise and transform healthcare ecosystems

Patient participation in shared decision-making in palliative care - an integrative review

Background Shared decision-making is a process where the decisions regarding patients' care are done in collaboration with the patient, the patient's family and a healthcare professional or an interdisciplinary team. Shared decision-making is considered to be a part of patient centred care, and it enables patient autonomy which is a cornerstone of palliative care. In the past, research on the experiences of palliative care patients' participation in shared decision-making involving a nurse has been limited as the focus has mainly been on specific medical interventions, rather than holistic palliative care. Objectives To synthesise research findings on patient participation in shared decision-making in palliative care. Research design An integrative literature review. Methods The literature search was conducted by searching computerised databases (CINAHL, PubMed, PsychINFO and COCHRANE). The search resulted in 12 articles. The quality of the included articles was evaluated with JBI checklist, and the data analysis was done using inductive content analysis. Reporting was done according to a PRISMA checklist. Findings Patients do participate in shared decision-making and desire to participate in everyday nursing care decisions, treatment-related medical decisions and end-of-life decisions. The prerequisites for patient participation in shared decision-making are interdisciplinary teamwork, open communication, good patient-healthcare professional relationship, a favourable environment and mutual information. Conclusion Palliative care patients do participate and desire to participate in decisions that cover a much broader range of topics than just medical interventions and this should be addressed in future research and in practise. The main responsibility for successful patient participation in shared decision-making lies with the healthcare professionals and the organisations providing palliative care. There is a need to conduct more research from the patient's perspective and explore the meaning of participating in shared decision-making from the patient's point of view.Peer reviewe

Benefits and losses: a qualitative study exploring healthcare staff perceptions of teamworking

ABSTRACT Objectives: To examine staff perceptions of teamworking practice in the field of stroke care. Design: Qualitative interview study. Setting: Three teams providing care to patients with stroke across a typical care pathway of acute hospital ward, specialist stroke unit, and community rehabilitation. Participants: 37 staff members from a range of professions. Main outcome measures: Healthcare staff perceptions of teamworking. Results: Through detailed coding and analysis of the transcripts, five perceptions regarding the impact of teamworking on staff and patients were identified. These were: (1) mutual staff support, (2) knowledge and skills sharing, (3) timely intervention/discharge, (4) reduced individual decision-making and responsibility and (5) impact on patient contact time. Conclusions: Teamworking practice may be associated with a number of perceived benefits for staff and patient care; however, the potential for losses resulting from reduced patient contact time and ill-defined responsibility needs further investigation

The evaluation of interdisciplinary learning initiative in managing depression

This paper reports the findings from a descriptive study exploring community-nursing students’ experiences of interdisciplinary learning on managing depression. The study was completed as part of a specialist module workshop included in a post-registration community specialist practitioner programme. Questionnaire data included attitude ratings and qualitative evaluations of problem-based learning (PBL). A cohort of 34 community nurses responded. The findings identified issues relating to the learning process and its influence on the knowledge gained and attitudes to team work. Community nurses reported the workshop was thought provoking and the challenging issue is the different opinions of the district nurses role in managing depression from the perspective of the students. This study suggests that problem based learning had a positive impact on students’ learning which makes it a well-received contribution to learning. It also reinforced the importance of healthy attitudes towards collaboration in promoting mental health practice. All of these do ultimately have implications for clinical practice