Introducing Interprofessional Education and Care Concepts in a Geriatric Multilevel Centre: Development and Introduction of a Toolkit for Staff and Students

Background: Although interprofessional education (IPE) is not new, there has been limited research in IPE focused on the care of older adults. The objective of this study was to develop and implement an interprofessional education and care (IPE/C) toolkit, to help staff and students understand and apply the concepts of IPE/C.Methods and Findings: Focus groups identified staff and students’ understanding of IPE/C and informed development of an IPE/C toolkit comprised of IPE/C tools and resources. Five clinical teams (N = 51) attended workshops that introduced the toolkit and educated teams about IPE/C. Focus group participants had heard of but had limited exposure to IPE/C. Responses to the Attitudes Toward Health Care Teams (ATHT) questionnaire indicated a positive trend on all questions; 2 questions in subscale 1 were statistically significant (p = .01 & p = .005), indicating a positive attitude toward teams and teamwork. Several limitations were identified, including inconsistent attendance at workshops, scheduling challenges, and limited physician participation.Conclusions: This pilot project provided baseline data on staff and students’ understanding of and attitudes toward IPE/C in a multilevel geriatric centre and demonstrated that an IPE/C toolkit delivered via team workshops can enhance healthcare team attitudes. Next steps include expanding the rollout to other teams and introducing the toolkit to all staff and students

A Multi-Methods Study of the Role of Middle Managers in Brokering Knowledge in Hospitals

Hospitals are complex environments that are accountable for the quality of the services they provide. The quality of care in hospitals, however, is often less than ideal – patients may not receive treatments with proven effectiveness or may receive unnecessary or even potentially harmful care (Grimshaw et al., 2012; McGlynn et al., 2003). Hospital managers play a pivotal role in facilitating high quality care and may play a brokerage role in the sharing and use of knowledge in healthcare organizations (Birkin et al., 2018; Urquhart et al., 2019). The body of research on knowledge brokers (KBs) suggests that they may have multiple roles, but prior research has focused primarily on KBs in formal roles external to the practice community they seek to influence (CHSRF, 2003). Little is known about internal KB roles, and it remains unclear how the KB role is enacted in health care. There is a dearth of research on what impact KBs within organizations have in brokering knowledge in hospitals (Burgess Currie, 2014; Glegg Hoens, 2016). Although middle managers (MMs) may potentially play a key role as KBs, how MMs act as KBs in health care has not been adequately studied in Canada or elsewhere (Birkin et al., 2018; Currie et al., 2014). This multi-methods study examined the role that MMs play in brokering knowledge in hospitals, the determinants of their KB efforts, and the impact of those efforts. The findings of a qualitative descriptive study, using semi-structured interviews with MMs in hospitals across Ontario, Canada, conducted concurrently with a Critical Interpretive Synthesis of the literature, found that MMs enact many of the roles and activities of knowledge brokers in hospitals to create, share or implement an innovative or evidence-based practice. In addition to roles and activities, this study contributes to the extant literature by revealing determinants that may influence MM KBs efforts and their impact in hospitals and by providing actionable insights into how to optimize the role. This study also makes recommendations that administrators and policy makers can use to strengthen KB roles to better equip MM KBs to ultimately improve quality of care.Ph.D

The roles, activities and impacts of middle managers who function as knowledge brokers to improve care delivery and outcomes in healthcare organizations: a critical interpretive synthesis

Abstract Background Middle Managers (MMs) are thought to play a pivotal role as knowledge brokers (KBs) in healthcare organizations. However, the role of MMs who function as KBs (MM KBs) in health care is under-studied. Research is needed that contributes to our understanding of how MMs broker knowledge in health care and what factors influence their KB efforts. Methods We used a critical interpretive synthesis (CIS) approach to review both qualitative and quantitative studies to develop an organizing framework of how MMs enact the KB role in health care. We used compass questions to create a search strategy and electronic searches were conducted in MEDLINE, CINAHL, Social Sciences Abstracts, ABI/INFORM, EMBASE, PubMed, PsycINFO, ERIC and the Cochrane Library. Searching, sampling, and data analysis was an iterative process, using constant comparison, to synthesize the results. Results We included 41 articles (38 empirical studies and 3 conceptual papers) that met the eligibility criteria. No existing review was found on this topic. A synthesis of the studies revealed 12 MM KB roles and 63 associated activities beyond existing roles hypothesized by extant theory, and we elaborate on two MM KB roles: 1) convincing others of the need for, and benefit of an innovation or evidence-based practice; and 2) functioning as a strategic influencer. We identified organizational and individual factors that may influence the efforts of MM KBs in healthcare organizations. Additionally, we found that the MM KB role was associated with enhanced provider knowledge, and skills, as well as improved organizational outcomes. Conclusion Our findings suggest that MMs do enact KB roles in healthcare settings to implement innovations and practice change. Our organizing framework offers a novel conceptualization of MM KBs that advances understanding of the emerging KB role that MMs play in healthcare organizations. In addition to roles, this study contributes to the extant literature by revealing factors that may influence the efforts and impacts of MM KBs in healthcare organizations. Future studies are required to refine and strengthen this framework. Trial registration A protocol for this review was not registered