AN ETHNOGRAPHIC STUDY OF INTERPROFESSIONAL COLLABORATION IN A PAEDIATRIC SETTING: INSIGHTS THROUGH THE LENS OF SCRIPTEDNESS

Abstract

PhDInterprofessional collaboration (IPC) is when professionals from health and social care work together to provide a service for the patient or solve problems. Literature shows that although IPC is widely advocated, it is not always easy to achieve. IPC in the adult patient setting has been widely researched and despite the challenges, evidence shows several benefits. However, there is little IPC literature in hospitalised children’s settings. In view of this gap, the purpose of this study was to examine how healthcare providers enacted IPC in a paediatric setting. Goffman’s (1959) script theory and the different categories of scriptedness, guided the analytical process and gave structure and depth to the emerging findings, helping to see aspects of IPC that would otherwise remain invisible. This ethnography took place in a paediatric setting comprising of four wards namely; two medical, one surgical, and one oncology unit in one large hospital. Data collection and analysis were done iteratively and followed by time focusing exclusively on analysis and findings. The data corpus was generated through 114 hours of observation from 38 sessions, generating extensive field notes; 14 semi-structured formal interviews with professionals coming from seven different professions, and several informal interviews during observations. IPC was commonly observed during the weakly scripted encounters, mainly the unscheduled day-to-day interactions, not only because they were frequently observed, but also because the nature of these encounters was more conducive to IPC. Scriptedness also revealed that different professions contribute to the ward round IPC but not necessarily at the bedside. This became visible when the ward round was classified in five stages, guided by a multi-level metascript. Findings have added to the knowledge on IPC in paediatrics by highlighting how weak scripts guide the unscheduled encounters, and having a metascript guide the different stages of the ward round. This study has shown that the lens of scriptedness helps individuals discover how IPC is achieved during different encounters.University of Malt

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