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Open Access Highly Accessed Research article

A four-year, systems-wide intervention promoting interprofessional collaboration

Jeffrey Braithwaite1*, Mary Westbrook1, Peter Nugus1, David Greenfield1, Joanne Travaglia1, William Runciman2, A Ruth Foxwell3, Rosalie A Boyce4, Timothy Devinney5 and Johanna Westbrook1

Author Affiliations

1 Faculty of Medicine, University of New South Wales, Kensington, NSW 2052, Australia

2 The University of South Australia, GPO Box 2471, Adelaide, South Australia 5001, Australia

3 University of Canberra, Canberra, ACT 2601, Australia

4 University of Southern Queensland, Toowoomba, QLD 4350, Australia

5 University of Technology, 15 Broadway, Ultimo, Sydney, NSW 2007, Australia

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BMC Health Services Research 2012, 12:99  doi:10.1186/1472-6963-12-99

Published: 20 April 2012

Abstract

Background

A four-year action research study was conducted across the Australian Capital Territory health system to strengthen interprofessional collaboration (IPC) though multiple intervention activities.

Methods

We developed 272 substantial IPC intervention activities involving 2,407 face-to-face encounters with health system personnel. Staff attitudes toward IPC were surveyed yearly using Heinemann et al's Attitudes toward Health Care Teams and Parsell and Bligh's Readiness for Interprofessional Learning scales (RIPLS). At study's end staff assessed whether project goals were achieved.

Results

Of the improvement projects, 76 exhibited progress, and 57 made considerable gains in IPC. Educational workshops and feedback sessions were well received and stimulated interprofessional activities. Over time staff scores on Heinemann's Quality of Interprofessional Care subscale did not change significantly and scores on the Doctor Centrality subscale increased, contrary to predictions. Scores on the RIPLS subscales of Teamwork & Collaboration and Professional Identity did not alter. On average for the assessment items 33% of staff agreed that goals had been achieved, 10% disagreed, and 57% checked neutral. There was most agreement that the study had resulted in increased sharing of knowledge between professions and improved quality of patient care, and least agreement that between-professional rivalries had lessened and communication and trust between professions improved.

Conclusions

Our longitudinal interventional study of IPC involving multiple activities supporting increased IPC achieved many project-specific goals. However, improvements in attitudes over time were not demonstrated and neutral assessments predominated, highlighting the difficulties faced by studies targeting change at the systems level and over extended periods.

Keywords:
Systems research; Action research; Intervention; Change; Interprofessionalism; Survey; Longitudinal research; Attitudinal improvement; Collaboration; Socio-ecological theory