What is the General Practitioner’s understanding of multi-professional teamwork?

Auteurs

  • John Wilfred Neden University of Kent
  • Claire Parkin
  • Catherine Neden

DOI:

https://doi.org/10.22024/UniKent/03/ajpp.755

Samenvatting

Abstract

Background 

There has been a move to increase multidisciplinary working in primary care, driven both by policy changes and by workforce challenges. The perspectives of the General Practitioners have not been widely investigated. 

Aim

The aim of this project was to explore what general practitioners (GPs) understand by ‘multi-disciplinary, primary healthcare team working’ in the current climate.

Design, Setting and Methods

A descriptive qualitative study, using semi-structured interviews was undertaken to explore the views of six GPs. Transcribed interviews were thematically analysed.

Results

Analysis of the interviews identified six broad themes. These were: practice team structure and function, GPs’ perceptions of their own role within the team, others’ roles within the team, communication issues, constraints impacting upon change and lastly, relationships with external organisations. 

Conclusions

General practice multidisciplinary teams are at present in a considerable state of flux due to changes in the workforce, with the introduction of new members, notably paramedic practitioners, extended nursing team roles and physician associates. The extension of the team has implications for increasing the supervisory and leadership role of the GP, without GPs necessarily feeling that they have the skill set for extending that role. The transition from providing physician-only care to team care provision, is seen as inevitable, given the work force strictures on general practice, but this study suggests it is not universally welcomed.

Biografie auteur

John Wilfred Neden, University of Kent

MSc student

Referenties

RCGP. General Practice and the Integration of Care. London: RCGP; 2012.

RCGP. The future of GP collaborative working. London: RCGP; 2016.

Dale J, Potter R, Owen K, Parsons N, Realpe A, Leach J. Retaining the general practitioner workforce in England: what matters to GPs? A cross-sectional study. BMC Fam Pract. 2015;16:140.

Kuzel AJ. Keys to high-functioning office teams. Fam Pract Manag. 2011;18(3):15–18.

Bodenheimer T. Primary Care — Will It Survive? N Engl J Med. 2006 Aug 31;355(9):861–4.

Williams A, Sibbald B. Changing roles and identities in primary health care: exploring a culture of uncertainty. J Adv Nurs. 1999 Mar 1;29(3):737–45.

Bramwell D, Peckham S, Allen P, Checkland K. How can GPs and community health services work more effectively together? Br J Gen Pr. 2015;65(636):374–375.

Arksey H, Snape C, Watt I. Roles and expectations of a primary care team. J Interprof Care. 2007 Jan 1;21(2):217–9.

Gerada C, Riley B. The 2022 GP: our profession, our patients, our future. Br J Gen Pr. 2012 Nov 1;62(604):566–7.

NHSEngland. Five Year Forward View [Internet]. London: NHSE; 2014 Oct. Available from: https://www.england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf

Matteliano MA, Street D. Nurse practitioners’ contributions to cultural competence in primary care settings. J Am Acad Nurse Pract. 2012 Jul;24(7):425–35.

Quinlan E, Robertson S. The communicative power of nurse practitioners in multidisciplinary primary healthcare teams. J Am Acad Nurse Pract. 2013;25(2):91–102.

Stewart KR, Stewart GL, Lampman M, Wakefield B, Rosenthal G, Solimeo SL. Implications of the Patient-Centered Medical Home for Nursing Practice. J Nurs Adm. 2015 Nov;45(11):569–74.

Vail L, Bosley S, Petrova M, Dale J. Healthcare assistants in general practice: a qualitative study of their experiences. Prim Health Care Res Dev. 2011;12(1):29–41.

Mazzaglia G, Lapi F, Silvestri C, Roti L, Giustini SE, Buiatti E. Association between satisfaction and stress with aspects of job and practice management among primary care physicians. Qual Prim Care. 2009 Jun;17(3):215–23.

Tierney E, O’Sullivan M, Hic

key L, Hannigan A, May C, Cullen W, et al. Do primary care professionals agree about progress with implementation of primary care teams: Results from a cross sectional study. BMC Fam Pract [Internet]. 2016;17(1). Available from: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85011277095&doi=10.1186%2fs12875-016-0541-9&partnerID=40&md5=c35f62a1c2c8acd61c9631ba9a29d9a9

Kislov R, Walshe K, Harvey G. Managing boundaries in primary care service improvement: A developmental approach to communities of practice. Implement Sci [Internet]. 2012;7(1). Available from: https://www.scopus.com/inward/record.uri?eid=2-s2.0-84867386514&doi=10.1186%2f1748-5908-7-97&partnerID=40&md5=f33f0f844676ac5fd7b0c5606e9b3f1c

Pullon S, Morgan S, Macdonald L, McKinlay E, Gray B. Observation of interprofessional collaboration in primary care practice: A multiple case study. J Interprof Care. 2016;30(6):787–94.

Creswell JW. Research Design: Qualitative, Quantitative, and Mixed Methods Approaches. Third Edition edition. Thousand Oaks, Calif: SAGE Publications, Inc; 2008. 296 p.

Miller P, Cannell C. Interviewing for social research. In: Educational research, methodology and measurement: An international handbook. 2nd ed. Oxford: Elsevier Science; 1997. p. 361–70.

Kvale S. InterViews: An Introduction to Qualitative Research Interviewing. 1 edition. Thousand Oaks, Calif: SAGE Publications, Inc; 1996. 344 p.

Bengtsson M. How to plan and perform a qualitative study using content analysis. NursingPlus Open. 2016 Jan 1;2:8–14.

Fischer CT. Bracketing in qualitative research: Conceptual and practical matters. Psychother Res. 2009;19(4–5):583–90.

Gray CP, Harrison MI, Hung D. Medical Assistants as Flow Managers in Primary Care: Challenges and Recommendations. J Healthc Manag Am Coll Healthc Exec. 2016;61(3):181–91.

Vegesna A, Coschignano C, Hegarty SE, Karagiannis T, Polenzani L, Messina E, et al. Attitudes towards physician-nurse collaboration in a primary care team-based setting: Survey-based research conducted in the chronic care units of the Tuscany region of Italy. J Interprof Care. 2016;30(1):65–70.

Harrod M, Weston LE, Robinson C, Tremblay A, Greenstone CL, Forman J. “It goes beyond good camaraderie”: A qualitative study of the process of becoming an interprofessional healthcare “teamlet”. J Interprof Care. 2016 May;30(3):295–300.

Patterson C, Arthur H, Peachey G, Vohra J, Price D, Pearson D, et al. Planning for interprofessional change in primary health care: exploring the use of the Interprofessional Resource Centre. Adv Med Educ Pract. 2013;4:117–25.

Irvine R, Kerridge I, McPhee J, Freeman S. Interprofessionalism and ethics: consensus or clash of cultures? J Interprof Care. 2002 Jan 1;16(3):199–210.

Pullon S. Competence, respect and trust: key features of successful interprofessional nurse-doctor relationships. J Interprof Care. 2008 Mar;22(2):133–47.

Macdonald MB, Bally JM, Ferguson LM, Lee Murray B, Fowler-Kerry SE, Anonson JMS. Knowledge of the professional role of others: a key interprofessional competency. Nurse Educ Pract. 2010 Jul;10(4):238–42.

Lawn S, Lloyd A, King A, Sweet L, Gum L. Integration of primary health services: being put together does not mean they will work together. BMC Res Notes. 2014;7:66.

Soubhi H, Bayliss EA, Fortin M, Hudon C, van den Akker M, Thivierge R, et al. Learning and Caring in Communities of Practice: Using Relationships and Collective Learning to Improve Primary Care for Patients with Multimorbidity. Ann Fam Med. 2010 Mar;8(2):170–7.

Croxson CH, Ashdown HF, Hobbs FR. GPs’ perceptions of workload in England: a qualitative interview study. Br J Gen Pr. 2017 Feb 1;67(655):e138–47.

Grumbach K, Bodenheimer T. Can Health Care Teams Improve Primary Care Practice? JAMA. 2004 Mar 10;291(10):1246–51.

Shaw EK, Howard J, Etz RS, Hudson SV, Crabtree BF. How Team-Based Reflection Affects Quality Improvement Implementation: A Qualitative Study. Qual Manag Health Care. 2012;21(2):104–13.

Bidwell S, Thompson L. GPs, community pharmacists and shifting professional boundaries - New Zealand Medical Journal [Internet]. 2015 [cited 2017 May 14]. Available from: https://www.nzma.org.nz/journal/read-the-journal/all-issues/2010-2019/2015/vol-128-no-1414-15-may-2015/6533

Naccarella L. General practitioner networks matter in primary health care team service provision. Aust J Prim Health. 2009;15(4):312–8.

Jaruseviciene L, Liseckiene I, Valius L, Kontrimiene A, Jarusevicius G, Lapão LV. Teamwork in primary care: perspectives of general practitioners and community nurses in Lithuania. BMC Fam Pract. 2013 Aug 15;14:118.

Brown JS, Duguid P. Organizational learning and communities-of-practice: Toward a unified view of working, learning, and innovation. Organ Sci. 1991;2(1):40–57.

##submission.downloads##

Gepubliceerd

2019-11-22

Citeerhulp

Neden, J. W., Parkin, C., & Neden, C. (2019). What is the General Practitioner’s understanding of multi-professional teamwork?. Advanced Journal of Professional Practice, 2(1), 14–21. https://doi.org/10.22024/UniKent/03/ajpp.755

Nummer

Vol 2 Nr 1 (2019)

Sectie

Articles

Licentie

© The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

AJPP requests that, as the creator(s)/author(s) of the manuscript you are submitting, that you assign certain rights to the manuscript to the AJPP in exchange for undertaking to publish the article in electronic form and, in general, to pursue its dissemination throughout the world. The rights the AJPP requests are:

  1. The right to publish the article in electronic form or in any other form it may choose that is in keeping with its role as a scholarly journal with the goal of disseminating the work as widely as possible;
  2. The right to be the sole publisher of the article for a period of 12 months;
  3. The right to make the article available to the public within a period of not more than 24 months, as determined by relevant journal staff of the AJPP;
  4. The right to grant republication rights to itself or others in print, electronic, or any other form, with any revenues accrued to be shared equally between the author(s) and the journal;
  5. The right to administer permission to use portions of the article as requested by others, seeking recompense when the AJPP sees it as warranted;
  6. The right to seek or take advantage of opportunities to have the article included in a database aimed at increasing awareness of it;
  7. As the author(s), the AJPP wishes you to retain the right to republish the article, with acknowledgement of the AJPP as the original publisher, in whole or in part, in any other pbulication of your own, including any anthology that you might edit with up to three others;
  8. As the author(s), the AJPP wishes you to retain the right to place the article on your personal Web page or respository of your university or institution. The AJPP askes that you include this notice: A fully edited, peer-reviewed version of this article was first published by the Advanced Journal of Professional Practice, <Year>, <Volume>, <Issue>, <Page Numbers>.
  9. You retain the right to unrestricted use of your paper for yourself or for your own teaching purposes.

BY AGREEING TO THE FOREGOING, YOU CONFIRM THAT THE MANUSCRIPT YOU ARE SUBMITTING HAS NOT BEEN PUBLISHED ELSEWHERE IN WHOLE OR IN PART, AND THAT NO AGREEMENT TO PUBLISH IS OUTSTANDING.

SHOULD THE ARTICLE CONTAIN MATERIAL WHICH REQUIRES WRITTEN PERMISSION FOR INCLUSION, YOU AGREE THAT IT IS YOUR OBLIGATION IN LAW TO IDENTIFY SUCH MATERIAL TO THE EDITOR OF THE AJPP AND TO OBTAIN SUCH PERMISSION. THE AJPP WILL NOT PAY ANY PERMISSION FEES. SHOULD THE AJPP BE OF THE OPINION THAT SUCH PERMISSION IS NECESSARY, IT WILL REQUIRE YOU TO PURSUE SUCH PERMISSSION PRIOR TO PUBLICATION.

AS AUTHOR(S), YOU WARRANT THAT THE ARTICLE BEING SUBMITTED IS ORIGINAL TO YOU.

Provided the foregoing terms are satisfactory, and that you are in agreement with them, please indicate your acceptance by checking the appropriate box and proceed with your submission.