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The Experience of Family Physicians and Home Health Staff Involved in an Intervention to Increase Patient-Related Collaboration

  • Shannon Berg (a1) (a2) (a3), Sam Sheps (a4), Morris Barer (a4), Sabrina T. Wong (a5), Margaret McGregor (a1) (a6) and Ying C MacNab (a7)...

Abstract

Canadian family physicians (FPs) and home health staff (HHS) experience significant barriers to patient-related collaboration about patients they share. This mixed-methods study sought to determine the quality and sustainability of secure audio conferencing as a way to increase care planning about shared patients. Primary data sources included pre-and post-study administration of a published survey and post-study semi-structured interviews and focus groups. Non-parametric statistical procedures were used to analyze survey results and thematic content analysis was undertaken for qualitative data. Results from both quantitative and qualitative analysis were integrated into the overall analysis, in order to draw inferences reflecting both approaches to barriers and benefits of collaborative care planning for FPs and HHS. Both FPs and HHS provided evidence that structural barriers impede their ability to collaborate. HHS and FPs also agreed that joint conferences were beneficial for patients, and that the use of audio conferencing provided an efficient method of collaborative care planning. Limitations included a small sample size and short timeline for the intervention period, given the magnitude of the expected change.

Les médecins de famille (MF) et le personnel de soins de santé à domicile (PSD) canadiens rencontrent d’importants obstacles lorsqu’ils doivent collaborer pour la prestation de soins aux patients qu’ils ont en commun. Cette étude à méthodologie mixte visait à évaluer la qualité et la viabilité de l’utilisation de l’audioconférence sécurisée dans une optique d’amélioration de la planification des soins pour ces patients. Les données primaires incluaient les résultats d’un sondage réalisé avant et après l’intervention, ainsi que des entretiens semi-structurés et des groupes de discussion post-intervention. Des méthodes statistiques non paramétriques ont été utilisées pour analyser les résultats du sondage, et les données qualitatives ont fait l’objet d’une analyse thématique de contenu. Les résultats des analyses quantitatives et qualitatives ont ensuite été intégrés afin de faire ressortir les inférences reflétant les approches des MF et du PSD relatives aux obstacles et aux avantages de la planification interdisciplinaire des soins. Les MF et le PSD ont montré que des obstacles structurels limitent leur capacité à collaborer. Le PSD et les MF ont également convenu que les rencontres entre les intervenants des deux services étaient bénéfiques pour les patients et que l’utilisation de l’audioconférence constituait une méthode efficiente de planification collaborative des soins. Les limites comprenaient la petite taille de l’échantillon et la courte période d’intervention, compte tenu de l’ampleur des changements attendus.

Copyright

Corresponding author

La correspondance et les demandes de tirés-à-part doivent être adressées à : / Correspondence and requests for offprints should be sent to: Shannon Berg, Ph.D., M.Sc., B.Sc.OT 7th Floor 828 West 10th Avenue, Research Pavilion Vancouver, BC V5Z 1M9 (shannon.berg@ubc.ca)

Footnotes

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This research was funded through Canadian Institutes of Health Research (CIHR) Catalyst Grant number 212467. In-kind funding from the Vancouver Coastal Health Authority was received (time for research activities for Shannon Berg, administrative support for teleconferencing, and supplies). TELUS Business Solutions provided in-kind support including involvement in the research team and provision of audio conference solutions for eight months.

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References

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