Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article

Degree

Doctor of Philosophy

Program

Nursing

Supervisor

Kerr, Michael S.

Abstract

Interprofessional practice (IPP) has been a focus of attention over the last several decades as a key strategy to support the provision of safe quality care. Research suggests that interactional and organizational factors can either promote or hinder IPP. However, little empirical research is available about the relationships between these factors and healthcare provider outcomes. This study examines these relationships in the context of the introduction of an interprofessional model of patient care in a tertiary level hospital. Kanter’s Theory of Organizational Power, the Framework for Interprofessional Education for Collaborative Patient-Centred Practice, and the Analytical Framework of Interprofessional Collaboration were used to frame the study. This study investigates how interactional (i.e., levels of interprofessional collaboration; conflict; respect) and organizational (i.e., empowerment; patient safety climate) factors are related to IPP and healthcare provider outcomes (i.e., job satisfaction; satisfaction with quality of care). A hypothesized theoretical model was developed and tested to examine the relationships among global empowerment, interprofessional collaboration, conflict, respect, and patient safety climate linking to job satisfaction and satisfaction with the quality of care provision.

A non-experimental design and structural equation modeling techniques were used to conduct a secondary analysis of cross-sectional data post-intervention of an interprofessional model of care introduced in a tertiary care hospital setting. Participants were healthcare providers (n=1707). Confirmatory factor analysis supported the use of the revised 17-item Intensity of Interprofessional Collaboration Tool. The hypothesized study model had an acceptable fit: 2 (927) = 4013.18, p <.000; RMSEA =.043 [.041, .046]; CFI = .93; TLI =.94; SRMR = .043). Empowerment was positively related to interprofessional collaboration, respect, job satisfaction, and patient safety climate. Interprofessional collaboration was positively related to job satisfaction, patient safety climate, and satisfaction with the quality of care and mediated the relationship between empowerment to job satisfaction, patient safety climate, and satisfaction with the quality of care delivered. Conflict was negatively related to interprofessional collaboration, and respect was positively related to job satisfaction. Job satisfaction was positively related to satisfaction with the quality of care. Patient safety climate was positively related to job satisfaction and satisfaction with the quality of care delivered. In this study, empowering organizational structures in support of IPP were linked to interprofessional collaboration, respect, patient safety climate, and in turn, these factors were positively associated with job satisfaction, and satisfaction with the quality of care delivered. To our knowledge, this is the first study to examine these relationships. The study offers organizational leaders, researchers, and academics valuable information related to the introduction of interprofessional models of care.

Key words: interprofessional practice, interprofessional collaboration, conflict, respect, job satisfaction, patient safety, quality of care, empowerment, healthcare providers, models of care, tertiary care, structural equation modeling (SEM)

Summary for Lay Audience

Interprofessional practice (IPP) is an approach to health care delivery in hospital settings designed to improve the quality of patient care, improve healthcare provider relationships and job satisfaction, and reduce health care costs. It requires healthcare providers to work collaboratively together to organize patient care, and the decisions made in relation to care must include the patient and family. However, we still do not have enough information about the many factors that can influence an IPP approach to health care delivery. This study investigates how healthcare providers rate their interactions with one another (i.e., levels of interprofessional collaboration, conflict, respect), and how they view organizational support, patient safety, the quality of care they provided, and their job satisfaction after an interprofessional model of patient care was introduced in a large Canadian acute care hospital. Findings suggest that organizational support promotes interprofessional collaboration and respect among healthcare providers which in turn links to patient safety, job satisfaction, and satisfaction with the quality of care delivered.


Available for download on Wednesday, February 01, 2023

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