What's So Great About Rehabilitation Teams? An Ethnographic Study of Interprofessional Collaboration in a Rehabilitation Unit

Authors

Lynne B. Sinclair, University of Toronto
Lorelei A. Lingard, University of Toronto
Ravindra N. Mohabeer, University of Toronto

Document Type

Article

Publication Date

7-2009

Journal

Archives of Physical Medicine and Rehabilitation

Volume

90

Issue

7

First Page

1196

Last Page

1201

URL with Digital Object Identifier

http://dx.doi.org/10.1016/j.apmr.2009.01.021

Abstract

OBJECTIVE: To explore team structures, team relationships, and organizational culture constituting interprofessional collaboration (IPC) in a particular rehabilitation setting; to develop a description of IPC practice that may be translated, adapted, and operationalized in other clinical environments.

DESIGN: An ethnographic study involving: Field observations: 40 hours, over 4 weeks, daily activities, 7 interprofessional meetings, 3 care planning meetings, 1 business meeting, and 3 family meetings; Individual observations: a physiotherapist, an occupational therapist, and a social worker individually observed for 45 minutes to an hour; and Interviews: 19 participants, 11 professions, 27 informal, 5 formal interviews. Data analysis consisted of an iterative process involving coding field notes for themes by 3 members of the research team by qualitative analysis software.

SETTING: Single inpatient spinal cord rehabilitation care unit in a Canadian urban academic rehabilitation hospital.

PARTICIPANTS: Purposive convenience sample of core team, more than 40 professionals: physiatrist, over 21 nurses, 3 physiotherapists, 3 occupational therapists, 2 social workers, chaplain, psychologist, therapeutic recreationist, program assistant, program manager, pharmacist, advanced practice leader, 6 students (1 pharmacy, 4 registered nurse, and 1 psychology), and on-site community organizations. After university and hospital ethical approvals, all staff members were recruited to participate in the study.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Not applicable.

RESULTS: Recurrent examples of IPC fit 2 dominant themes: team culture (divided into leadership, care philosophy, relationships, and the context of practice) and communication structures (both formal and informal).

CONCLUSIONS: IPC practice in rehabilitation care is supported by clinical, cultural, and organizational factors. This understanding of daily IPC work may guide initiatives to promote IPC in other clinical team settings.

Notes

Dr. Lorelei Lingard is currently a faculty member at The University of Western Ontario.