What fosters or prevents interprofessional teamworking in primary and community care? A literature review
Section snippets
What is already known about the topic?
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The increase in prevalence of long-term conditions requires an integrated approach to promoting and maintaining population health, whilst improving service effectiveness.
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Interprofessional working is not always achieved in delivery of healthcare services; this may be due to a variety of reasons.
What this paper adds
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Two main factors, team structure and team processes, continue to have an impact on interprofessional teamworking in primary and community care in the 21st century.
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Within team structure, team premises, team size and composition and the availability of organisational support are important indicators of successful teamworking. Within team processes, setting clear goals and objectives for the team, ensuring regular team meetings and audit appear to foster effective teamworking.
Methods
For the purpose of this literature review and considering time and cost limitations, we included an electronic search of three bibliographic databases, a web-based search, a hand search of relevant journals, and an ancestry approach (Cooper, 1998).
Many different terms are used to describe the collaborative work between professionals such as ‘interprofessional collaboration’ and ‘teamwork’. Indeed, the terms ‘multiprofessional’, ‘interdisciplinary’ and ‘multidisciplinary’, are often used
Findings
The search yielded a final total of 43 articles. After a preliminary reading of the full papers, ten articles were identified and included in the review. Reasons for excluding 31 articles were: review papers (5); discussion papers (5); not focused on primary or community care (4); not identifying barriers or facilitators to teamwork (17). In addition, the two papers identified through informal channels were not considered in the research synthesis since their findings did not add anything new
Discussion
The analysis of studies included in this review revealed that the structure of the team, including the geographical proximity of team members, its size and composition, and the support an organisation provides, is vital for successful teamworking. Using thematic analysis, the findings were separated into themes and categories to allow in-depth consideration of issues; however it should be noted that these categories are not mutually exclusive, and the functioning of a team will also depend on
Implications for primary and community care team members
Some barriers identified in this review, such as team size and base, may be out of nurses’ control, but others may be more amenable to change. The Department of Health, 2004c, Department of Health, 2004d recent policies Agenda for Change and NHS Knowledge and Skills Framework have provided opportunities for nurse development. Both policies advocate nurses’ role in supporting reward systems, innovation, and implementation of change. In addition, nurses could facilitate the development of team
Conclusion
We conclude that the functions of interprofessional healthcare teams working in the 21st century are complex, being influenced by many interrelating factors. Governmental support for teamwork in healthcare is ongoing, although further work needs to be conducted at both a team and organisation level to ensure that enhancement and maintenance of teamwork leads to an improved quality of healthcare provision over the coming decades. Taking this review's suggestions into consideration may facilitate
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