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Nursing home geriatric rehabilitation care and interprofessional collaboration; a practice-based study

BACKGROUND: Frailty and multimorbidity are common among patients in geriatric rehabilitation care (GRC). Proper care of these patients involves multiple professionals which requires optimal interprofessional collaboration to provide the best possible support. Interprofessional collaboration (IPC) go...

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Autores principales: Drenth, Hans, Krijnen, Wim, van der Weerd, Lourens, Reinders, Jan Jaap, Hobbelen, Hans
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10478267/
https://www.ncbi.nlm.nih.gov/pubmed/37670260
http://dx.doi.org/10.1186/s12877-023-04212-6
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author Drenth, Hans
Krijnen, Wim
van der Weerd, Lourens
Reinders, Jan Jaap
Hobbelen, Hans
author_facet Drenth, Hans
Krijnen, Wim
van der Weerd, Lourens
Reinders, Jan Jaap
Hobbelen, Hans
author_sort Drenth, Hans
collection PubMed
description BACKGROUND: Frailty and multimorbidity are common among patients in geriatric rehabilitation care (GRC). Proper care of these patients involves multiple professionals which requires optimal interprofessional collaboration to provide the best possible support. Interprofessional collaboration (IPC) goes beyond multi-professional collaboration. It requires professionals to think beyond the expertise of their own discipline and work on joint outcomes in which the patient is actively involved. This study describes the development of the GRC teams of an elderly care organization towards the IPC. METHODS: Mixed method pre-post study of 15 months. The interprofessional training program comprised team trainings, webinars, and online team sessions. Data was aggregated by administering the Extended Professional Identity Scale (EPIS) and QuickScan Interprofessional Collaboration (QS) measurements to GRC staff and by observations of the multi-professional team consultation (MPC) meetings of six GRC teams of an organization for elderly care in Drachten and Dokkum in the Netherlands. ADL independence (Barthel Index) and number of inpatient days were analyzed before and after the project. RESULTS: Pretest healthcare professional response was 106, patients for analyses was 181; posttest response was 84, patients was 170. The EPIS shows improvement on “interprofessional belonging” (P = .001, 95%CI: 0.57–2.21), “interprofessional commitment” (P = .027, 95%CI: 0.12–1.90), and overall “interprofessional identity” (P = .013, 95%CI: 0.62 − 5.20). On the QS, all domains improved; “shared values” (P = .009, 95%CI: 0.07 − 0.47), “context” (P = .005, 95%CI: 0.08 − 0.44), “structure & organization” (P = .001, 95%CI: 0.14 − 0.56), “group dynamics & interaction” (P < .001, 95%CI: 0.18 − 0.58), and “entrepreneurship & management” (P = .039, 95%CI: 0.01 − 0.48). A qualitative analysis of the reflection responses and MPC observations indicate a shift from multi-professional to more IPC. Differences in ADL over time were not statistically significant. The mean number of inpatient days was reduced by 11.8 (P < .001, 95%CI: -17.34 - − 6.31) days. CONCLUSIONS: Within the GRC teams, there was a shift observed to more IPC and better representation of the patient’s wishes and needs. ADL independence did not change, yet we found a statistically significant decrease in the number of inpatient days. The basis for IPC was well established, however, it remains necessary that the teams continue to develop and invest in the collaboration with each other and the patient to further improve it. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-023-04212-6.
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spelling pubmed-104782672023-09-06 Nursing home geriatric rehabilitation care and interprofessional collaboration; a practice-based study Drenth, Hans Krijnen, Wim van der Weerd, Lourens Reinders, Jan Jaap Hobbelen, Hans BMC Geriatr Research BACKGROUND: Frailty and multimorbidity are common among patients in geriatric rehabilitation care (GRC). Proper care of these patients involves multiple professionals which requires optimal interprofessional collaboration to provide the best possible support. Interprofessional collaboration (IPC) goes beyond multi-professional collaboration. It requires professionals to think beyond the expertise of their own discipline and work on joint outcomes in which the patient is actively involved. This study describes the development of the GRC teams of an elderly care organization towards the IPC. METHODS: Mixed method pre-post study of 15 months. The interprofessional training program comprised team trainings, webinars, and online team sessions. Data was aggregated by administering the Extended Professional Identity Scale (EPIS) and QuickScan Interprofessional Collaboration (QS) measurements to GRC staff and by observations of the multi-professional team consultation (MPC) meetings of six GRC teams of an organization for elderly care in Drachten and Dokkum in the Netherlands. ADL independence (Barthel Index) and number of inpatient days were analyzed before and after the project. RESULTS: Pretest healthcare professional response was 106, patients for analyses was 181; posttest response was 84, patients was 170. The EPIS shows improvement on “interprofessional belonging” (P = .001, 95%CI: 0.57–2.21), “interprofessional commitment” (P = .027, 95%CI: 0.12–1.90), and overall “interprofessional identity” (P = .013, 95%CI: 0.62 − 5.20). On the QS, all domains improved; “shared values” (P = .009, 95%CI: 0.07 − 0.47), “context” (P = .005, 95%CI: 0.08 − 0.44), “structure & organization” (P = .001, 95%CI: 0.14 − 0.56), “group dynamics & interaction” (P < .001, 95%CI: 0.18 − 0.58), and “entrepreneurship & management” (P = .039, 95%CI: 0.01 − 0.48). A qualitative analysis of the reflection responses and MPC observations indicate a shift from multi-professional to more IPC. Differences in ADL over time were not statistically significant. The mean number of inpatient days was reduced by 11.8 (P < .001, 95%CI: -17.34 - − 6.31) days. CONCLUSIONS: Within the GRC teams, there was a shift observed to more IPC and better representation of the patient’s wishes and needs. ADL independence did not change, yet we found a statistically significant decrease in the number of inpatient days. The basis for IPC was well established, however, it remains necessary that the teams continue to develop and invest in the collaboration with each other and the patient to further improve it. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-023-04212-6. BioMed Central 2023-09-05 /pmc/articles/PMC10478267/ /pubmed/37670260 http://dx.doi.org/10.1186/s12877-023-04212-6 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Drenth, Hans
Krijnen, Wim
van der Weerd, Lourens
Reinders, Jan Jaap
Hobbelen, Hans
Nursing home geriatric rehabilitation care and interprofessional collaboration; a practice-based study
title Nursing home geriatric rehabilitation care and interprofessional collaboration; a practice-based study
title_full Nursing home geriatric rehabilitation care and interprofessional collaboration; a practice-based study
title_fullStr Nursing home geriatric rehabilitation care and interprofessional collaboration; a practice-based study
title_full_unstemmed Nursing home geriatric rehabilitation care and interprofessional collaboration; a practice-based study
title_short Nursing home geriatric rehabilitation care and interprofessional collaboration; a practice-based study
title_sort nursing home geriatric rehabilitation care and interprofessional collaboration; a practice-based study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10478267/
https://www.ncbi.nlm.nih.gov/pubmed/37670260
http://dx.doi.org/10.1186/s12877-023-04212-6
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