P1:SFK/UKS P2:SFK/UKS QC:SFK/UKS T1:SFK fm BLBK287-Reeves May25,2010 21:58 Trim:244mm×172mm promoting partnership for health Interprofessional Teamwork for Health and Social Care Interprofessional Teamwork for Health and Social Care Scott Reeves, Simon Lewin, Sherry Espin and Merrick Zwarenstein © 2010 Blackwell Publishing Ltd. ISBN: 978-1-405-18191-4 i P1:SFK/UKS P2:SFK/UKS QC:SFK/UKS T1:SFK fm BLBK287-Reeves May25,2010 21:58 Trim:244mm×172mm promoting partnership for health Interprofessional Teamwork for Health and Social Care Scott Reeves Simon Lewin Sherry Espin Merrick Zwarenstein Series Editor: Hugh Barr A John Wiley & Sons, Ltd., Publication iii P1:SFK/UKS P2:SFK/UKS QC:SFK/UKS T1:SFK fm BLBK287-Reeves May25,2010 21:58 Trim:244mm×172mm Thiseditionfirstpublished2010 (cid:1)c 2010BlackwellPublishingLtd BlackwellPublishingwasacquiredbyJohnWiley&SonsinFebruary2007.Blackwell’spublishing programmehasbeenmergedwithWiley’sglobalScientific,Technical,andMedicalbusinesstoform Wiley-Blackwell. 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Designationsusedbycompaniestodistinguishtheirproductsareoftenclaimedastrademarks.All brandnamesandproductnamesusedinthisbookaretradenames,servicemarks,trademarksor registeredtrademarksoftheirrespectiveowners.Thepublisherisnotassociatedwithanyproductor vendormentionedinthisbook.Thispublicationisdesignedtoprovideaccurateandauthoritative informationinregardtothesubjectmattercovered.Itissoldontheunderstandingthatthepublisher isnotengagedinrenderingprofessionalservices.Ifprofessionaladviceorotherexpertassistanceis required,theservicesofacompetentprofessionalshouldbesought. LibraryofCongressCataloging-in-PublicationData Interprofessionalteamworkforhealthandsocialcare/ScottReeves...[etal.]. p.;cm.–(Promotingpartnershipforhealth) Includesbibliographicalreferencesandindex. ISBN978-1-4051-8191-4(hardback:alk.paper) 1.Healthcareteams. I.Reeves,Scott,1967– II.Series:Promotingpartnershipforhealth. [DNLM: 1.PatientCareTeam. 2.DeliveryofHealthCare–organization& administration. 3.InterprofessionalRelations. 4.SocialWork–methods. W84.8I6132010] R729.5.H4I5832010 362.1–dc22 2010007736 AcataloguerecordforthisbookisavailablefromtheBritishLibrary. (cid:1) Setin10/12.5ptPalatinobyAptaraR Inc.,NewDelhi,India PrintedinSingapore 1 2010 iv P1:SFK/UKS P2:SFK/UKS QC:SFK/UKS T1:SFK fm BLBK287-Reeves May25,2010 21:58 Trim:244mm×172mm Contents ListofBoxes,FiguresandTables vi TheAuthors viii SeriesForeword ix Acknowledgements xi Glossary xii Introduction 1 1. Interprofessionalteamwork–thebasics 10 2. Currentdevelopmentsaffectinginterprofessionalteamwork 24 3. Interprofessionalteamwork:keyconceptsandissues 39 4. Aconceptualframeworkforinterprofessionalteamwork 57 5. Usingtheorytobetterunderstandinterprofessionalteamwork 77 6. Interprofessionalteamworkinterventions 91 7. Evaluatinginterprofessionalteamwork 105 8. Synthesisingstudiesofinterprofessionalteamwork 121 9. Waysforward 137 References 144 Appendices 164 Index 189 P1:SFK/UKS P2:SFK/UKS QC:SFK/UKS T1:SFK fm BLBK287-Reeves May25,2010 21:58 Trim:244mm×172mm List of Boxes, Figures and Tables Boxes 1.1. BuildingteamworkinaruralAustraliancommunity 13 1.2. TheBrazilianFamilyHealthTeamProgramme 14 1.3. ThefamilyhealthteaminitiativeinCanada 15 1.4. TheSTRETCHProjectinSouthAfrica 16 1.5. UK-basedinterprofessionalteamworkinmaternitycare 17 1.6. TheMagnetHospitalinitiativeintheUS 18 2.1. Operatingroomteammembers’perceptionsoferror 26 2.2. Thedevelopmentofcollaborativepatient-centredpracticein Canada 27 2.3. Arecentlyfundedstudyoninterprofessionalteamworkin strokecare 32 2.4. ITandteamwork 34 3.1. Theinfluenceofteamtasksonteamwork 41 3.2. Anexampleofinterprofessionalteamwork 45 3.3. Anexampleofinterprofessionalcollaboration 46 3.4. Anexampleofinterprofessionalcoordination 46 3.5. Anexampleofaninterprofessionalnetwork 47 3.6. Anadaptiveinterprofessionalteam 47 3.7. Acomparisonofteamworkbasedinprivateandpublic fundedsettings 51 4.1. Interprofessionalteamworkandhierarchy 59 4.2. Howroutinesandspatialissuesaffectteamwork 66 4.3. Theroleoforganisationalsupportinteamwork 70 4.4. Aninsightintohowcontextualfactorscanaffectteamwork 73 5.1. TheuseofMarris’spsychodynamictheoryonlossandchange 81 5.2. TheuseofTajfelandTurner’ssocialidentitytheory 82 5.3. Theuseofasociologicalperspective–Goffman’sinteractionist approach 84 5.4. TheuseofEngestro¨m’sactivitytheoryinmedicalwards 85 5.5. Theusetheprofessionalisationapproachtounderstand medicalsportsteams 87 P1:SFK/UKS P2:SFK/UKS QC:SFK/UKS T1:SFK fm BLBK287-Reeves May25,2010 21:58 Trim:244mm×172mm ListofBoxes,FiguresandTables vii 5.6. TheuseofFoucauldiantheoryinprimarycareteams 89 6.1. Interprofessionalteamtrainingintervention 93 6.2. Ateamcommunicationintervention 95 6.3. Anintegratedcarepathwayintervention 97 6.4. Introducinganewroleintoprimarycare 98 6.5. Amultifacetedteamworkinterventionbasedingeneralmedicine 101 6.6. Anexampleofconsultant-ledintervention 104 7.1. Examplesofformativeandsummativeevaluations 109 7.2. Usesoflocalknowledgeinunderstandingorimproving teamworking 111 7.3. Anexampleofqualitativestudyusedtodevelopanintervention 115 7.4. Aqualitativestudyofinterventionimplementationprocesses 116 7.5. Amixedmethodsstudy 119 8.1. Factorswhichlimitedtheeffectsofteamworkinterventions 134 8.2. Implicationsforthefuturedesignofteamworkinterventions 136 Figures 3.1. Differingformsofinterprofessionalwork 44 4.1. Aframeworkforunderstandinginterprofessionalteamwork 58 Tables 3.1. Synthesisingsomeelementsofteamwork 41 3.2. Makingsenseofdifferentteamworktypologies 48 3.3. Summaryoffactorsinfluencingteamperformance 50 5.1. Socialsciencetheoriesthataidbetterunderstandingof interprofessionalteamwork 79 6.1. Summarisinginterprofessionalteaminterventions 102 7.1. Teamworkevaluationquestionsfordifferentteamworkactivities 110 8.1. Overviewofthekeyfeaturesoftheincludedinterprofessional studies 124 8.2. Mainfindingsfromthethreestudies 126 P1:SFK/UKS P2:SFK/UKS QC:SFK/UKS T1:SFK fm BLBK287-Reeves May25,2010 21:58 Trim:244mm×172mm The Authors ScottReevesisasociologistandaScientistattheKeenanResearchCentre,LiKa ShingKnowledgeInstituteofStMichael’sHospitalandtheWilsonCentre,Univer- sityHealthNetwork,Toronto,Canada.HeisalsotheDirectorofResearch,Centre forFacultyDevelopment,St.Michael’sHospital,andanAssociateProfessorinthe DepartmentofPsychiatryattheUniversityofTorontoandEditor-in-Chiefofthe JournalofInterprofessionalCare. SimonLewintrainedasaphysicianandnowworksasasocialscientistandhealth serviceresearcher.HeholdsresearchpositionsintheNorwegianKnowledgeCen- tre for the Health Services and in the Health Systems Research Unit of Medical Research Council of South Africa, where his work is focused largely on mixed methodimplementationresearchinlow-andmiddle-incomecountries.Heisalso an editor for the Cochrane Consumers and Communication Review Group and theCochraneEffectivePracticeandOrganisationofCareReviewGroup. SherryEspinisaregisterednurseandanAssociateProfessorintheDaphneCock- wellSchoolofNursing,RyersonUniversity,Toronto.Shepreviouslyheldseveral positions in perioperative clinical practice and education. She currently teaches in the post diploma and graduate programmes at Ryerson University, with an emphasis on qualitative research, interprofessional education and collaboration, currentissuesandnursingpracticecourses. Merrick Zwarenstein is a physician and a health services researcher. He is a Se- niorScientistattheSunnybrookResearchInstituteandattheInstituteforClinical EvaluativeSciences,andanAssociateProfessorintheDepartmentofHealthPol- icyManagementandEvaluationattheUniversityofToronto. P1:SFK/UKS P2:SFK/UKS QC:SFK/UKS T1:SFK fm BLBK287-Reeves May25,2010 21:58 Trim:244mm×172mm Series Foreword Promoting partnership for health Such is the faith in the efficacy of teamwork between professions in health and social care that it is in danger of being reified as a self-evident virtue in need of neitherjustificationnorcriticalreview. Challenging complacency, Scott Reeves and his co-authors subject interprofes- sional teamwork to critical scrutiny, mindful throughout of their obligation to chartwaysthroughthelabyrinthofproblems.Scepticalaboutfacilesolutionsim- portedfromotherworkingworlds,theydrivehometheneedforcriticalinvestiga- tion,generated withinhealthandsocial care. Grounding arguments inevidence, theyputapremiumonsystematicandrigorousevaluation,contributingunstint- inglyfromtheirownwealthofexperience.Cautioningagainstrelianceonanyone theoryordiscipline,theycomplementperspectivesfromdynamicandsocialpsy- chology, with which readers may be more familiar, with others from sociology, withwhichtheymaybelessfamiliar.Conceptualisingteamwork,theyconstructa robustanduser-friendlyframeworkwhichpromisestofindanenduringplacein theunderstandingofcollaborationbetweenprofessions. The outcome is a groundbreaking contribution to the teamwork literature and a noteworthy addition to the Wiley/CAIPE series. Packed with implications for policymakers,servicemanagersandpractisingprofessionalsasmuchasteachers, students and researchers, the book complements others in the series, especially MeadsandAshcroft(2005),byintroducingamuch-neededcritiqueofteamwork into the politics and practice of collaboration, and Glasby and Dickinson (2009), byremindingusthatintegratedservices,howeverwellconceived,canonlybeas goodastheteamworkbetweenthepeopleentrustedwiththeirimplementation. Thebookalsoprovidesamuch-neededresourcetohelpremedytheshortfallin teamworkteachingandlearningonprofessionalandinterprofessionalcoursesin health and social care (see Barr et al., 2005; Freeth et al., 2005). Teachers and stu- dents will find this book indispensable. It is being published concurrently with anotherintheseriesbyMickMcKeownandcolleagues(2010)whichputscollab- orationwithserviceusersandcarersattheheartofnotonlyhealthandsocialcare practicebutalsoeducation. Partnershipforhealth–thecatchphrasewhichwechoseforthisseries–hasmany meaningstoexplorefrommanyangles. HughBarr SeriesEditor EmeritusProfessorofInterprofessionalEducation UniversityofWestminster,UK P1:SFK/UKS P2:SFK/UKS QC:SFK/UKS T1:SFK fm BLBK287-Reeves May25,2010 21:58 Trim:244mm×172mm x SeriesForeword The books in the series BarrH,KoppelI,ReevesS,HammickM&FreethD(2005)EffectiveInterprofessionalEduca- tion:Argument,AssumptionandEvidence.BlackwellPublishing,Oxford. FreethD,HammickM,ReevesS,KoppelI&BarrH(2005)EffectiveInterprofessionalEduca- tion:Development,DeliveryandEvaluation.BlackwellPublishing,Oxford. Glasby J & Dickinson H (2009) International Perspectives on Health and Social Care. Wiley- Blackwell,Oxford. McKeownM,Malihi-ShojaL&DowneSwiththeComensusWritingCollective(2010)Ser- vice User and Carer Involvement in Education for Health and Social Care. Wiley-Blackwell, Oxford. Meads G & Ashcroft J with Barr H, Scott R & Wild A (2005) The Case for Collaboration in HealthandSocialCare.BlackwellPublishing,Oxford. ReevesS,LewinS,EspinS&ZwarensteinM(2010)InterprofessionalTeamworkforHealthand SocialCare.Wiley-Blackwell,Oxford. P1:SFK/UKS P2:SFK/UKS QC:SFK/UKS T1:SFK fm BLBK287-Reeves May25,2010 21:58 Trim:244mm×172mm Acknowledgements WewouldliketoacknowledgethehelpofIlonaAbramovichandAbigailWickson Griffithsfortheirworkinprovidingarangeofmaterialsforthebook;andJoanne Goldmanforhercriticalfeedbackonanearlierdraftofthetext. We are also very grateful for the support of our colleagues who were very generous in offering materials for the book and/or providing critical feedback on the contents of draft chapters – in alphabetical order – Anne Biringer, Simon Carmel,Philip Clark,Shelley Cohen Konrad, Signe Flottorp, JohnGilbert,Brigid Gillespie,PippaHall,RuthHarris,GillianHewitt,ValerieIles,ChrisKenaszchuk, Byrony Lamb, Tony Leiba, Jill Maben, Pat Mayers, Mary McAllister, Filomena Meffe,PatriciaParra,MadelineSchmitt,BrianSimmons,SarahSims,JulianSmith, KerryUebel,ElisabethWillumsenandCharmaineZankowicz. We would also like to acknowledge the support of our various institutions in thewritingofthisbook. Lastly,butimportantly,wewouldlikethankallourpartnersandfamilieswho supported us while we worked on the text. In particular, Scott would like to ex- press a special note of thanks to Ruth for her continued support and for her (extreme) patience during the writing of this book; he would also like to thank William,EwanandJoshuafortheirpatience.Simonwouldliketothankhispart- ner,SimonG,forhissupportonthisandmanyotherendeavours.