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Exploring interprofessional collaboration during the integration of diabetes teams into primary care

机译：在将糖尿病团队整合到初级保健过程中探索专业间的合作

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Specialised diabetes teams, specifically certified nurse and dietitian diabetes educator teams, are being integrated part-time into primary care to provide better care and support for Canadians living with diabetes. This practice model is being implemented throughout Canada in an effort to increase patient access to diabetes education, self-management training, and support. Interprofessional collaboration can have positive effects on both health processes and patient health outcomes, but few studies have explored how health professionals are introduced to and transition into this kind of interprofessional work. Data from 18 interviews with diabetes educators, 16 primary care physicians, 23 educators’ reflective journals, and 10 quarterly debriefing sessions were coded and analysed using a directed content analysis approach, facilitated by NVIVO software. Four major themes emerged related to challenges faced, strategies adopted, and benefits observed during this transition into interprofessional collaboration between diabetes educators and primary care physicians: (a) negotiating space, place, and role; (b) fostering working relationships; (c) performing collectively; and (d) enhancing knowledge exchange. Our findings provide insight into how healthcare professionals who have not traditionally worked together in primary care are collaborating to integrate health services essential for diabetes management. Based on the experiences and personal reflections of participants, establishing new ways of working requires negotiating space and place to practice, role clarification, and frequent and effective modes of formal and informal communication to nurture the development of trust and mutual respect, which are vital to success.
机译：专门的糖尿病团队，特别是获得认证的护士和营养师糖尿病教育团队，正在兼职纳入初级保健，以为加拿大糖尿病患者提供更好的护理和支持。该实践模型正在加拿大各地实施，旨在增加患者获得糖尿病教育，自我管理培训和支持的机会。专业间的合作可以对健康过程和患者健康状况产生积极影响，但是很少有研究探索如何将医疗专业人员引入这种专业间的工作中并向其过渡。在NVIVO软件的帮助下，使用定向内容分析方法对18位糖尿病教育者，16位初级保健医生，23位教育者的反思性期刊以及10次季度汇报会议的访谈数据进行了编码和分析。在与糖尿病教育者和初级保健医生之间的跨专业合作的过渡过程中，出现了四个主要主题，涉及面临的挑战，采用的策略以及所观察到的好处：（a）谈判空间，位置和角色; （b）建立工作关系; （c）集体表演; （d）加强知识交流。我们的发现提供了对传统上在基层医疗领域未曾一起工作过的医护人员如何合作以整合糖尿病管理必不可少的健康服务的见解。根据参与者的经验和个人反思，建立新的工作方式需要就实践空间和地点进行谈判，明确角色，以及经常和有效的正式和非正式沟通方式，以培养信任和相互尊重的发展，这对成功。

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