Interprofessional Practice: Possibility or Pipedream

Abstract

Recognition of the importance of interprofessional practice in health care is growing. This recognition is based on research that identifies improvements in patient and service delivery resulting from shared decision making and coordinated activity. However, other studies identify interprofessional teams as a site of tension and contested authority. This paper reports the findings drawn from a qualitative study that examined health care professionals experiences of being part of an interprofessional team, the challenges as well as the triumphs. Method: Focus groups and interviews were held with teams and individuals who were members of an interprofessional team in an acute care context in a tertiary referral hospital in NSW, Australia. Participants included nurses, doctors, physiotherapist, speech therapists, and dieticians. Results: Participants highlighted openmindedness and goal co-operativeness as factors that enabled the development and ongoing functioning of the team and consequent adoption of team identity. Team member supported each other in dealing with the structural barriers to team working within the hospital environment. Tensions arose from the discipline specific demands on individuals that threatened the teams' activity. Processes that were identified as critical to team success were team processes, communication and shared leadership. Although there were often arguments within teams, individuals felt that being able to put forward their professional perspective increased their profile and their sense of being valued within the organization. Participants described having to work hard to keep the team together. Conclusion: Interprofessional team success is contingent on resisting persistent destabilizing forces and creating supportive and enabling processes.