Exploring Professional Culture in the Context of Family Health Team Interprofessional Collaboration

摘要

BACKGROUND While family health teams (FHTs) seek to deliver collaborative patient-centered care, the barriers that can arise due to a practitioner’s professional culture pose a challenge to attaining interprofessional collaboration. The effect of professional culture in relation to FHT collaboration has not yet been examined, and a heightened awareness and appreciation of how this concept influences team dynamics holds promise to improve interprofessional collaboration on these and other evolving health care teams. METHODS Qualitative secondary data analysis was conducted on data collected from in-depth semi-structured focus groups (n=5). A non-random convenience sample consisted of 42 participants from medicine, nursing, and allied health professions at the Family Health Centre and Diabetes Education Centre in a large academic teaching hospital in urban Canada. Discussions were audio-taped and transcribed verbatim. Transcripts were analyzed for themes using a modified directed content analysis approach. FINDINGS Three main themes emerged: professional culture; FHT culture; and resources. Professional culture cannot be neatly separated from one’s personal, social or professional history, which ties in with opinions of accountability, power and hierarchy. Structure and processes of the FHT that encourage collaborative processes; clearly articulated scopes of practice, skills, authority; clarifications of roles and responsibilities; and opportunities to develop team relationships are necessary to diffuse the tension that exists between professional and FHT cultures. CONCLUSIONS FHTs are multidisciplinary groups co-located but with a lack of meaningful structures and processes to support collaboration. There is heavy physician dominance and physicians seem to adhere to old hierarchical structures and beliefs, consistent with their professional culture. In general, the health care providers need to build collaborative competencies (e.g. role clarity, effective communication) in order to move a group of interdisciplinary health care providers toward being a highly performing interprofessional team.