Gestão do trabalho interprofissional no projeto terapêutico singular: proposta de modelo de processo de trabalho / Management of interprofessional work in the singular therapeutic project: proposal for a work process model

Objetivo: propor um modelo para organização das atividades de um Projeto Terapêutico Singular (PTS) no contexto da estratégia da Saúde da Família (ESF), facilitando a colaboração interprofissional. Método: Trata-se de pesquisa qualitativa. Utilizou-se a estratégia de pesquisa-ação, envolvendo uma equipe multiprofissional de saúde e ações de colaboração interprofissional para aprimorar a prática. A pesquisa-ação foi escolhida por mostrar-se adequada para estudos em cenários sociais, em contextos diversos. Os pesquisadores e a equipe acordaram que a discussão do PTS ocorresse em reuniões amplas para favorecer a discussão, reflexão e propostas de ações para o caso. O trabalho de campo envolveu aproximadamente 20 reuniões com a equipe que geravam subsequentes momentos reflexivos da pesquisa. Essa dinâmica favoreceu a proposta do modelo. As etapas do trabalho da pesquisa foram reconhecimento do problema, planejamento, implementação e avaliação. Resultado: Nas reuniões do trabalho coletivo, a equipe pesquisadora percebeu problemas no processo do PTS, tais como: falta de clareza dos objetivos; planejamento e direcionamento das ações colaborativas interprofissionais pouco efetivos para envolver paciente e família no cuidado de saúde. Nesse contexto, propôs-se um modelo de PTS com quatro etapas: Discussão do caso, Designação, Execução e Encerramento ou nova abordagem do processo de atenção. Conclusão: O modelo proposto é uma contribuição teórica e necessita de mais estudos empíricos para validar sua aplicação no âmbito da ESF. Identificou-se, como limitante para a gestão do cuidado para o PTS, a falta de formação pré- e pós-graduada em educação interprofissional dos participantes. No entanto, o modelo se justifica na medida que ajuda a construir ações interprofissionais, recomendadas pelo Sistema Único de Saúde (SUS) e órgãos internacionais da saúde (OMS e OPAS) (AU).

Objective: propose a model for organizing the activities of a Singular Therapeutic Project (STP) in the context of Family Health Strategy (FHS), contemplating interprofessional collaboration. Method: It is qualitative research. The action-research strategy was used, involving a multidisciplinary health team and interprofessional collaboration actions, in order to improve the practice. Action research was chosen because it is suitable for studies in social settings, in different contexts. The researchers and the team agreed the discussion of the STP would take place in large meetings to encourage discussion, reflection and proposals for actions to be taken for the case. Fieldwork involved approximately 20 meetings with the team that generated subsequent reflective moments of the research. This dynamic favored the proposal of the model. The stages of the research work were: problem recognition, planning, implementation and evaluation. Result: In the collective work meetings, some flaws in the STP process were noticed, such as: a lack of clarity of objectives; few interprofessional collaborative actions directed and planned along with the patient and family and low resolution. Thus, a four-step model was proposed: staff meeting, assignment of STP cases, executing the STP, and closing the STP. These steps range from case selection to completion of the STP, or definition of a new care approach by the team. Conclusion: The proposed model is a theoretical contribution and needs further empirical studies in order to validate its application within the FHS. The lack of pre and postgraduate training in interprofessional education of the participants was identified as a limiting factor for the care management for the STP. However, the model is justified as it helps to build interprofessional actions, recommended by the Unified Health System (UHS) and international health agencies (WHO and PAHO) (AU).

The role of librarians in healthcare interprofessional collaboration: a literature review

Background: As the delivery of healthcare evolves to become more interconnected, coordinating care between nurses, pharmacists, physicians, social workers as well as medical librarians and other disciplines has become increasingly important. Librarians are more deeply involved in ward rounds routine exercise, provision of instruction in health information literacy, medical informatic, evidence-based research skills, and problembased learning. This article introduces key concepts relating to the interprofessional collaborative teamwork among health professionals and its impact on medical librarians. Methods: Data for this paper was collected through the literature review and it was done using various online searching tools with relevant information including, PubMed, LibHub, Science Direct and Google Scholar. Results: The results show that the emerging and changed roles have resulted in a shift in professional identity with the health sciences librarians moving toward a collaborative, consultative practice that is more closely aligned to user's needs and approaching patient care from a team-based perspective. Conclusion and Recommendation: The paper concludes among others that there is a need for library science educators and health sciences librarians to seek and identify skills needed for evolving library practice and formal documentation of new roles within clinical settings. It is recommended that they should add technology, collaborative, consultative, instructional design, and teaching skills to their professional toolbox

Nurses’ Perception of Interprofessional Collaboration in Hospitals in the Maldives

@#Introduction: The concept of interprofessional collaboration (IPC) is widely used in healthcare organizations, where patients are treated. However, there is no definite terminology that can explain the term IPC. The aim of this research is to understand nurses’ perception of IPC in Hospitals in the Maldives. Methods: A cross -sectional survey was conducted among 292 nurses from two hospitals followed by Focus Group Discussions with 5 nurses from each hospital. The instrument tool used for the survey was “conceptualization of interdisciplinary collaboration” by D’Amour which was adapted for this study with 9 items and an expert validated open ended questionnaire. Results: The findings from the study shows positive responses for IPC1-Disciplinary groups do exchange information 58.65% (n=171), IPC2- Share clinical decision making 60.3% (n=176), IPC3-Patient data are collectively reviewed 62.7% (n=183), IPC4- Supports each other in the multidisciplinary team 59.2% (n=173), IPC5 highest rate of positive response was for “IPC 6- conflict resolution which was 63.7% (n=186), IPC7- common care plan 63.0% (n=184), IPC8- Data collected at one point is shared with the team 57.5% (n=168) and the lowest was for “IPC 9- level of collaboration -56.8% (n=166) respectively. Conclusion: This study revealed that importance should be given to promoting a culture of interprofessional collaboration in the hospitals of Maldives. Therefore, there is a need to address this and implement IPC with respect to all professionals, by mitigating the hierarchical differences in the healthcare system. Thus, it is crucial to educate all HCPs with regard to sustaining IPC.

The Role of Pharmacies for Elderly Individuals with Complex Issues: Promotion of Support Tools by a Community Pharmaceutical Association / 社会薬学

The aging population in Japan continues to grow, leading to the emergence of complex issues. To understand the current awareness of these issues among member pharmacies of the Fukuoka City Minami Ward Pharmaceutical Association and promote various initiatives, support tools such as the “Consultation Flowchart” and “Consultation Checklist” were distributed to share information about the elderly with the local comprehensive support center. A survey was conducted to assess the awareness of complex issues and support tools. The survey revealed that about half of the pharmacy pharmacists were aware of the complex issues themselves, but the Consultation Flowchart had a recognition rate of 35.34%, and the Consultation Checklist had a recognition rate of 31.03%. It was also found that pharmacies with higher participation in regional collaboration meetings and a greater number of visits for medication management counseling had higher awareness of complex issues and support tools. To enhance efforts in addressing complex issues, the Fukuoka City Minami Ward Pharmaceutical Association needs to approach pharmacies with limited participation in regional collaboration meetings and a lower number of visits for medication management counseling. Building visible relationships with diverse professions in the community is crucial for improvement initiatives related to complex issues.

Reflection on Interprofessional Collaboration Based on Uncomfortable Experiences / 医学教育

The first author set up a study group with other members in 2014, aiming to improve multidisciplinary collaboration through reflection and discussions on discomfort ( “Moyatto” in Japanese) while focusing on group members’ experiences at work. One-hour online sessions were conducted monthly with multidisciplinary professionals from several institutions. We reflected on interprofessional collaboration based on Moyatto. This paper describes the history of the study group’s inception and development, the learning process of each session, and the theory as a framework. It also reports on the practice and changes in our study group, concluding that interprofessional collaboration requires first-order reflection within a same-profession group and second-order reflection among diverse professionals.

Paradoxos e limites da colaboração interprofissional: análise de um Núcleo Ampliado de Saúde da Família e Atenção Básica / Paradoxes and limits of interprofessional collaboration: analysis of an Extended Family Health and Primary Care Center / Paradojas y límites de la colaboración interprofesional: análisis de un Núcleo Ampliado de Salud de la Familia y Atención Primaria

Resumo Este artigo analisa as possibilidades e os limites da colaboração interprofissional no âmbito do cuidado em saúde mental, considerando-se as articulações entre as equipes do Núcleo Ampliado de Saúde da Família e Atenção Básica e da Estratégia de Saúde da Família em um município do estado do Rio de Janeiro. Trata-se de uma pesquisa qualitativa, baseada na abordagem hermenêutica filosófica, que se pautou em um estudo de caso, utilizando como estratégias metodológicas a observação participante, grupos focais narrativos e entrevistas semiestruturadas. Os resultados indicam a indissociabilidade dos elementos estruturais, organizacionais e intersubjetivos na colaboração interprofissional, com fortes tensionamentos no que diz respeito à organização dos processos de trabalho tanto em sua dimensão formal quanto intersubjetiva. Identificou-se que o compartilhamento de alguns objetivos do cuidado, como a desmedicalização, fomentava a construção de parcerias entre as equipes. Por outro lado, a partir do diálogo com os referenciais utilizados, compreendeu-se que regras construídas com o intuito de induzir a cooperação tiveram efeito paradoxal, gerando participação desimplicada em parte dos trabalhadores. Conclui-se que as relações de confiança no trabalho mostraram-se um elemento fundamental para a colaboração, o que exige a configuração de um ambiente organizacional capaz de aglutinar interesses e lidar com conflitos.

Abstract This article analyzes the possibilities and limits of interprofessional collaboration in mental health care, considering the articulations between the teams of the Extended Family Health and Primary Care Center and the Family Health Strategy in a city in the state of Rio de Janeiro, Brazil. This is a qualitative research, based on the philosophical hermeneutic approach, which was based on a case study, using as methodological strategies participant observation, narrative focus groups, and semi-structured interviews. The results indicate the inseparability of structural, organizational, and intersubjective elements in interprofessional collaboration, with strong tensions regarding the organization of work processes in both their formal and intersubjective dimensions. It was identified that the sharing of some care goals, such as demedicalization, fostered the construction of partnerships among the teams. On the other hand, from the dialog with the references used, it was understood that rules constructed with the intention of inducing cooperation had a paradoxical effect, generating unimplicated participation on part of the workers. It is concluded that trust at work has proven to be a fundamental element for collaboration, which requires the configuration of an organizational environment capable of bringing together interests and dealing with conflicts.

Resumen Este artículo analiza las posibilidades y los límites de la colaboración interprofesional en el ámbito de la atención de salud mental, considerando las articulaciones entre los equipos del Núcleo Ampliado de Salud de la Familia y Atención Primaria y de la Estrategia de Salud de la Familia en un municipio del estado de Río de Janeiro. Se trata de una investigación cualitativa, basada en un enfoque hermenéutico filosófico, que se basó en un estudio de caso, utilizando como estrategias metodológicas la observación participante, grupos focales narrativos y entrevistas semiestructuradas. Los resultados indican la indisociabilidad de los elementos estructurales, organizacionales e intersubjetivos en la colaboración interprofesional, con fuertes tensiones en cuanto a la organización de los procesos de trabajo tanto en su dimensión formal como intersubjetiva. Se identificó que el intercambio de algunos objetivos de la atención, como la desmedicalización, fomentaba la construcción de asociaciones entre los equipos. Por otro lado, a partir del diálogo con las referencias utilizadas, se entendió que las reglas construidas con el objetivo de inducir la cooperación tuvieron un efecto paradójico, generando una participación desinteresada en parte de los trabajadores. Se concluye que las relaciones de confianza en el trabajo demostraron ser un elemento fundamental para la colaboración, lo que requiere la configuración de un entorno organizacional capaz de aglutinar intereses y tratar conflictos.

Implications of Health Care Providers by Physicians' and Pharmacists' Attitudes and Perceptive Barriers towards Interprofessional Collaborative Practices

Abstract The study was aimed at assessing and comparing physicians' and pharmacists' attitudes and experiences with collaborative practices, along with the extent of barriers toward interprofessional collaboration in Iraqi healthcare settings. A descriptive, cross-sectional study was conducted among physicians and pharmacists in different healthcare settings in Baghdad, Iraq through an interview using a structured 3-part questionnaire, assessing the demographic characteristics, attitudes and barriers to interprofessional collaborative practices. A total of 384 participants were enrolled in this study. The physicians and pharmacists reported a significant positive attitudes towards collaboration, such as ''pharmacists are qualified to assess and respond to patients' drug treatment needs'' (69.8%, vs. 89.6%,; P=0.001);''pharmacists have special expertise in counseling patients on drug treatment'' (59.9%, vs. 86%; P=0.001); ''physicians and pharmacists should be educated to establish collaborative relationships'' (80.7%, vs. 100%; P=0.001), respectively. However, 57.3% of the physicians agreed about ''lack or inadequate of pharmacists' time to provide direct and effective patient care because of medications dispensing duties'', while 56.8% of the pharmacists disagreed about this barrier (P=0.005). Both professions reported significant, positive attitudes and shared some barriers toward collaborative practices; however, there is a disagreement in some areas in which both professions would like more collaboration for better patient care.

Application of Interprofessional Education Model to University Pre-Licensure Health Students in the Management of Chronic Care Conditions in Zambia

Background:Thereisevidencethatmultidisciplinary healthcare teams can provide better quality of care and treatment outcomes compared to that delivered by individuals from a single health discipline. The project on which this article isbased applied the interprofessional education model to university pre-licensure health students in the management of chronic care conditions in Zambia. Methods:Four distinct but interrelated approaches, name ly desk review; module development workshops; review and validation of modules by experts; piloting and review of the training modules were employed. Results: Severalmodelsofinterprofessionaleducationcurrentlyinexistenceandusedsuccessfully by higher education institutions in other settings were identified. While several models of Interprofessional Education were identified, our project adapted the "didactic program, community-based experience, and interprofessional-simulation experience" models. To apply the models, modules of seven chronic care conditions were developed and piloted. The extent to which the module activities promoted interprofessional education were rated between 74 - 87% (agree or strongly agree) by the students. Conclusion: Three models of Interprofessional Education were identified and adapted in the project and seven modules were developed and administered to the students. The process was effective for putting forth an interprofessional training program at the undergraduate level, with the potential to improve quality of care for patients.

Interprofessional collaboration role of school nurse: A concept analysis

@#This concept analysis seeks to clarify the interprofessional collaboration role of school nurses and provide a definition using Rodgers' evolutionary method. A literature search was utilized to determine the interprofessional collaboration role and its notable attributes, antecedents, and consequences. Defining attributes of interprofessional collaboration include values/ethics for interprofessional practice, roles and responsibilities of a school nurse, communication, and teamwork, which explain and constitute the definition of the concept. Antecedents include care coordination, case management, case finding and collaboration with consequences of health outcomes, interdisciplinary mobilization, and school health services integration were recognized in the text as those events or aspects that occur before and after interprofessional collaboration takes place in a practical situation, respectively. Indeed, this paper adds and builds further understanding of the concept, potentially guiding a standard reference to the term, and facilitating further knowledge on how school nurses and other health care providers can effectively apply interprofessional collaboration in various settings.

Implementation of a remote interprofessional education module on role understanding of community health workforce

Background and Objectives@#Interprofessional education (IPE) is considered by the World Health Organization “a necessary step in producing collaborative practice-ready health professionals.” In the Philippines, the ability to “work collaboratively within interprofessional and multi professional teams”, was identified by the Commission on Higher Education as one of the outcomes common to all health-related professions programs. Although steps were taken to integrate IPE in health professions education, majority of academic institutions in the country are yet to implement this. This study aimed to present the implementation of an online IPE module about the community health workforce among dental, medical and pharmacy students in a national health sciences university. @*Methodology@#The IPE module was developed and facilitated jointly by an interprofessional team of faculty engaged with the Community Health and Development Program of the University of the Philippines Manila. A total of 48 students from the Colleges of Dentistry, Medicine and Pharmacy participated. Teaching-learning activities used in the sessions included lectures, small group discussions, interviews, case study, large group discussions, and reflections. @*Results@#Insights gained by the participants included the complementary roles of health care workforce in the community, importance of communication and role understanding for better provision of care, the challenges that the workforce experience and their roles as future health workers in promoting collaborative practice by demonstrating respect and professional equality. @*Conclusion@#The module has shown that IPE activities may be successfully implemented through remote learning if done with proper planning and execution with the commitment of faculty facilitators.

El trabajo colaborativo interprofesional en el proceso de formación profesional en salud

RESUMEN Fundamento: Con el propósito de alcanzar un tratamiento integral de los pacientes es necesario que los profesionales de las diferentes disciplinas de la salud trabajen de forma conjunta en equipos colaborativos, colaboración cuyo escenario va a encontrarse también fuera de los muros de las universidades, donde a través de actividades de extensión universitaria, se concreta la formación de los estudiantes. Objetivo: argumentar la necesidad del trabajo colaborativo interprofesional en el proceso de formación profesional en salud. Método: se realiza una revisión documental en idioma español e inglés. Se utilizaron diferentes bases de datos como SciELO, Google Académico, Red Nacional de Información en Salud (INFOMED). Se utilizaron las siguientes palabras clave: educación interprofesional, colaboración interprofesional, extensión universitaria. Se seleccionaron 33 referencias actualizadas que permitieron con la utilización de métodos empíricos y teóricos hacer referencia a la colaboración interprofesional en la formación del profesional de la salud. Desarrollo: Las organizaciones de atención médica deben adoptar una amplia cultura de equipo y trabajo colaborativo en la que ciertos valores y principios se compartan y se comuniquen de forma transparente entre los miembros del equipo. Es un proceso que incluye la comunicación y la toma de decisiones, permitiendo una influencia sinérgica de conocimientos y habilidades agrupadas. Conclusiones: Es importante que desde la propia formación los estudiantes adquieran habilidades de trabajo en equipo interprofesionales para posteriormente aplicarlas en su desarrollo profesional. El trabajo colaborativo interprofesional brinda a los estudiantes la capacidad de compartir habilidades y conocimientos entre profesiones.

ABSTRACT Foundation: With the purpose of reach an integral treatment of the patients is necessary that the professionals of the different disciplines of health work of form joint in collaborative teams, collaboration whose scene is going to meet also out of the walls of the universities, where through activities of university extension, the students' formation is concretized. Objective: Argumenting the need of the collaborative interprofessional work in the process of technical training in health. Method: A documentary revision in Spanish language and English are accomplished. They utilized themselves different bases of data like SciELO, Google Scholar and National Network of Information on Health (INFOMED). They utilized the following keywords: Interprofessional education, interprofessional collaboration, university extension. 33 updated references that they enabled with the utilization of empiric methods and theoreticians selected making reference to the interprofessional collaboration in the health-care professional's formation themselves. Development: The institutions of medical attention must embrace team's ample culture and I work collaborative in the one that certain moral values and beginnings share in themselves and get in touch of transparent form between the team's members. It is a process that includes the communication and the overtaking, permitting a synergetic influence of knowledge and grouped abilities. Conclusions: It is important than from the own formation the students acquire abilities of work in team interprofessional stops at a later time to apply them in his professional development. The collaborative interprofessional work offers the students the capability to share abilities and knowledge between professions.

Educación interprofesional y seguridad del paciente: una revisión sistemática / Interprofessional Education and Patient Safety: A Systematic Review / Educação interprofissional e segurança do paciente: uma revisão sistemática

Introducción: la educación interprofesional (EIP) se define como una iniciativa educativa, formativa o docente que involucra a más de una profesión en el aprendizaje conjunto e interactivo. La formación del recurso humano en salud tiene como desafío plantear soluciones a la escasez de personal sanitario en el mundo y formar profesionales que tengan un desempeño óptimo. Objetivo: caracterizar las publicaciones relacionadas con la implementación de modelos en educación interprofesional y el impacto generado en algunos aspectos relacionados con la seguridad del paciente. Método: se realizó una revisión sistemática de la literatura científica en Pubmed, Science Direct, Scielo, LILACS y Google Scholar con siete estrategias de búsqueda garantizando la exhaustividad y reproducibilidad en las fases de la guía PRISMA. Resultados: se incluyeron n = 33 estudios de los cuales n = 19 (57,5%) fueron aplicados en el contexto hospitalario, n = 14 (42,4%) utilizaron metodologías cuasiexperimentales, de estos n = 4 estudios miden desenlaces directos relacionados con la seguridad del paciente, y en los otros n = 29 (87,8%) se encontró una mejora en la comunicación, percepción y conocimiento en los equipos de trabajo. Conclusión: el aprendizaje interprofesional mejora la comunicación y la interacción entre los profesionales de salud. No obstante, es difícil generalizar los resultados debido a la diversidad de metodologías de interacción interprofesional aplicadas en los estudios.

Introduction: interprofessional education (IPE) is an educational, training, or teaching initiative involving more than one profession in joint and interactive learning. The challenge of training human resources in health is to propose solutions to the shortage of health personnel globally and to train professionals who have optimal performance. Objective: characterize the publications related to the implementation of interprofessional education models and the impact generated in aspects related to patient safety. Method: a systematic review of the scientific literature was carried out in PubMed, Science Direct, SciElo, LILACS, and Google Scholar with seven search strategies guaranteeing completeness and reproducibility in the phases of the PRISMA guide. Results: n = 33 studies were included, of which n = 19 (57.5%) were applied in the hospital context, n = 14 (42.4%) used quasi-experimental methodologies, of these n = 4 studies measure direct outcomes related to patient safety, and in the other n = 29 (87.8%) an improvement was found in communication, perception, and knowledge in in the work teams. Conclusion: interprofessional learning improves communication and interaction between health professionals. However, it is difficult to generalize the results due to the diversity of interprofessional interaction methodologies applied in the studies.

Introdução: a educação interprofissional (EIP) é definida como uma iniciativa educacional, de treinamento ou de ensino que envolve mais de uma profissão na aprendizagem conjunta e interativa. O desafio da formação de recursos humanos em saúde é propor soluções para a carência de pessoal de saúde no mundo e formar profissionais com ótimo desempenho. Objetivo:caracterizar as publicações relacionadas à implantação de modelos na educação interprofissional e o impacto gerado em alguns aspectos relacionados à segurança do paciente. Método: foi realizada uma revisão sistemática da literatura científica no Pubmed, Science Direct, Scielo, LILACS e Google Scholar com sete estratégias de busca garantindo completude e reprodutibilidade nas fases do guia PRISMA. Resultados: n = 33 estudos foram incluídos, dos quais n = 19 (57,5%) foram aplicados no contexto hospitalar, n = 14 (42,4%) utilizaram metodologias quase-experimentais, destes n = 4 estudos medem resultados diretos relacionados com a segurança do paciente, e nos demais n = 29 (87,8%) houve melhora na comunicação, percepção e conhecimento nas equipes de trabalho. Conclusão: a aprendizagem interprofissional melhora a comunicação e a interação entre os profissionais de saúde. No entanto, é difícil generalizar os resultados devido à diversidade de metodologias de interação interprofssional aplicadas nos estudos

Comparison of Interprofessional Collaboration, Work Burden, Workplace Satisfaction, and Relationship with Neighboring Facilities between Clinic/Small Hospital Staff and those at Regional Core Hospitals / 日本プライマリ・ケア連合学会誌

Introduction: This study compared perceptions of interprofessional collaboration and recognition of work between clinic/small hospital staff and those at regional core hospitals.Methods: An anonymous, self-administered questionnaire was administered to the staff at 4 clinics/small hospital and those at 3 regional core hospitals responsible for regional medical care. The following items were compared between the 2 groups: Assessment of Interprofessional Team Collaboration (AITCS) Japanese version, Readiness for Interprofessional Learning Scale (RIPLS) Japanese version, workplace satisfaction, and relationship with neighboring facilities.Results: The subjects were 74 staff members at clinics and small hospital and 576 staff members at regional core hospitals; their average ages were 41.9 years and 40.6 years, respectively. Compared to staff at regional core hospitals, those at the clinics and small hospitals had significantly higher AITCS scores, RIPLS scores, and workplace satisfaction, and they also considered their institutions to have better relationship with neighboring facilities.Conclusion: The staff of clinics and small hospital were more aware of interprofessional collaboration than hospital staff, and were more satisfied with their workplaces. Understanding the underlying organizational differences may facilitate vertical integration in community-based integrated care systems.

A rapid literature review on the strategies for collaboration between occupational therapists and speech-language therapists in the field of augmentative and alternative communication

@#An alternative and augmentative communication (AAC) device replaces or supplements a person’s natural speech. Speech-Language Pathologists (SLPs) collaborate with a team of healthcare professionals in the process of identification and use of the right AAC device for a person with complex communication needs (CCN). In the Philippines, occupational therapists (OTs) and SLPs are more likely to collaborate in the treatment of their clients due to their interprofessional education (IPE) experience. However, most Filipino SLPs do not engage in interprofessional collaboration (IPC) when rendering AAC services. Thus, there is a need to identify existing literature that tackles collaborative practices to raise the quality of service and care. Hence, this study aimed to identify and discuss existing literature that documented IPE and IPC strategies between OTs and SLPs in the field of AAC. The structure of this literature review was guided and adapted from the topics outlined in the preferred reporting items for systematic reviews and meta-analyses (PRISMA). Literature archived in two databases (Pubmed and Scopus) were reviewed. Two articles out of five studies were included in this review. Strategies found were “case based learning approach” for post-graduate students and the “Beyond Access model” in supporting practitioners. In conclusion, there is a dearth of literature on IPC practices among OTs and SLPs in the field of AAC. There is a need to report IPE and IPC efforts in the Philippines to provide applicable strategies to the local healthcare landscape.

Oral Health Knowledge among Healthcare Professionals and Their Challenges in Dealing with Patients’ Oral Health Problems (Pengetahuan Kesihatan Pergigian di Kalangan Pengamal Penjagaan Kesihatan Profesional dan Cabaran dalam Mengendalikan Masalah Pergigian Pesakit) / Jurnal Sains Kesihatan Malaysia

@#The important role of non-dental healthcare professionals (HCPs) in promoting oral health is well-accepted and has received increased attention in recent years. However, greater efforts are needed to train them in ensuring better competency in delivering this role. The aim of the present study is to assess oral health and care knowledge among HCPs by further exploring possible challenges faced by them in managing oral health problems, particularly in regard to patients in a public primary healthcare clinic. In the case of the current research, a focus group discussion was carried out with ten HCPs who are directly involved with patients from different units within the health clinics. In particular, the questions developed for the focus group discussion were divided into two parts: (1) knowledge on oral health and its link to general health, and (2) issues and challenges faced by HCPs in handling patients with oral health problems in their daily routine. The session was recorded on a digital audio tape, the responses were then transcribed, followed by the grouping of the scripts which were then qualitatively analysed. The results revealed that majority of the participants appeared to have good knowledge of general and basic oral health; however, only very few of them were aware of the relationship between oral health problems with systemic conditions. Meanwhile, one of the main challenges faced by HCPs in handling patients with oral health problems is their limited knowledge of oral health problems. Specifically, the main challenges refer to the management of medically compromised patient requiring dental treatment as well as the difficulty in changing the mindset of patients regarding oral health issues, especially in terms of seeking dental treatment. In conclusion, it has been clearly observed that HCPs involved in the present study have good knowledge of general health and oral health but limited knowledge related to oral health to systemic health. Furthermore, they tend to face numerous challenges when dealing with patients, especially due to their limited knowledge of oral health facts and drug prescription for oral problems. Therefore, there is an urgent need of additional training for both HCPs and dental teams for the purpose of enabling both parties to provide coordinated and comprehensive service to patients with oral health problems at the primary healthcare clinics.

How do Health Care Professionals Change the Recognition of Relationships and Problems Among Them Through Dialogue? Qualitative Descriptive Research Exploring the Process of Home Health Care Promotion in Areas Where Medical Resources are Insufficient Using the Theoretical Framework of Complexity / 日本プライマリ・ケア連合学会誌

Introduction: The Japanese government implemented a community-based integrated care system that provides community healthcare resources for elderly people focusing on home health care in particular. To achieve this, interprofessional teams in the community need to function seamlessly. Thus, we explored the process by which healthcare professionals change their recognition of the relationships and problems among them through the dialogue of home health care promotion.Methods: We held the World Cafe to discuss with healthcare professionals about home health care in a city in Ibaraki Prefecture. All dialogues were audio-recorded, transcribed verbatim, and analyzed using thematic analysis.Results: Although healthcare professionals had strongly recognized the hierarchical relationship, they deepened their mutual understanding by sharing their background and values. While sharing the hope to make equitable relationships, they changed their recognition as follows: home health care was not "someone else's problem" but "their own problem" and "their own community's problem".Conclusion: It is necessary for healthcare professionals to share issues and explore methods to solve them in the community, and to change the relationships among stakeholders because problems related to home health care promotion are complex. This study clarified that healthcare professionals are motivated to seek solutions to problems proactively via their relationships in interprofessional teams in the community.

Práticas colaborativas nas urgências em Saúde: a interprofissionalidade do Programa PermanecerSUS, Secretaria Estadual de Saúde da Bahia, Brasil / Prácticas colaborativas en las urgencias en Salud: la interprofesionalidad del Programa "PermanecerSUS", Secretaría Estadual de Salud de Bahia, Brasil / Collaborative practices in emergency services in Health: the interprofessionality of the "PermanecerSUS" Program, Health Department of the State of Bahia, Brazil

Este artigo apresenta e discute o Programa PermanecerSUS como uma proposta de educação interprofissional (EIP) à formação em Saúde. Possui abordagem qualitativa, sob a perspectiva da Etnografia Institucional (EI). A discussão se respalda no conteúdo registrado no diário de campo construído pelo pesquisador-etnógrafo durante a observação participante em duas unidades de urgência hospitalar, na cidade de Salvador, Bahia, Brasil. Os resultados sugerem que o programa desenvolve competências como o trabalho em equipe, a intercomunicação e a solução de problemas em conjunto entre os estudantes; e proporciona integração educação e trabalho. Entretanto, os desafios do PermanecerSUS estão pautados em proporcionar melhorias na relação comunicacional entre os estagiários e profissionais do serviço e investir na formação dos preceptores do estágio, com perspectivas de mudanças das práticas e impactos à qualidade da assistência nos serviços de saúde.(AU)

Este artículo presenta y discute el Programa PermanecerSUS, como una propuesta de Educación Interprofesional para la formación en Salud. Tiene un abordaje cualitativo, bajo la perspectiva de la Etnografía Institucional. La discusión se respalda en el contenido registrado en el diario de campo construido por el investigador-etnógrafo, durante la observación participante en dos unidades de urgencias hospitalarias, en la ciudad de Salvador, en el Estado de Bahia, Brasil. Los resultados sugieren que el programa desarrolla competencias, tales como el trabajo en equipo, la intercomunicación, la solución de problemas en conjunto entre los estudiantes y proporciona integración entre educación y trabajo. No obstante, los desafíos del PermanecerSUS siguen la pauta de proporcionar mejoras en la relación de comunicación entre los pasantes y profesionales del servicio e invertir en la formación de los preceptores de la pasantía, con perspectivas de cambios de las prácticas e impactos para la calidad de la asistencia en los servicios de salud.(AU)

This article presents and discusses the PermanecerSUS Program a proposal of interprofessional education to the formation in Health. It has a qualitative approach in the perspective of Institutional Ethnography. The discussion focuses on the content registered in the field diary constructed by the researcherethnographer during participant observation sessions carried out at the urgent care units of two hospitals located in the city of Salvador, State of Bahia, Brazil. The results suggest that the program develops competencies such as teamwork, intercommunication and joint solution of problems among students, and integrates education and work. However, the challenges of the PermanecerSUS are based on improving the communication relationship between interns and service professionals and investing in the education of internship preceptors, with perspectives of changes in practices and impacts on the quality of care in health services.(AU)

Multiprofissionalidade e interprofissionalidade em uma residência hospitalar: o olhar de residentes e preceptores / Multiprofessionality and interprofessionality in a hospital residence: preceptors and residents' view / Multi-profesionalidad e inter-profesionalidad en una residencia hospitalaria: la mirada de residentes y preceptores

Buscou-se compreender a percepção de residentes e preceptores sobre a multiprofissionalidade e a interprofissionalidade de uma Residência Integrada Multiprofissional em Saúde Hospitalar. Foi realizado um estudo com abordagem qualitativa, envolvendo o Grupo Focal como estratégia de produção de dados, apreciados por meio da análise de conteúdo de Bardin. Na prática, os conceitos sobre multiprofissionalidade e interprofissionalidade ainda são fragilizados. Contudo, foram elencadas ferramentas que podem auxiliar nessa efetivação, inclusive, com vistas ao fomento do trabalho colaborativo. Há confusão e dualidade quanto ao (re)conhecimento do papel dos residentes nos cenários de prática. O preceptor consiste em um importante ator nas Residências Multiprofissionais em Saúde. Apesar dos avanços percebidos, a viabilização da interprofissionalidade ainda se configura como um desafio do setor saúde. Nesse contexto, os processos formativos contínuos, com base na educação interprofissional, constituem ferramentas estratégicas.(AU)

We sought to understand the perception of residents and preceptors regarding multiprofessionality and interprofessionality of a Multiprofessional Integrated Residence in Hospital Health. A qualitative approach study was carried out, involving focus groups as the data production strategy, using Bardin's content analysis. Concepts of multiprofessionality and interprofessionality are still weak. However, tools have been listed that can assist in this realization to foster the collaborative work. There is confusion and duality in the recognition of the role of residents in practice scenarios. The preceptor is an important actor in Multiprofessional Residences in Health. Despite the perceived progress, the feasibility of interprofessionality is still a challenge to the health sector. In this context, continous educational processes based on interprofessional education, are strategic tools.(AU)

Se buscó comprender la percepción de residentes y preceptores sobre la multi-profesionalidad y la inter-profesionalidad de una Residencia Integrada Multi-profesional en Salud Hospitalaria. Se realizó un estudio con abordaje cualitativo, envolviendo al Grupo de Opinión como estrategia de producción de datos, analizados por medio del análisis de contenido de Bardin. En la práctica, los conceptos sobre multi-profesionalidad e inter-profesionalidad todavía están fragilizados. No obstante, se enumeraron herramientas que pueden auxiliar en esa efectivación, incluso con el objetivo del fomento del trabajo colaborativo. Hay confusión y dualidad en relación al (re)conocimiento del papel de los residentes en los escenarios de práctica. El preceptor es un importante actor en las Residencias Multi-profesionales en Salud. A pesar de los avances percibidos, la viabilidad de la inter-profesionalidad todavía se configura como un desafío del sector salud. En ese contexto, los procesos formativos continuos, con base en la educación inter-profesional, constituyen herramientas estratégicas.(AU)

Prática interprofissional colaborativa e clima do trabalho em equipe na Atenção Primária à Saúde / Interprofessional collaborative practice and team climate in Primary Health Care

Introdução: Nas organizações de saúde, a Prática Interprofissional Colaborativa (PIC) e Clima do Trabalho em Equipe (CTE) são essenciais para promoção do cuidado integrado e melhoria na qualidade da assistência em saúde. Entretanto, a implementação da PIC tem se mostrado um desafio, com lacuna de conhecimentos relacionados a sua operacionalização no âmbito do Sistema Único de Saúde (SUS). Assim como a PIC, o CTE preocupa-se com aspectos relacionais e organizacionais do trabalho interprofissional. Poucas investigações têm explorado a relação entre PIC e CTE. Este estudo considera as implicações do CTE para a PIC, destaca as ligações teóricas e empíricas entre os dois, e sugere como o CTE pode ter um papel na compreensão e operacionalização da PIC. Objetivo geral: Analisar a PIC em equipes de Atenção Primária à Saúde (APS) com diferentes perfis de CTE. Método: estudo de método misto sequencial explanatório (quantitativo-qualitativo) realizado em 18 equipes da Estratégia Saúde da Família (ESF), em município da região metropolitana de São Paulo. Na fase 1 (quantitativa), o CTE foi avaliado com a aplicação da Escala de Clima do Trabalho em equipe (ECTE) em 18 equipes da ESF (N=144). Para análise dos dados utilizou-se estatística descritiva, análise de agrupamentos (método Ward) e análise bivariada (t student). Na fase 2 (qualitativa), realizou-se estudo de caso múltiplo com entrevistas em profundidade com membros das equipes (N=24) que apresentaram escores contrastantes na ECTE. Na coleta e análise dos achados qualitativos foram utilizadas técnicas da teoria fundamentada em dados. Os resultados das fases 1 e 2 foram integrados. Resultados: Na fase 1 foram identificados dois agrupamentos de equipes: (A) com maiores e (B) de menores escores na ECTE. As diferenças entre os grupos foram estatisticamente significativas em todos os fatores da escala: participação na equipe (p<0,001), apoio para ideias novas (p=0,002), objetivos da equipe (p=0,001) e orientação para as tarefas (p=0,015). Achados da fase 2 corroboram os achados da fase 1, sendo as equipes do agrupamento A aquelas que apresentaram características relacionais e processuais mais favoráveis ao CTE e também à PIC. A análise interpretativa permitiu a identificação de duas modalidades contingenciais e dinâmicas de colaboração: 1) colaboração em equipe e 2) colaboração intersetorial, em rede e com a comunidade. Em torno das modalidades identificadas foi proposto um modelo da PIC. O modelo descreve as condições em que a PIC ocorre, as formas como se apresenta e suas consequências na organização da assistência à saúde. Conclusões: A análise do CTE mostrou-se capaz de prover insights sobre a PIC nas equipes. O modelo proposto apresenta conhecimentos que contribuem para compreensão e operacionalização da PIC. Os resultados sugerem que embora o clima de equipe tenha um papel importante na construção da colaboração, a compreensão da PIC no âmbito do SUS requer a consideração de elementos pertinentes à inovação no trabalho interprofissional e da própria forma de organização da APS e das Redes de Atenção à Saúde.

Background: In health care organizations, Interprofessional Collaborative Practice (ICP) and Team Climate (TC) are essential means to promote integrated care and improve health care quality. However, implementing ICP presents a series of challenges, and there is a lack of knowledge of how to operationalize this approach within the Brazilian Health Care System (SUS). Like Interprofessional Collaborative Practice, Team Climate is concerned with the effectiveness of relational and organisational aspects of interprofessional work. Few studies have explored the relationship between these two concepts or the role that Team Climate might play in establishing the operational conditions needed for Interprofessional Collaborative Practice. This study considers the implications of Team Climate for Interprofessional Practice, highlights the theoretical and empirical links between the two, and suggests how Team Climate may have a role in understanding and operationalising Interprofessional Collaborative Practice more effectively. Aim: To analyse ICP in Primary Health Care (PHC) teams with different TC. Methods: This is a mixed methods sequential explanatory study (quantitative-qualitative) conducted with 18 primary care teams from the Family Health Strategy (FHS), in the metropolitan region of São Paulo. In Stage 1 (quantitative), Team Climate was assessed using the Team Climate Inventory (TCI) in all 18 teams (144 participants in total). Data from the TCI were analysed using descriptive statistics, cluster analysis (Wards method) and bivariate analysis (Student t). In Stage 2, which used a multiple qualitative case study approach, data were collected through in-depth interviews with members (N=24) from teams with contrasting scores on the TCI. Grounded theory techniques were employed to analyse the qualitative data. Findings from both stages of the research were then compared and considered together. Results: Two different clusters of teams were identified in Stage 1: (A) teams with the highest mean scores; and (B), teams with the lowest mean scores on the TCI. Differences between cluster A and B were statistically significant for all TCI factors: participative safety (p <0.001), support for new ideas (p = 0.002), team goals (p = 0.001) and task orientation (p=0.015). Findings from Stage 2 reinforced quantitative findings from Stage 1. Teams from cluster A demonstrated more positive relational and processual characteristics to support TC and ICP. Interpretative analysis revealed two dynamic and contingent modalities of collaboration: 1) team collaboration; and 2) collaboration between different health and social sectors, within a healthcare network, and with the community. A framework for Interprofessional Collaborative Practice in primary health care was developed, based on these modalities of collaboration, and describing the conditions, modalities and health care consequences of ICP. Conclusions: Analysis of Team Climate provided insights into ICP in healthcare teams. The proposed framework provides fresh insights into the understanding and operationalization of ICP, and suggests that although Team Climate is important in establishing collaboration, the understanding of ICP within SUS also requires consideration of a range of other factors, including innovation in interprofessional work and the organizational structure of PHC and Health Care Networks.