Introduction: Health service in the current global era requires health workers to provide qualified service, this also applies to teaching hospitals. Collaboration between several professions involved (doctors, nurses, and pharmacists) in an interprofessional collaboration system is needed in providing such service. Factors influencing interprofessional collaboration is unique to each health care center. The purpose of this study was to determine the factors that influence the implementation of interprofessional collaborative practice among health workers in Dr. Wahidin Sudirohusodo General Hospital. Methods: This is a mixed-method explanatory sequential design study, utilizing quantitative and qualitative data. Quantitative data were obtained from the Indonesian-validated Collaborative Practice Assessment Tool (CPAT) questionnaire. CPAT in Indonesian language has been validated in previous research by Findyartini, et al. in 2019 in Indonesian population. The questionnaire was internally validated with the study population with Cronbach alpha of 0.812. All health care professionals meeting the selection criteria were enrolled for the quantitative study. The questionnaire was given to 152 health professionals enrolled as research subjects, including nutritionists, nurses, doctors, pharmacists, and medical rehabilitation specialists serving in Dr. Wahidin Sudirohusodo Hospital for >3 years. Five participants with highest and lowest CPAT score from each profession were invited for FGD entitled “Exploring factors involved in interprofessional collaboration in Wahidin Sudirohusodo General Hospital” and divided into 2 groups according to the CPAT score. The score from each subscale in the questionnaire is obtained for each research subjects and the median is compared among each profession group using Kruskall-Wallis test significant to a p-value of <0.05. Qualitative data as recording transcript is acquired from FGD; the transcript was then coded into several general themes by 2 of the authors and was discussed using thematic analysis using MaxQDA. Results: Research subjects were predominantly women (121 respondents (79.6%)), 32.9% were nurses, and most of the healthcare professional (81 subjects (55.1%)) have been working for >10 years. Among profession groups (Doctors, Pharmacists, Medical Rehabilitation Specialists, Nutritionists, and Nurses), difference in score distribution (P<0.05) was found in relationships among team members (40 vs 39 vs 39.5 vs 36 vs 42, P<0.001), barriers to team collaboration (10 vs 18.5 vs 14 vs 18 vs 10, P<0.001), and leadership (20 vs 20 vs 23 vs 20 vs 20, p 0.045). From the FGD, factors influencing interpersonal collaborative practice are leadership factors, system/rule factors, and personal factors. Conclusion: This research showed that personal, system/organizational and leadership factors influence the implementation of interprofessional collaboration. In this study, there is a different perception regarding relationships among team members, barriers to team collaboration, and leadership among profession group. |
- World health statistics 2010. USA: OCHA; 2010.
- Morgan S, Pullon S, McKinlay E. Observation of interprofessional collaborative practice in primary care teams: an integrative literature review. International journal of nursing studies. 2015;52(7):1217-30.
- Green BN, Johnson CD. Interprofessional collaboration in research, education, and clinical practice: working together for a better future. Journal of Chiropractic Education. 2015;29(1):1-10.
- Keith KM, Askin DF. Effective collaboration: the key to better health care. Canadian Journal of Nursing Leadership. 2008;21(2):51-61
- Lucyda H, Vionalisa, Yecy A. Collaboration of Nurses and Doctor in the Inpatient Room at Arifin Achmad General Hospital of Riau Province. Journal Health Community. 2019;5(3):235-40.
- Bollen A, Harrison R, Aslani P, van Haastregt JCM. Factors influencing interprofessional collaboration between community pharmacists and general practitioners - A systematic review. Health sac care community. 2019;27:e189-e212
- Yusra RY, Findyartini A, Soemantri D. Healthcare professionals’ perceptions regarding interprofessional collaborative practice in Indonesia. Journal of Interprofessional Education Practice. 2019;15:24-9.
- Findyartini A, Kambey DR, Yusra RY, Timor AB, Khairani CD, Setyorini D, et al. Interprofessional collaborative practice in primary healthcare settings in Indonesia: A mixed-methods study. Journal of Interprofessional Education Practice. 2019;17:100279.
- Patima P, Ridwan Amiruddin R, Pasinring SA, Salmah AU, Saleh A, Rivai F, et al. Determinant factors of interprofessional collaboration in Labuang Baji General Hospital. Medico Legal Update. 2020;20(4):2117-20.
- Bradley F, Elvey R, Ashcroft DM, Hassell K, Kendall J, Sibbald B, et al. The challenge of integrating community pharmacists into the primary health care team: a case study of local pharmaceutical services (LPS) pilots and interprofessional collaboration. Journal of interprofessional care. 2008;22(4):387-98.
- Supper I, Catala O, Lustman M, Chemla C, Bourgueil Y, Letrilliart L. Interprofessional collaboration in primary health care: a review of facilitators and barriers perceived by involved actors. Journal of public health. 2015;37(4):716-27.
- Reeves S, Pelone F, Harrison R, Goldman J, Zwarenstein M. Interprofessional collaboration to improve professional practice and healthcare outcomes. Cochrane database of systematic reviews. 2017;6(6):CD000072.
- Köberlein-Neu J, Mennemann H, Hamacher S, Waltering I, Jaehde U, Schaffert C, et al. Interprofessional medication management in patients with multiple morbidities: a cluster-randomized trial (the WestGem Study). Deutsches Ärzteblatt International. 2016;113(44):741.
- Hojat M, Gonnella JS, Nasca TJ, Fields SK, Cicchetti A, Scalzo AL, et al. Comparisons of American, Israeli, Italian and Mexican physicians and nurses on the total and factor scores of the Jefferson scale of attitudes toward physician–nurse collaborative relationships. International Journal of Nursing Studies. 2003;40(4):427-35.
- Rawlinson C, Carron T, Cohidon C, Arditi C, Hong QN, Pluye P, et al. An overview of reviews on interprofessional collaboration in primary care: barriers and facilitators. International Journal of Integrated Care. 2021;21(2):32.
- Sangaleti C, Schveitzer MC, Peduzzi M, Zoboli ELCP, Soares CB. Experiences and shared meaning of teamwork and interprofessional collaboration among health care professionals in primary health care settings: a systematic review. JBI Evidence Synthesis. 2017;15(11):2723-88.
- MacNaughton K, Chreim S, Bourgeault IL. Role construction and boundaries in interprofessional primary health care teams: a qualitative study. BMC Health Services Research. 2013;13(1):1-13.
- Shrivastava S, Martinez J, Coletti DJ, Fornari A. Interprofessional Leadership Development: Role of Emotional Intelligence and Communication Skills Training. MedEdPORTAL. 2022;18:11247.
- Cameron A. Impermeable boundaries? Developments in professional and inter-professional practice. Journal of Interprofessional Care. 2011;25(1):53-8.
- Morley L, Cashell A. Collaboration in health care. Journal of Medical Imaging Radiation Sciences. 2017;48(2):207-16.
- Mattessich PW, Monsey BR. Collaboration: what makes it work. A review of research literature on factors influencing successful collaboration. USA: ERIC; 1992.
- Thompson L, Bidwell S. Space, time, and emotion in the community pharmacy. Health Place. 2015;34:251-6
- Dey RM, de Vries MJ, Bosnic-Anticevich S. Collaboration in chronic care: unpacking the relationship of pharmacists and general medical practitioners in primary care. International Journal of Pharmacy Practice. 2011;19(1):21-9
- Hashemian F, Emadi F, Roohi E. Collaboration between pharmacists and general practitioners in the health care system in the Islamic Republic of Iran. East Mediterr Health J. 2016;22(6):375-82.
- Degu T, Amsalu E, Kebede A, Adal O. Inter-professional collaboration and associated factors among nurses and physicians in specialized public hospitals, the northwest, Ethiopia: mixed method multi-centered cross-sectional study. BMC Health Services Research. 2023:23(1):286.
- Löffler C, Koudmani C, Böhmer F, Paschka SD, Höck J, Drewelow E, et al. Perceptions of interprofessional collaboration of general practitioners and community pharmacists-a qualitative study. BMC health services research. 2017;17:1-7.
- Dupotey Varela NM, Oliveira DRd, Sedeño Argilagos C, Oliveros Castro K, Mosqueda Pérez E, Hidalgo Clavel Y, et al. What is the role of the pharmacist?: physicians' and nurses' perspectives in community and hospital settings of Santiago de Cuba. Brazilian Journal of Pharmaceutical Sciences. 2011;47:709-18.
- Zillich AJ, McDonough RP, Carter BL, Doucette WR. Influential characteristics of physician/pharmacist collaborative relationships. Annals of pharmacotherapy. 2004;38(5):764-70.
- Hughes CM, McCann S. Perceived interprofessional barriers between community pharmacists and general practitioners: a qualitative assessment. British Journal of General Practice. 2003;53(493):600-6.
- Pottie K, Farrell B, Haydt S, Dolovich L, Sellors C, Kennie N, et al. Integrating pharmacists into family practice teams: physicians’ perspectives on collaborative care. Canadian Family Physician. 2008;54(12):1714-7.
- Cherry K. Individualistic cultures and behavior. USA: VeryWellMind Awards. 2017.
- Erdogan B, Bauer TN. Differentiated leader–member exchanges: The buffering role of justice climate. Journal of Applied Psychology. 2010;95(6):1104.
- Rieck AM. Exploring the nature of power distance on general practitioner and community pharmacist relations in a chronic disease management context. Journal of interprofessional care. 2014;28(5):440-6.
- Weissenborn M, Haefeli WE, Peters-Klimm F, Seidling HM. Interprofessional communication between community pharmacists and general practitioners: a qualitative study. International Journal of Clinical Pharmacy. 2017;39:495-506.
- Rubio-Valera M, Jové AM, Hughes CM, Guillen-Solà M, Rovira M, Fernández A. Factors affecting collaboration between general practitioners and community pharmacists: a qualitative study. BMC Health Services Research. 2012;12:1-10.
- Tan KT, Adzhahar FBB, Lim I, Chan M, Lim WS. Transactive memory system as a measure of collaborative practice in a geriatrics team: implications for continuing interprofessional education. Journal of Interprofessional Care. 2014;28(3):239-45.
- Soemantri D, Kambey DR, Yusra RY, Timor AB, Khairani CD, Setyorini D, et al. The supporting and inhibiting factors of interprofessional collaborative practice in a newly established teaching hospital. Journal of Interprofessional Education Practice. 2019;15:149-56.
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