“It’s Not Just About Getting Along”: Exploring Learning Through the Discourse and Practice of Interprofessional Collaboration (original) (raw)

Through our pilot work we identified an important organizing principle for IPC that relates to acuity and the perceived complexity of the care required by a given patient. We conducted over 70 hours of observation and 40 semi-structured interviews with different health professionals in three different clinical contexts (emergency paediatric medicine, adult trauma care, and paediatric acute care) noting health professionals and trainees make decisions all the time about whom to listen to, whom to seek out when they need information, whom to pay attention to when problem-solving and whom to collaborate with in the completion of a particular task. These decisions affected the composition of 'team membership' in relation to a specific clinical problem. Moreover, the perceived acuity of a patient or the perceived complexity of a task, underpinned decisions related to team composition and tolerance for practices and behaviours that may or may not be associated with collaboration: "The extreme of such a situation would be a patient coding. Then there will be clearly a need for everyone's input, and there will be a decision to make things better, but again that's the acuity of the situation. Plus the fact that this is no place I would say to study the way I interact with people or [whether] my interprofessional attitude could change anything." (MD surgeon) Indeed, acuity and complexity were evoked as reasons to abandon aspects of what is promoted discursively as "good" team care in order to deliver the care patients actually needed, with statements that decoupled civility from problem solving. This nuance in the way health care