Representing complexity well: a story about teamwork, with implications for how we teach collaboration

Area of Science:

• Healthcare Management
• Medical Sociology
• Organizational Behavior

Background:

• Current models of interprofessional collaboration (IPC) and interprofessional education (IPE) may not fully capture the complexities of healthcare teamwork.
• Understanding collaborative practice in distributed teams is crucial for effective patient care.

Purpose of the Study:

• To explore the complexity of collaborative practice within a distributed solid organ transplant team.
• To apply activity theory to understand interprofessional collaboration (IPC) and interprofessional education (IPE) in healthcare.

Main Methods:

• Conducted 162 hours of observation and 47 interviews with 39 members of a transplant team over 4 months.
• Utilized inductive analysis to identify emergent themes in collaborative practice.
• Focused on 'interservice' challenges encountered by the core transplant team.

Main Results:

• Daily collaborative practice on distributed teams involves significant improvisation and recurring challenges.
• The study highlights 'interservice' challenges, where the core team engages other hospital services (e.g., radiology, pathology).
• An in-depth case illustrates strategies used to navigate conflicting expectations among cardiology, anesthesiology, and radiology services.

Conclusions:

• Findings question the premises of stable professional roles and a single 'caring for the patient' objective in current IPC and IPE models.
• Suggests elaborations to IPC and IPE conceptualizations to better reflect the intricate nature of everyday healthcare collaboration.
• Emphasizes the need for more nuanced approaches to teaching and practicing interprofessional collaboration.