Transcending boundaries for collaborative patient care.

Area of Science:

• Healthcare Management
• Medical Education
• Sociology of Health

Background:

• Dutch general practitioners (GPs) and medical specialists (MSs) develop collaborative patient care agreements (CPCAs) to enhance intraprofessional collaboration.
• Activity theory (AT) provides a framework to analyze contradictions within and between primary and secondary care activity systems.

Purpose of the Study:

• To identify contradictions between primary and secondary care activity systems that hinder or enable collaborative learning.
• To explore how co-creating CPCAs can lead to expansive learning and new collaborative practices.

Main Methods:

• Analysis of nineteen semi-structured interviews using activity theory (AT).
• Focus on contradictions within and between the activity systems of general practitioners and medical specialists.
• Iterative co-creation of CPCAs in group settings.

Main Results:

• Contradictions were identified, stemming from differing understandings of 'care' between generalist and specialist settings.
• GPs and MSs demonstrated expansive learning and identified contradictions when co-creating CPCAs collaboratively.
• Disseminating CPCAs within professional communities proved more challenging, leaving contradictions unresolved.

Conclusions:

• Collective responsibility for improving collaborative patient care yields significant educational benefits.
• Addressing contradictions through iterative co-creation of CPCAs is key to enhancing intraprofessional collaboration.
• Further strategies are needed to effectively disseminate and integrate collaborative tools within professional communities.