An activity theory perspective on interprofessional teamwork in long-term care

Area of Science:

• Healthcare teamwork dynamics
• Sociocultural theories in medicine
• Interprofessional education

Background:

• Teamwork in healthcare is influenced by member interactions and the clinical environment.
• Cultural Historical Activity Theory (CHAT) offers a developmental framework for studying teamwork.
• The study aimed to derive practical guidelines for educators by observing Interprofessional Healthcare Teams (IHTs).

Purpose of the Study:

• To identify practical guidelines for educators on interprofessional healthcare teamwork.
• To explore the application of Cultural Historical Activity Theory (CHAT) in analyzing healthcare team interactions.
• To understand how healthcare providers navigate challenges and adapt within their clinical context.

Main Methods:

• Observations of two Interprofessional Healthcare Team (IHT) meetings in a long-term care facility.
• Video-recorded interactions analyzed through subsequent video-recall interviews with team members.
• Analysis employed CHAT's Activity Systems framework, focusing on contradictions and themes.

Main Results:

• Identified contradictions within Activity Systems related to quality of life, improvisation for care goals, and role fluidity.
• Diverging views on enhancing/maintaining quality of life, using unconventional tools, and managing safety amidst constraints were observed.
• Unease regarding unconventional interventions despite compensation was also noted.

Conclusions:

• Adaptations in healthcare teamwork are driven by practical, goal-oriented improvisation and dialogue.
• Educating healthcare providers should emphasize situational awareness to promote continuous adaptation of interventions.
• Findings provide insights into fostering effective interprofessional collaboration and improving healthcare delivery.