Interprofessional Collaboration: How is it Created and Sustained in Intermediate Care?

The perceived value of interprofessional collaboration, in the provision of services, has continued to be prominent in the United Kingdom’s contemporary health and social care policy, however, there has been limited empirical evidence of how the interpersonal elements of this are created and sustained within operational teams.

This qualitative research provides important insight into the experiences of National Health Service (NHS) staff working in the specialist area of Intermediate Care. It ascertains their perception of the presence of interprofessional collaboration within their respective services, the impact that this had on the staff within them and the factors that had affected its evolution.

Semi-structured interviews were undertaken during 2014 and 2015 to collect and analyse data from clinical staff working in five intermediate care services and a Constructivist Grounded Theory approach was utilised to abstract themes from the data obtained.

The findings offer an original contribution to knowledge through determining that the presence of adversity in the workplace was a significant factor in creating and sustaining interprofessional collaboration within the services in this study. A strong, collective identity for their respective social groups was formulated by the participants through situated learning, with a greater emphasis placed on interpersonal relationships, rather than interprofessional competencies.

Theorising the findings, the participants interacted in their contextualised settings, communicating with each other to attain and maintain consensus, applying coping strategies to manage the internal and external stressors affecting them. By working dynamically in this way, consistency of meanings, behaviours and culture were negotiated, offering an assurance of stability and order within settings that were frequently affected by change. These four components were labelled the 4Cs of Interprofessional Collaboration.

The strength of these components was evident, even though an exercise to explore the constituent elements of the participants’ services discovered that all of the participants perceived the construction of their respective services differently, reinforcing the presence of subjective, multiple realities.

The results of this study offer an improved recognition that creating and sustaining interprofessional collaboration is a process in constant flux to manage the internal and external stressors affecting it. It requires proactive action, mutual engagement, “Facilitating Interaction” and negotiation between individuals, to develop shared mental models.

Participants worked flexibly within defined parameters of practice maintaining Dynamic Consistency in order to achieve this.