Abstract
Introduction: Interprofessional relations in health care have been examined through the frame of “clinical democracy”. Yet, traditional interpretations of democracy have assumed a zero-sum, competitive interpretation of power, leading to unelaborated invocations for health professionals to “collaborate” more or do “teamwork” better. The aim of this study was to understand the priorities that health professionals from different occupations have for individual patient care, and the opportunities they have to express those priorities, as a foundation for a more expansive democratic theory. Materials and methods: The case setting was a mixed-method, pre-post, participatory research (PR) study examining the dynamics and levels of satisfaction of interprofessional information-sharing and decision-making on an acute aged care unit. Results: Stage 1, pre-intervention, revealed that non-medical health professionals – nursing and, in particular, allied health professionals – lacked opportunities for input into decision-making for patient care. Following deliberative, public feedback of the findings to managers and health professionals, an intervention was negotiated to re-structure the weekly case conference and referral processes. Stage 2, the post-interventional findings showed an increase in perceptions of information-sharing, and participation in case conferences, as well as recognition of power differentials in interprofessional relations. Conclusions: In the public negotiation of increased prominence of particular roles and aligning role clarity with the needs of particular patients, the findings show that the notion of deliberative democracy characterizes the qualitative-cumulative, rather than merely quantitative-redistributive power among health professionals in different occupational roles. As a case of conscientization, deliberation engages practical interprofessional improvement simultaneously as educational empowerment.
| Language | English |
|---|---|
| Pages | 100-111 |
| Number of pages | 12 |
| Journal | Journal of Interprofessional Education and Practice |
| Volume | 15 |
| DOIs | |
| Publication status | Published - 1 Jun 2019 |
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Keywords
- aged care
- collaboration
- conscientization
- decision-making
- deliberative democracy
- Interprofessional collaborative practice
- interprofessional education
- participatory research (PR)
Cite this
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Advancing interprofessional theory : deliberative democracy as a participatory research antidote to power differentials in aged care. / Nugus, Peter; Ranmuthugala, Geetha; Travaglia, Joanne; Greenfield, David; Lamothe, Josianne; Hogden, Anne; Kolne, Kendall; Braithwaite, Jeffrey.
In: Journal of Interprofessional Education and Practice, Vol. 15, 01.06.2019, p. 100-111.Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - Advancing interprofessional theory
T2 - Journal of Interprofessional Education and Practice
AU - Nugus, Peter
AU - Ranmuthugala, Geetha
AU - Travaglia, Joanne
AU - Greenfield, David
AU - Lamothe, Josianne
AU - Hogden, Anne
AU - Kolne, Kendall
AU - Braithwaite, Jeffrey
PY - 2019/6/1
Y1 - 2019/6/1
N2 - Introduction: Interprofessional relations in health care have been examined through the frame of “clinical democracy”. Yet, traditional interpretations of democracy have assumed a zero-sum, competitive interpretation of power, leading to unelaborated invocations for health professionals to “collaborate” more or do “teamwork” better. The aim of this study was to understand the priorities that health professionals from different occupations have for individual patient care, and the opportunities they have to express those priorities, as a foundation for a more expansive democratic theory. Materials and methods: The case setting was a mixed-method, pre-post, participatory research (PR) study examining the dynamics and levels of satisfaction of interprofessional information-sharing and decision-making on an acute aged care unit. Results: Stage 1, pre-intervention, revealed that non-medical health professionals – nursing and, in particular, allied health professionals – lacked opportunities for input into decision-making for patient care. Following deliberative, public feedback of the findings to managers and health professionals, an intervention was negotiated to re-structure the weekly case conference and referral processes. Stage 2, the post-interventional findings showed an increase in perceptions of information-sharing, and participation in case conferences, as well as recognition of power differentials in interprofessional relations. Conclusions: In the public negotiation of increased prominence of particular roles and aligning role clarity with the needs of particular patients, the findings show that the notion of deliberative democracy characterizes the qualitative-cumulative, rather than merely quantitative-redistributive power among health professionals in different occupational roles. As a case of conscientization, deliberation engages practical interprofessional improvement simultaneously as educational empowerment.
AB - Introduction: Interprofessional relations in health care have been examined through the frame of “clinical democracy”. Yet, traditional interpretations of democracy have assumed a zero-sum, competitive interpretation of power, leading to unelaborated invocations for health professionals to “collaborate” more or do “teamwork” better. The aim of this study was to understand the priorities that health professionals from different occupations have for individual patient care, and the opportunities they have to express those priorities, as a foundation for a more expansive democratic theory. Materials and methods: The case setting was a mixed-method, pre-post, participatory research (PR) study examining the dynamics and levels of satisfaction of interprofessional information-sharing and decision-making on an acute aged care unit. Results: Stage 1, pre-intervention, revealed that non-medical health professionals – nursing and, in particular, allied health professionals – lacked opportunities for input into decision-making for patient care. Following deliberative, public feedback of the findings to managers and health professionals, an intervention was negotiated to re-structure the weekly case conference and referral processes. Stage 2, the post-interventional findings showed an increase in perceptions of information-sharing, and participation in case conferences, as well as recognition of power differentials in interprofessional relations. Conclusions: In the public negotiation of increased prominence of particular roles and aligning role clarity with the needs of particular patients, the findings show that the notion of deliberative democracy characterizes the qualitative-cumulative, rather than merely quantitative-redistributive power among health professionals in different occupational roles. As a case of conscientization, deliberation engages practical interprofessional improvement simultaneously as educational empowerment.
KW - aged care
KW - collaboration
KW - conscientization
KW - decision-making
KW - deliberative democracy
KW - Interprofessional collaborative practice
KW - interprofessional education
KW - participatory research (PR)
UR - http://www.scopus.com/inward/record.url?scp=85063323635&partnerID=8YFLogxK
U2 - 10.1016/j.xjep.2018.09.005
DO - 10.1016/j.xjep.2018.09.005
M3 - Article
VL - 15
SP - 100
EP - 111
JO - Journal of Interprofessional Education and Practice
JF - Journal of Interprofessional Education and Practice
SN - 2405-4526
ER -