Collaboration in practice

Funded by the Gordon and Betty Moore Foundation (2012-3) and CIHR (2017-22).

This research aims to answer basic questions about what collaboration looks like today in a variety of healthcare settings, and the factors that impact it. What constitutes a team? How is teamwork organized and done? Why are or aren't people living up to the rhetoric of collaborative care delivery?

The Moore Foundation study was conducted in four intensive care units in two American cities.

The CIHR study, titled “The collaborative ideal in Canadian healthcare delivery: Its rise, practice and future“, is still ongoing, in the operating room and in an ambulatory primary care setting.

Key Insights

  • Interprofessional rounds often fail to meet their aims because there are too many players, too little time, too little space, and the continuation of medical dominance, which constrains conversations.

  • Health information technologies are not great teamwork equalizers; they often reproduce previous care hierarchies and exclude patients and their families from care.

  • Greater technological demands in critical care appears to negatively impact the quality of interprofessional relationships and decrease the time clinicians spend with patients.

  • Clinicians use their bodies in space to include and exclude other clinicians, and involve or ignore patients. Some clinicians are empowered to fight using their bodies; others less so.

  • The way clinicians conceptualize patients and their families impacts the way they communicate with them.

Research still in progress.

Articles or Chapters

Paradis E, Liew W, and M Leslie. Forthcoming 2019. Embodied spatial practices and the power to care. Oxford University Handbook of the Sociology of the Body. Eds. Natalie Boero and Kate Mason. Oxford University Press. Download

Leslie M, Paradis E, Gropper MA, Kitto S, Reeves S and PJ Pronovost. August 2017. “An ethnographic study of health information technology’s intended and unintended communications effects in acute care settings.” Health Services Research. 52(4): 1330-48. Impact Factor: 3.089. doi: 10.1111/1475-6773.12466 Download

Leslie M, Paradis E, Gropper MA, Millic MM, Kitto S, Reeves S and PJ Pronovost. June 2017. “A typology of ICU patients and families from the clinician perspective: towards improving communication.” Health Communication. 32(6)777-83. doi: 10.1080/10410236.2016.1172290 Download

Paradis E and G Sutkin. January 2017. “Beyond a good story: from Hawthorne effect to reactivity in health professions education research” Medical Education. 51(1), 31-39. doi: 10.1111/medu.13122 Download

Paradis E, Leslie M and MA Gropper. 2016. “Interprofessional rhetoric and operational realities: a study of morning interprofessional rounds in four intensive care units.” Advances in Health Sciences Education. 21(4), 735-748. doi:10.1007/s10459-015-9662-5 Download

Reeves S, McMillan S, Kachan N, Paradis E, Leslie M and S Kitto. 2015. “Interprofessional collaboration and family member involvement in intensive care units: emerging themes from a multi-sited ethnography.” Journal of Interprofessional Care. 29(3): 230-7. doi: 10.3109/13561820.2014.955914 Visit Site

Paradis E, Reeves S, Leslie M, Aboumatar H, Chesluk B, Clark P et al. 2014. “Exploring the nature of interprofessional collaboration and family member involvement in an intensive care context.” Journal of Interprofessional Care. 28(1): 74-5. doi:10.3109/13561820.2013.781141. Visit Site

 

Co-Investigators

Moore Foundation

Myles Leslie, U Calgary

Scott Reeves

Peter Pronovost, Johns Hopkins

Michael Gropper, UCSF

 

Collaborative Ideal, CIHR

Cynthia Whitehead

Heather Boon

Sioban Nelson

Salvatore Spadafora

 

Students and Research Assistants

Chanté De Freitas

Victoria Whyte