Collaborating in the context of co-location: An interprofessional collaborative relationship building model

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Date
2013, 2016
Authors
Wener, Pamela
Journal Title
Journal ISSN
Volume Title
Publisher
Taylor & Francis
BioMed Central
Abstract
Background: Primary care providers, family physicians and nurse practitioners provide most mental health services in Canada. However, primary care providers lack knowledge, skills, and time to provide these services. Access to onsite mental health consultation or collaborative mental health care, affords primary care providers support to offer patients increased access to mental health services. Researchers suggest that interprofessional collaborative relationships are foundational to the success of collaborative mental health care. However, there is little understanding of how to build these relationships. Purpose: The purpose of this grounded theory study was to develop an understanding of how primary care and mental health care providers collaborate to deliver mental health care in primary care settings. Methods: Counsellors, family physicians, psychiatrists, nurse practitioners, and program leaders were recruited (N=40). Data were collected using individual (19) and focus group (7) semi-structured interviews. Interviews were audio recorded, transcribed and open coded. After open coding the first seven interviews, memos were written on each participant and focus group. These memos were sorted, compared to previous memos and then used to create a coding table. This iterative process of open coding, memo writing and then adding emergent codes to the coding table was repeated for all transcripts. Similar codes were grouped then collapsed to create the preliminary categories. Preliminary categories were sent to the participants after the primary care provider interviews and again after the provider focus groups to create the final categories. The final categories were compared to examine their relationships to one another. Findings: The main finding of this study is a theoretical rendering of the participants’ experiences and ascribed meaning of interprofessional collaboration to deliver mental health services in primary care. Specifically, a collaborative relationship building model with four developmental stages: 1) Primary Care Providers Need for Collaboration, 2) Initiating Co-location, 3) Fitting-in, and 4) Growing Reciprocity is offered. Conclusions: The findings underscore that collaborative care requires an understood need for collaboration, organizational support, contextually effective modes of communication, and a perception that collaboration improves patient care. Further research may explore the applicability of this model to other health care contexts.
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Keywords
Interprofessional Collaboration, Grounded Theory, Primary Care, Mental Health
Citation
Wener, P., & Woodgate, R. L. (2013). Use of a qualitative methodological scaffolding process to design robust interprofessional studies. Journal of Interprofessional Care, 27(4), 305-312. doi:10.3109/13561820.2013.763775
Wener, P., & Woodgate, R. L. (2016). Collaborating in the context of co-location: A grounded theory study BMC family practice, 17(1), 1.