Exploring the interactional determinants of collaboration on interprofessional practice in community-based geriatric care
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Collaboration is neither the ethos, nor the experience, of most professionals in health care. Nevertheless, the concept of collaboration has become increasingly popular in recent years, promising to enhance all aspects of work, academic, and political life. And while collaboration is a significant and complex phenomenon, it has not been clearly understood for its impact on health care professionals and their work, or for the factors that influence its success or failure. The purpose of the study was to explore the meaning of collaboration, as conveyed by the lived experience of health care professionals, as well as the interpersonal and interactional determinants and their impact on the outcomes of their collaboration. The conceptual paradigm of phenomenology and hermeneutic phenomenological methods guided the research. In-depth interviews were conducted with 10 health care professionals engaged in interprofessional practice in a novel community-based geriatric care program. The interviews were audiotaped and transcribed verbatim. Ricoeur’s procedural steps were used to analyze the transcripts. Acquiring the ‘real world’ experiences of health care professionals enabled the emergence of six themes: engaging in collective thinking and action to produce best outcomes and optimize clients’ health; responding to collaboration for self and other members as a continued work in progress; experiencing the personal and professional rewards as markers of success with collaboration; existing challenges create barriers that impede collaboration; experiencing the interactional dynamics of collaboration and their influences requires the interpersonal attributes of quality communication, openness, trust, and respect; and forming a common vision is necessary for collaboration but difficult to achieve. The findings of this study suggest that collaboration is a genuinely experiential phenomenon: it is a human process that requires leadership on the part of all health care professionals to negotiate and agree upon the processes that will enhance their relationships and are necessary for collaboration to unfold. This study produced a number of recommendations that can be offered to multiple stakeholders in the geriatric care setting, as well as extended to those in the other domains of health care.