title: Exploring interprofessional collaboration during the integration of diabetes teams into primary care.
abstract: BACKGROUND
  Specialised diabetes teams, specifically certified nurse and dietitian diabetes educator teams, are being integrated part-time into primary care to provide better care and support for Canadians living with diabetes. This practice model is being implemented throughout Canada in an effort to increase patient access to diabetes education, self-management training, and support. Interprofessional collaboration can have positive effects on both health processes and patient health outcomes, but few studies have explored how health professionals are introduced to and transition into this kind of interprofessional work.
  
  
  METHODS
  Data from 18 interviews with diabetes educators, 16 primary care physicians, 23 educators' reflective journals, and 10 quarterly debriefing sessions were coded and analysed using a directed content analysis approach, facilitated by NVIVO software.
  
  
  RESULTS
  Four major themes emerged related to challenges faced, strategies adopted, and benefits observed during this transition into interprofessional collaboration between diabetes educators and primary care physicians: (a) negotiating space, place, and role; (b) fostering working relationships; (c) performing collectively; and (d) enhancing knowledge exchange.
  
  
  CONCLUSIONS
  Our findings provide insight into how healthcare professionals who have not traditionally worked together in primary care are collaborating to integrate health services essential for diabetes management. Based on the experiences and personal reflections of participants, establishing new ways of working requires negotiating space and place to practice, role clarification, and frequent and effective modes of formal and informal communication to nurture the development of trust and mutual respect, which are vital to success.
authors.affiliation: School of Nutrition, Ryerson University, 350 Victoria Street, Kerr Hall South, room 349-I, Toronto, ON, M5B 2K3, Canada. egucciar@ryerson.ca.
authors.forename: Enza
authors.initials: E
authors.lastname: Gucciardi
authors.affiliation: School of Nutrition, Ryerson University, 350 Victoria Street, Kerr Hall South, room 349-I, Toronto, ON, M5B 2K3, Canada. sespin@ryerson.ca.
authors.forename: Sherry
authors.initials: S
authors.lastname: Espin
authors.affiliation: School of Nutrition, Ryerson University, 350 Victoria Street, Kerr Hall South, room 349-I, Toronto, ON, M5B 2K3, Canada. antonia.morganti@gmail.com.
authors.forename: Antonia
authors.initials: A
authors.lastname: Morganti
authors.affiliation: School of Nutrition, Ryerson University, 350 Victoria Street, Kerr Hall South, room 349-I, Toronto, ON, M5B 2K3, Canada. ldorado@ryerson.ca.
authors.forename: Linda
authors.initials: L
authors.lastname: Dorado
mesh_terms: D000328:Adult; D002170:Canada; D003299:Cooperative Behavior; D003695:Delivery of Health Care / Q000458:organization & administration; D003920:Diabetes Mellitus / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009726:Nurses; D064686:Nutritionists; D010348:Patient Care Team / Q000458:organization & administration*; D010353:Patient Education as Topic; D058007:Physicians, Primary Care; D011320:Primary Health Care / Q000458:organization & administration*; D036301:Qualitative Research
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