title: Staff perception of interprofessional working relationships after a work redesign intervention in a Danish orthopaedic hand unit outpatient clinic.
abstract: There is evidence that clinical pathways improve quality of care; however, knowledge is limited concerning the influence on and the benefits experienced by the interprofessional teams working with these pathways. Our working methods in a hand unit in an orthopaedic outpatient clinic in Denmark were redesigned to include, among other changes, the introduction of clinical pathways. Changes included standardising treatment and communication methods, delegating tasks from medical specialists to nurses, and providing nurses with their own consultation room. Using focus group interviews before and after the implementation of the new working methods, we investigated staff-perceived experiences of the effects on working relationships and the utilisation of professional skills and attitudes, resulting from the mentioned change in working methods. The results were changes in daily communication methods among healthcare staff and improvements in the actual communication and collaborative problem solving skills concerning standard patients with simple hand pathology; however, there are still challenges for patients with more complex hand pathology. Though this new interprofessional arrangement improves the use of nurse and medical specialist professional competencies, it also requires a high degree of trust among the team members.
authors.affiliation: a Orthopaedic Research Unit, University Clinic for Hand, Hip and Knee Surgery, Regional Hospital Holstebro , Holstebro , Denmark.
authors.forename: Anke Elisabeth
authors.initials: AE
authors.lastname: de Beijer
authors.affiliation: a Orthopaedic Research Unit, University Clinic for Hand, Hip and Knee Surgery, Regional Hospital Holstebro , Holstebro , Denmark.|b Department of Clinical Medicine , University of Aarhus , Aarhus , Denmark.
authors.forename: Torben Bæk
authors.initials: TB
authors.lastname: Hansen
authors.affiliation: a Orthopaedic Research Unit, University Clinic for Hand, Hip and Knee Surgery, Regional Hospital Holstebro , Holstebro , Denmark.|b Department of Clinical Medicine , University of Aarhus , Aarhus , Denmark.
authors.forename: Maiken
authors.initials: M
authors.lastname: Stilling
authors.affiliation: a Orthopaedic Research Unit, University Clinic for Hand, Hip and Knee Surgery, Regional Hospital Holstebro , Holstebro , Denmark.
authors.forename: Flemming
authors.initials: F
authors.lastname: Jakobsen
mesh_terms: D001291:Attitude of Health Personnel; D003142:Communication; D003266:Continuity of Patient Care / Q000458:organization & administration; D003299:Cooperative Behavior; D019091:Critical Pathways / Q000592:standards; D003718:Denmark; D017144:Focus Groups; D006801:Humans; D007400:Interprofessional Relations; D009985:Orthopedics; D010044:Outpatient Clinics, Hospital / Q000458:organization & administration* / Q000592:standards; D010348:Patient Care Team / Q000458:organization & administration* / Q000592:standards; D011340:Problem Solving; D024382:Professional Role; D013997:Time Factors; D016526:Workload
keywords: Focus groups; interprofessional collaboration; shared problem solving; team effectiveness; team-based care