title: Interprofessional collaboration in nursing homes (interprof): a grounded theory study of general practitioner experiences and strategies to perform nursing home visits.
abstract: Interprofessionalism, considered as collaboration between medical professionals, has gained prominence over recent decades and evidence for its impact has grown. The steadily increasing number of residents in nursing homes will challenge medical care and the interaction across professions, especially nurses and general practitioners (GPs). The nursing home visit, a key element of medical care, has been underrepresented in research. This study explores GP perspectives on interprofessional collaboration with a focus on their visits to nursing homes in order to understand their experiences and expectations. This research represents an aspect of the interprof study, which explores medical care needs as well as the perceived collaboration and communication by nursing home residents, their families, GPs and nurses. This paper focusses on GPs' views, investigating in particular their visits to nursing homes in order to understand their experiences.
  
  
  
  Open guideline-interviews covering interprofessional collaboration and the visit process were conducted with 30 GPs in three study centers and analyzed with grounded theory methodology. GPs were recruited via postal request and existing networks of the research partners.
  
  
  
  Four different types of nursing home visits were found: visits on demand, periodical visits, nursing home rounds and ad-hoc-decision based visits. We identified the core category "productive performance" of home visits in nursing homes which stands for the balance of GPs´ individual efforts and rewards. GPs used different strategies to perform a productive home visit: preparing strategies, on-site strategies and investing strategies.
  
  
  
  We compiled a theory of GPs home visits in nursing homes in Germany. The findings will be useful for research, and scientific and management purposes to generate a deeper understanding of GP perspectives and thereby improve interprofessional collaboration to ensure a high quality of care.
authors: Department of General Practice, University Medical Center Göttingen, Humboldtallee 38, 37073, Göttingen, Germany. nina.fleischmann@med.uni-goettingen.de.
authors: Nina
authors: N
authors: Fleischmann
authors: Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
authors: Britta
authors: B
authors: Tetzlaff
authors: Psychiatric Epidemiology and Demographic Change, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, J5, 68159, Mannheim, Germany.
authors: Jochen
authors: J
authors: Werle
authors: University of Applied Sciences and Arts, Faculty V - Health, Religious Education, Social Affairs, Blumhardtstraße 2, 30625, Hannover, Germany.
authors: Christina
authors: C
authors: Geister
authors: Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
authors: Martin
authors: M
authors: Scherer
authors: Psychiatric Epidemiology and Demographic Change, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, J5, 68159, Mannheim, Germany.
authors: Siegfried
authors: S
authors: Weyerer
authors: Department of General Practice, University Medical Center Göttingen, Humboldtallee 38, 37073, Göttingen, Germany.
authors: Eva
authors: E
authors: Hummers-Pradier
authors: Department of General Practice, University Medical Center Göttingen, Humboldtallee 38, 37073, Göttingen, Germany.
authors: Christiane A
authors: CA
authors: Mueller
mesh_terms: D000328:Adult; D000368:Aged; D001071:Appointments and Schedules; D003299:Cooperative Behavior; D004526:Efficiency; D005260:Female; D058005:General Practitioners / Q000523:psychology*; D066296:Grounded Theory; D006792:House Calls; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes / Q000458:organization & administration; D019555:Physician-Nurse Relations; D010817:Physician-Patient Relations; D000068616:Professionalism
keywords: General practitioners; Grounded theory; Interdisciplinary communication; Nursing homes; Physician-nurse relations; Primary health care; Qualitative research; Residential facilities