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ABSTRACT
Models of care developed to improve the lives of people with chronic diseases highlight integrated care as essential to meeting their needs and achieving person (patient)-centered care (PCC). Nevertheless, barriers to collaborative practice and siloed work environments persist. To set in motion some groundwork for intersectoral collaboration this study brought two expert groups of epilepsy care practitioners together to engage in participatory action research (PAR). The expert practitioner groups were hospital-based epilepsy specialist nurses (ESNs) and community-based resource officers (CROs). The PAR highlighted, that while the participants share a mutual interest in caring for people with epilepsy, underdeveloped CRO-ESN relationships, arising from unconscious bias and ambiguity can result in missed opportunities for optimal care coordination with consequent potential for unnecessary replication and waste of finite resources. However, through dialogue and critical self-reflection, a growing emotional connection between the disciplines evolved over the course of the PAR. This allowed for buds of collaboration to develop with CROs and ESNs working together to tackle some of the key barriers to their collaboration.
Acknowledgments
The authors thank the employees of Epilepsy Ireland and the employees of the Health Service Executive who participated in this PAR study.
Declaration of interest
The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.
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Notes on contributors
Jarlath Varley
Jarlath Varley is an advanced nurse practitioner in emergency care. He holds a PhD in health services research. His research interests are focused on enhancing the patient journey, particularly in the context of chronic disease management.
Rachel Kiersey
Rachel Kiersey holds a PhD in public policy analysis from the Centre for Social and Educational Research at the Dublin Institute of Technology. She has significant research experience in social policy fields, including health, childhood studies, sociology and public affairs.
Robert Power
Robert Power is a social anthropologist with a PhD from Maynooth University Ireland. His research focuses on culture and culture change in a diversity of settings ranging from Andalusian tourist festival to the Irish healthcare system.
John-Paul Byrne
John-Paul Byrne holds a PhD in Sociology from Maynooth University Ireland. His research covers a comparison of working conditions in Ireland and Denmark, the concept of patient-centred care, and psychosocial work conditions and the social structures of work in healthcare.
Colin Doherty
Colin Doherty an Associate Professor of Clinical Epilepsy at Trinity College Dublin and was the National Clinical Lead for the Epilepsy Care Programme in Ireland. He has published widely on brain imaging, genetics, dementia, clinical epileptology and traumatic brain injury.
Jamie Saris
Jamie Saris is an Associate Professor in the Department of Anthropology, Maynooth University, Ireland. His research covers topics including the social life of mental hospitals, colonialism and its aftermath, structural violence and health risk, drug use/abuse, professionalism in medical education.
Veronica Lambert
Veronica Lambert is Professor of Children and Family Nursing at Dublin City University. Veronica’s research focuses on children and family: experience of health care communication; shared self-management for long-term conditions, psychosocial wellbeing and impact of illness.
Mary Fitzsimons
Mary Fitzsimons is the epilepsy eHealth lead with FutureNeuro, the SFI Research Centre at the Royal College of Surgeons in Ireland. Her interest is in the application of ehealth technologies to enable healthcare integration for people living with chronic conditions.