It’s all about presence: Health professionals’ experience of interprofessional collaboration when mobilizing patients with hip fractures

ABSTRACT

Mobilization is an interprofessional task in the evidence-based care pathway 'Enhanced Recovery After Surgery'; multiple health professionals collaborate when mobilizing patients with hip fractures. Drawing on the theory of relational coordination, and focusing on relationships and communication, we set out to explore how health professionals experience and describe interprofessional collaboration when mobilizing patients with hip fractures treated according to Enhanced Recovery After Surgery. Two rounds of interviews were conducted with 27 participants from 11 different professional groups, and the data were analyzed thematically. The main findings were that functional goals characterize the collaboration on mobilization due to undefined roles and responsibilities, and that specialized knowledge leads to a need for physical presence and formalization of work procedures in the collaboration. We argue that the hospital as a workplace can be characterized by logics of production and belonging. These logics create care work managed by quality, efficacy and scales of fairness that install power relations that must be recognized when engaging in interprofessional collaboration. We conclude that a primary focus on relationships and communication, as suggested by relational coordination, cannot solve the challenges of interprofessional collaboration, as the context in which health professionals work must also be considered.

KEYWORDS:

• Enhanced recovery after surgery
• fairness
• interprofessional collaboration
• logics of care production
• relational coordination
• qualitative method

Acknowledgments

We thank the Department of Orthopedic Surgery for providing the opportunity for this study as well as the Department of Physio- and Occupational Therapy, the Service Department and the Hospital Pharmacy for highly valued collaboration and financial support. Furthermore, we thank all health professionals who shared their experiences.

Contributions

Study design: LA, DE, CST. Data collection: LA, CST. Data analysis: LA, DE, CST, TSL. Manuscript preparation: LA, DE, CST, TSL. Final approval of manuscript: LA, DE, CST, TSL.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Additional information

Funding

This work was supported by the Fund of Working Environment at Amager & Hvidovre Hospital under Grant number 2018-185.

Notes on contributors

Lone Assafi

Lone Assafi, MA, is a Research Assistent at the Research Unit of Orthopaedic Nursing, Department of Orthopaedic Surgery, Copenhagen University Hospital, Hvidovre, Denmark.

Dorte Evaristi

Dorte Evaristi, Master, RN, is a Clinical Nursing Specialist and Quality Coordinator at the Research Unit of Orthopaedic Nursing, Department of Orthopaedic Surgery, Copenhagen University Hospital, Hvidovre, Denmark.

Cathrine Selnes Trevino

Cathrine Selnes Trivino, MscH, RN, is a Research Coordinator at Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Sem, Norway.

TrineSchifter Larsen

Trine Schifter Larsen, PhD, MA, RN, is a Post Doc Fellow at the Research Unit of Orthopaedic Nursing, Department of Orthopaedic Surgery and Clinical Research Centre, Copenhagen University Hospital, Hvidovre Denmark, and an Assistant Professor at Roskilde University, Department of People and Technology, Health Promotion Research Centre, Roskilde, Denmark.