Contested innovation: the diffusion of interprofessionalism across a health system

Objectives. Interprofessionalism (IP) has emerged as a new movement in healthcare in response to workforce shortages, quality and safety issues and professional power dynamics. Stakeholders can push for IP (e.g. education providers to the health system) or pull (e.g. the health system to the educati...

Full description

Saved in:
Bibliographic Details
Published in:International journal for quality in health care 2011-12, Vol.23 (6), p.629-636
Main Authors: TRAVAGLIA, JOANNE F., NUGUS, PETER, GREENFIELD, DAVID, WESTBROOK, JOHANNA, BRAITHWAITE, JEFFREY
Format: Article
Language:English
Subjects:
Care and treatment
Colleges and universities
Cooperative Behavior
Delivery of Health Care
Diffusion of Innovation
Free trade and protection
Health policy
Humans
Interdisciplinary Communication
Interviews as Topic
Medical service
Models, Theoretical
Technological innovations
Workplaces
Citations: Items that this one cites
Items that cite this one
Online Access:Request full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Objectives. Interprofessionalism (IP) has emerged as a new movement in healthcare in response to workforce shortages, quality and safety issues and professional power dynamics. Stakeholders can push for IP (e.g. education providers to the health system) or pull (e.g. the health system to the education provider). Based on innovation theory, we hypothesized that there would be unequal forces within and across stakeholder domains which would work to facilitate or resist IP. The strongest pull pressures would be from the health system and services; push pressures for IP would come from government and higher education; with weaker push forces and levels of resistance, from protectionist professional bodies. Design, setting and participants. Our model was tested in a geographically bounded health jurisdiction. Information was gathered and analysed via individual (n = 99 participants) and group (n = 372 participants) interviews with stakeholders, and through document analysis. Results. The health system and services exerted the strongest pull in demanding IP. The strongest push factor was individual champions in positions of power. Professional bodies balanced their support of IP competencies with their role as advocates for their individual professions. A weak push factor came from government support for health workforce reform. Conclusions. Our hypothesis was supported, as were our predictions that the strongest pull would be from the providers and the strongest push from government and higher education. Our original model should be extended to account for contextual factors such as large-scale workplace and professional reform, which worked both for and against, IP.
ISSN:1353-4505
1464-3677
DOI:10.1093/intqhc/mzr064