Summary
Interprofessional communication and clinical leadership in the development of network-based primary care
Minke Nieuwboer
AIM: To explore preconditions for collaboration in primary dementia care: clinical leadership and interprofessional communication.
METHOD: Systematic review to study clinical leadership in the context of integrated primary care. Mixed methods design: 1) to evaluate a clinical leadership support programme; 2) to explore communication between community nurses and general practitioners.
FINDINGS: Effective leadership support programs are scarce. Leaders’ relational and organizational skills as well as process-management and change-management skills were considered important to improve care integration. By following the DementiaNet leadership-program, professionals improved their leadership skills. Community nurses and general practitioners generally perceived their interprofessional communication as inadequate. Profession-specific factors (e.g., differences in responsibility and profession-specific language) and organizational factors (e.g., lack of shared care plans, no personal contact) negatively influenced communication. Content analysis of actual nurse-doctor communication showed that many conversations lacked structure and conciseness. Confident nurses communicated in a more structured way.
DISCUSSION and CONCLUSION: We found that leaders have a positive impact on the network’s quality improvement. However, primary care professionals’ leadership is currently practiced at a basic level. Communication structure and nurses’ self-confidence in communication with doctors are favourable targets for improvement of interprofessional communication. Therefore, we recommended supportive training and coaching on both preconditions.
Keywords: Primary care, interprofessional communication, clinical leadership, dementia, community care networks