BackgroundAn important element of value-based health care (VBHC) is interprofessional collaboration in integrated practice units (IPUs) for the delivery of the complete cycle of care. High levels... Show moreBackgroundAn important element of value-based health care (VBHC) is interprofessional collaboration in integrated practice units (IPUs) for the delivery of the complete cycle of care. High levels of interprofessional collaboration between clinical and nonclinical staff in IPUs are assumed rather than proven. Factors that may stimulate interprofessional collaboration in the context of VBHC are underresearched.PurposeThe aim of this study was to examine relational coordination (RC) in VBHC and its antecedents.ApproachA questionnaire was used to examine the association of both team practices and organizational conditions with interprofessional collaboration in IPUs. Gittell's Relational Coordination Survey was drawn upon to measure interprofessional collaboration by capturing the relational dynamics in coordinated working. The questionnaire also included measures of team practices (team meetings and boundary spanning behavior) and organizational conditions (task interdependence and time constraints).ResultsThe number of different professional groups participating in team meetings is positively associated with RC in IPUs. Boundary spanning behavior, task interdependence, and time constraints are not associated with RC.ConclusionsIn IPUs, the diversity within interprofessional team meetings is important for establishing high-quality communication and relationships.Practice ImplicationsHospital managers should prioritize facilitating and encouraging shared meetings to enhance RC levels among professional groups in IPUs. Show less
Objective: To discuss practical strategies to consider for morbidity and mortality conferences (M & M). Materials and Methods: This article reflects on (i) insights that can be drawn from the M... Show moreObjective: To discuss practical strategies to consider for morbidity and mortality conferences (M & M). Materials and Methods: This article reflects on (i) insights that can be drawn from the M & M literature, (ii) practical aspects to consider when organizing M & M, and (iii) possible future directions for development for this long-standing practice for routine reflection. Results: M & M offers the opportunity to learn from past cases in order to improve the care delivered to future patients, thereby serving both educational and quality improvement purposes. For departments seeking to implement or improve local M & M practice, it is difficult that a golden standard or best practice for M & M is nonexistent. This is partly because comparative research on different formats is hampered by the lack of objective outcome measures to evaluate the effectiveness of M & M. Common practical suggestions include the use of (i) a skillful and active moderator; (ii) structured formats for case presentation and discussion; and (iii) a dedicated committee to guide improvement plans that ensue from the meeting. M & M practice is affected by various sociological factors, for which qualitative research methods seem most suitable, but in the M & M literature these are sparsely used. Moreover, aspects influencing an open and blame-free atmosphere underline how local teams should tailor the format to best fit the local context and culture. Conclusion: This article presents practice guidance on how to organize and carry out M & M This practice for routine reflection needs to be tailored to the local setting, with attention for various sociological factors that are at play. Show less
