Massey Documents by Type
Permanent URI for this communityhttps://mro.massey.ac.nz/handle/10179/294
Browse
2 results
Search Results
Item The transition from multi-disciplinary team to inter-disciplinary team : the impact of integrated healthcare on the nature and identity of health social work practice in Aotearoa New Zealand : a thesis presented in partial fulfilment of the requirements for the degree of Master of Social Work at Massey University, Palmerston North, New Zealand(Massey University, 2018) Austin, Karlin EstherIntegrated healthcare aims to transform the health system and improve health outcomes, while managing national health spending, by providing a more co-ordinated, collaborative and cohesive response to patient-centred care. Inter-disciplinary teams (IDT) have become synonymous with integrated healthcare, as it provides a framework for conceptualising an alternative approach to patient-centred care, within the District Health Board (DHB). This study explored how the transition from a multi-disciplinary team (MDT) to an IDT structure, within the DHB, influences the nature and identity of health social work practice. The subjective experiences of the twelve registered health social workers, who participated in this study, reflect the unique Aotearoa New Zealand context at different stages of the transition from an MDT to an IDT. Critical theory and a constructivist theoretical framework guided this qualitative research study, in which health social work is conceptualised within the broader context of competing and inter-related socio-political, cultural and economic demands. Semi-structured interviews were conducted with each of the participants, from across Aotearoa New Zealand. The data from these interviews was collated, according to emerging themes and patterns and analysed in relation to relevant national and international literature. The participants in this study were unanimous in their support of the transition to an IDT, citing the correlation between increased professional collaboration and improved patient outcomes. The findings from this study reveal that while the nature and identity of health social work practice remains unchanged, the transition to an IDT affords further opportunities for practitioners to demonstrate competence and to gain credibility. Findings highlight that exposing other disciplines to the unique knowledge and skills that social work brings to patient-care, positions the profession as integral to the functioning of the IDT. The significance of this study and the recommendations that have emerged, highlight the need for DHBs to be more transparent about the rationale for change and to involve health social work at every stage of the transition to an IDT. This study concludes that distinguishing between the MDT and the IDT, and providing professionals with ongoing education and support around working collaboratively as an IDT, creates sustainable change. The bicultural nature of health social work in Aotearoa New Zealand offers opportunities to strengthen integrated healthcare, by drawing on Whakawhanaungatanga, the practice of appreciating and growing relationships and kotahitanga, which involves bringing people together. These serve as unifying concepts within the IDT.Item Pluralistic dialogue : a grounded theory of interdisciplinary practice : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy, Massey University, New Zealand(Massey University, 1999) McCallin, AntoinetteThis grounded theory study explains how health professionals work in interdisciplinary teams in health services where the call for new collaborations is intensifying. Forty-four participants from four teams in two major acute-care hospitals participated in the study. In total there were eighty hours of interviewing and eighty hours of participant observation. All data were constantly compared and analysed using Glaser's emergent approach to grounded theory. Underpinning the study are the premises of symbolic interactionism that are assumed to shape the focus of this study, team interactions, and collective action within an acute care setting. It is argued that interdisciplinary team members express a concern for meeting service needs, and continually resolve that concern through the process of pluralistic dialogue. This is a means for discussing differences, that supports team members who are thinking through and constructing new ways of working together. It emerges as various health professionals integrate multiple perspectives, which contribute to the clinical and organisational management of the client service. Pluralistic dialogue has two complementary phases. These are rethinking professional responsibilities and reframing team responsibilities. Rethinking and refraining are theoretical processes that are underpinned by team learning, and, by new ways of managing changing service structures. Therefore, it is suggested that, in an interdisciplinary team, health professionals must break stereotypical images in order to meet service needs in a context where teams are constantly grappling with different mind-sets. Team members continually resolve their concern for meeting service needs by negotiating service provision. As a result, the health professionals are free to engage in the dialogic culture. The process of pluralistic dialogue has the potential to challenge, to empower, to transform; or it can perpetuate mediocrity. The decision to dialogue mindfully with others is essentially individual. Any variation in an individual's commitment is covered by disciplinary associates but seldom challenged by colleagues from a different professional group. A person may choose a non-involved response at any time, although someone must fulfil functional responsibilities in the team. Any variation in an individual's commitment is covered by disciplinary associates but seldom challenged by colleagues from a different professional group. This study also highlighted several significant categories impacting on effective interdisciplinary practice. Competency, alternative world views, information exchange, accountability, personality differences, and leadership, all affected team processes and pluralistic dialogue. But, it was quite clear from the data that, interdisciplinary team members can, and do form synergistic relationships that benefit both clients and colleagues. Team success is dependent on the individual's courage to challenge the self and the humility to cooperate in collective learning experiences. This substantive theory presents just a glimpse of the practical life of interprofessional people working in two busy city hospitals. The teams studied were unusual in that they each offered specialist care to a select group of clients. Perhaps they were unique and are non-representative of the average person who is a health professional today. So many of the health professionals were highly educated, well-respected specialist practitioners who stand out for their individual investment and dedication to improving the client's pathway through acute care. The study participants' patterns of behaviour would suggest that, when interdisciplinary practice is well established, an attitude of cooperative inquiry pervades joint actions and interactions that focus on meeting service needs