Leadership and Followership Dynamics in Interprofessional Health Care Teams: Attending Physician Perspectives.

Autor:	Barry ES, Teunissen P, Varpio L, Vietor R, Kiger M
Jazyk:	angličtina
Zdroj:	Academic medicine : journal of the Association of American Medical Colleges [Acad Med] 2024 Nov 01; Vol. 99 (11), pp. 1208-1214. Date of Electronic Publication: 2024 Jul 22.
DOI:	10.1097/ACM.0000000000005819
Abstrakt:	Purpose: Effective interprofessional health care team (IHT) members collaborate to reduce medical errors, use resources effectively, and improve patient outcomes, making interprofessional collaboration imperative. Because physicians are often designated as the positional leaders of IHTs, understanding their perspectives on collaboration within IHTs could help to mitigate the disconnects between what is suggested in theory and what is happening in practice. This study aimed to explore leader-follower dynamics within medical teams that are commonly working in clinical care contexts. Method: Using a constructivist approach, the authors conducted 12 individual, semistructured interviews from November 2022 to September 2023 with attending physicians who have led IHTs in perioperative (i.e., preoperative clinic, operating room, postoperative and recovery unit) or emergency department settings. The transcripts were analyzed from December 2022 to December 2023 using inductive thematic analysis. Results: Three themes explained the physician perceptions of IHT leadership-followership dynamics: (1) physicians are comfortable sharing leadership intra professionally, (2) the clinical culture and environment constrain interprofessional followership and shared leadership, and (3) hierarchical models hold true even while active followers are appreciated, when appropriate. Conclusions: The data in this study suggest that, in perioperative and emergency department settings, shared leadership largely may not occur inter professionally but occurs intra professionally. Participants suggested that the clinical culture and environment (i.e., legal concerns, hierarchical assumption, patient care ownership responsibilities) constrained interprofessional followership and shared leadership. On the basis of the study's findings and how they align with previous research, future research into interprofessional collaboration and followership roles should focus on what factors enable and constrain active followership and shared leadership. Such collaboration can only be achieved when active followership and shared leadership are allowed and promoted. These findings and others suggest that not all contexts are enabling such types of interprofessional collaboration due to legal concerns, hierarchical traditions, and patient ownership considerations. (Copyright © 2024 Written work prepared by employees of the Federal Government as part of their official duties is, under the U.S. Copyright Act, a “work of the United States Government” for which copyright protection under Title 17 of the United States Code is not available. As such, copyright does not extend to the contributions of employees of the Federal Government.)
Databáze:	MEDLINE
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