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Interprofessional healthcare practices - processes and context

Bellon, Johanna (2016) Interprofessional healthcare practices - processes and context. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Abstract

Interprofessional practice is an integral part of improving the increasingly complex healthcare system. Communication and coordination between professional groups across settings is necessary for effective and efficient chronic disease management, population health, and transitions of care, all of which are important for public health. While the concept of teamwork is not new to healthcare, the specifics of how to carry out team-based care in different organizational contexts are largely unknown. This study explores context, mechanisms, and outcomes of interprofessional practice across a range of settings.

Chapter 1 is a rapid realist review of interprofessional models in the emergency department. It details common contexts for interprofessional practice, such as regulatory changes, management quality improvement initiatives, and professional association guidelines. The study also describes interventions and mechanisms associated with interprofessional practice, including empowering members of the clinical team to share decision making, formalizing communication to reduce uncertainty, and utilizing electronic monitoring to improve efficiency. Finally, it identifies potential outcomes, such as cost, process improvement, and patient health outcomes.

Chapter 2 is a qualitative study of the role of and context for advanced practice providers (APPs) in hospital medicine at two hospitals. This study describes the organizational context for implementing APPs, which include cost pressures and physician shortages. The study also details three different models of APPs in hospital medicine and associated perceived outcomes.

Chapter 3 is a quantitative study of the differences between APP and physician providers of e-visits. The study finds that patients of APPs tend to be younger, single and higher income. It also finds that APPs tend to prescribe more drugs per patient than physicians, which could have cost and quality implications.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Bellon, Johannajes189@pitt.eduJES189
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairCastle, Nicholascastlen@pitt.eduCASTLEN
Committee MemberDriessen, Juliadriessen@pitt.eduDRIESSEN
Committee MemberJames, A. Everetteaejames@pitt.eduAEJAMES
Committee MemberTrauth, Jeanette M.trauth@pitt.eduTRAUTH
Committee MemberZhang, Yutingytzhang@pitt.eduYTZHANG
Date: 27 January 2016
Date Type: Publication
Defense Date: 19 August 2015
Approval Date: 27 January 2016
Submission Date: 30 October 2015
Access Restriction: 5 year -- Restrict access to University of Pittsburgh for a period of 5 years.
Number of Pages: 69
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Health Policy & Management
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: Interprofessional practice, organizational context, healthcare
Date Deposited: 27 Jan 2016 21:53
Last Modified: 15 Nov 2016 14:30
URI: http://d-scholarship.pitt.edu/id/eprint/26286

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