Assessment of Interprofessional Collaboration amongHealthcare Providers inthe Provision of Health Services at GovernmentalHospitals- Gaza Governorates

Iyad Ibrahim Shaqura
اياد ابراهيم شقورة
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Al-Quds University
Universally, there is a growing interest in studying interprofessional collaborative care; whereas, most studies have shown that interprofessional collaborative care has positive outcomes on patient,provider and health system levels. Interprofessional collaboration becomes one of the important priorities for World Health Organization as well as scientific research in Palestine. This study ascertains the assessment of health providers collaboration in providing services at governmental hospitals in Gaza governorates. A mixed-methods approach was used, in which data has been triangulated. In total, 340 randomly selected healthcare providers from six hospitals who were eligible and consented to participate in the quantitative part of the study with 95.7% response rate. In addition, seven interviews and three focus group discussions were conducted with purposively selected 30 participants. Quantitative data were collected first through self-administered questionnaire and preliminary findings derived from the analysis of the questionnaires had directed the qualitative data collection. The researcher used the Collaborative Assessment Practice Tool. The overall reliability was (Cronbach's Alpha 0.815). The statistical Package for Social Sciences software was used for the quantitative data entry and analysis while open coding thematic technique was used to analyze the qualitative data in addition to cross hospital analysis. Findings reveal that 59.12% of participants were male and 79.7% were married at the time of data collection. Nearly half (52.1%) of respondents were nurses, 30.6% physicians, 5.6% lab. Technicians, 4.7% pharmacists, 3.8% radiology technicians and 3.2% physiotherapists 58.2% were bearing bachelors certificate. 40.3% were working at Al-Shifaa medical complex, 22.4% at EGH, 13.8% at Al- Aqsa, 10.9% at Kamal Adwan, 7% at Al-Rantisy and 5.6% at Al-Hilal hospital. 84.75% of participants were working in open departments. Around 84% were experience for 1-15 years. Nearly two thirds (64.1%) were regular employees without high administrative positions. Study participants proposed variations in their responses in relation to the 56 items of the eight domains of interprofessional collaboration. The domain of general relationships elicited the highest mean among other domains (3.943) whereas the mean of community linkages and coordination of care was the least (3.181) as this was referred to the centralized committee that is responsible for that issue. The domain of mission, meaningful purpose and goals was achieved by 74.5% which was mainly attributed to the problematic prioritization of interprofessional goals. Other domains were; patient involvement (68.96%), decision making and conflict management (68.96%), team leadership (69.88%), communication and information exchange (70.8%), and general role responsibilities and autonomy (71.9%). This means that all domains ranged from low to moderate in their current status. The overall perceived interprofessional collaboration was moderate as it was achieved by 71.66%. Inferential statistics show that gender, age, specialty and position had elicited statistically significant variations among healthcare providers (P value less than 0.05). The domains of interprofessional collaboration (except general relationships) also influenced by some independent variables and there were resultant significant variations. Post hoc tests reported some statistically significant differences among the groups of variables. Males and expert healthcare providers inversely affect general role responsibilities and autonomy. Older health professionals, Al-Hilal hospital as a workplace and regular employees positively influenced decision making and conflict management. Professionals bearing diploma certificate and nurses were positively influencing factors on patient involvement. Nurses were better off than pharmacists in communication and information exchange. The health providers who were having more experience years showed highest in community linkages and coordination of care. In addition, interviews and focus group discussions reported enablers and barriers to the interprofessional collaboration among healthcare providers at governmental hospitals. The study concluded that interprofessional collaboration is a new multi-faceted concept to healthcare professionals at governmental hospitals in Gaza governorates and then interventions aiming to enhance it, must be multi-level. Emphasis should be directed at establishing system-level policies, promoting organizational environment, supporting healthcare professional development and greater patients’ involvement in the track of providing quality health services and improving health outcomes.