Values oriented to coordination in integrated health CARE organizations: Collaboration and teamwork

Background. One of the factors that influences care coordination in an integrated healthcare organization (IHO) is its culture. Culture is defined as the pattern of basic assumptions that a group has learned to solve problems of external adaptation and internal integration, which have worked well enough to be deemed valid and transmitted to new members. Healthcare coordination is strengthened by the existence of a common culture that includes coordination-oriented values, such as collaboration and teamwork. Culture can be analyzed, from among others, the values expressed by the group in different situations. The objective is to analyze the exposed values in relation to collaboration and teamwork in IHOs.

Methods. A qualitative and descriptive study was carried out in three IHO of Catalonia, through semi-structured individual interviews. A two-stage criterion sample was designed. Stage I: 3 IHO were selected and, stage II: 18 managers and 12 professionals. Interviews were recorded and transcribed. A narrative content analysis was conducted, with a mixed generation of categories and segmentation by IHO, informants and themes

Results. Managers and professionals agree on the relevance and willingness to collaborate on the part of professionals of the IHO analyzed. Some believe, however, that it depends on the individual attitude. In one of the IHO, professionals consider that primary care teams dispose of more tools that encourage collaboration. Teamwork, according to informants, is important but difficult. In some organizations, teams work together within the same level of care and only occasionally between levels of care (to develop clinical guidelines). In one IHO, managers and professionals believe that their IHO promotes teamwork, while in other, lack of time is seen as a barrier.

Conclusions: While informants recognize the importance of collaboration and teamwork, those values are highlighted mostly referring to work within one level, rather than between levels.

Research funded by FIS 04/2688 and CHC