Enhancing interprofessional teamwork between youth care professionals using an electronic health record; a mixed methods intervention study

We aimed to investigate whether using a shared electronic patient record (EPR-Youth) strengthened interprofessional teamwork among professionals in youth care and child healthcare. Using a mixed-methods design, we compared two partly overlapping samples of professionals, who completed questionnaires before the introduction of EPR-Youth (<i>n</i> = 117) and 24 months thereafter (<i>n</i> = 127). Five components of interprofessional teamwork (interdependence, newly created professional activities, flexibility, collective ownership of goals, and reflection on processes) were assessed for this study. Midway through the study period, focus groups were held with 12 professionals to examine how EPR-Youth contributed to interprofessional teamwork. Professionals reported significantly more flexibility after the introduction of EPR-Youth than before. Professionals scored slightly -but not significantly- more positively on the other components of teamwork. Focus group participants reported that using EPR-Youth strengthened their sense of interdependence and collective ownership of goals, and contributed to newly created professional activities. At baseline, levels of interprofessional teamwork differed between organizations. Focus group participants confirmed these differences and attributed them to differences in facilitation of interprofessional teamwork. Our findings suggest that using EPR-Youth can foster interprofessional teamwork. Organizational differences underline that implementing an EPR alone is inadequate: shared definitions of teamwork and organizational facilities are needed to strengthen interprofessional teamwork.

本研究旨在探讨共享式电子患者记录（electronic patient record, EPR-Youth）能否强化青年照护与儿童保健领域专业人员间的跨专业团队协作。本研究采用混合研究设计，对两组部分重叠的专业人员样本进行比较：两组分别在EPR-Youth上线前（n=117）及上线24个月后（n=127）完成问卷调研。本研究评估了跨专业团队协作的五大维度：相互依存、新增专业活动、灵活性、团队目标共同归属以及流程反思。研究中期，研究团队对12名专业人员开展焦点小组访谈，以探究EPR-Youth对跨专业团队协作的赋能作用。调研结果显示，EPR-Youth上线后，专业人员感知到的团队灵活性显著高于上线前；在其余协作维度上，专业人员的评分略呈正向趋势，但未达到统计学显著性差异。焦点小组访谈参与者反馈，使用EPR-Youth强化了他们对团队相互依存与目标共同归属的感知，同时催生了新增的专业活动。基线阶段，不同机构间的跨专业团队协作水平存在差异。焦点小组参与者证实了这一差异，并将其归因于跨专业团队协作的推动机制存在差异。本研究结果表明，EPR-Youth可有效促进跨专业团队协作。同时，组织间的差异也提示，仅上线电子患者记录并不足以达成目标：需配套形成统一的团队协作定义及组织支持设施，方能切实强化跨专业团队协作。