Improving the primary-secondary care interface in Scotland: a qualitative exploration of impact on clinicians of an educational complex intervention

Objectives

To determine the impact on clinicians and any consequent influence on patient care of taking part in the bespoke interface-focused educational intervention.

Design

Qualitative design.

Setting

Primary and secondary care centres in NHS Highland health board area, Scotland.

Participants

33 urban-based clinicians (18 general practitioners and 15 hospital specialists) in NHS Highland, Scotland.

Intervention

An interface-focused educational intervention was carried out in primary and secondary care centres in NHS Highland health board area, Scotland. Eligible clinicians were invited to take part in the intervention which involved facilitated small group work, and use of a bespoke educational module. Subsequent one-to-one interviews explored the impact of the intervention. A standard thematic analysis was used, comprising an iterative process based on grounded theory.

Results

Key themes that emerged included fresh insights (in relation to those individuals and processes across the interface), adoption of new behaviours (eg, being more empowered to directly contact a colleague, taking steps to reduce the others workload and changes in professional approach) and changes in terms of communication (including a desire to communicate more effectively, with use of different modes and methods).

Conclusion

The study highlighted key areas that may serve as useful outcomes for a large-scale randomised trial. Addressing issues identified in the study may help to improve interface relationships and benefit patient care.

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