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Shared care requires a shared vision: communities of clinical practice in a primary care setting

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Listed:
  • Jessica Young
  • Tony Egan
  • Chrystal Jaye
  • Martyn Williamson
  • Anna Askerud
  • Peter Radue
  • Maree Penese

Abstract

Aims and objectives To understand how a vision of care is formed and shared by patients and the primary care professionals involved in their care. Background To achieve the best health outcomes, it is important for patients and those who care for them to have a mutual understanding about what is important to the patient in their everyday life and why, and what care is necessary to realise this vision. Shared or team care does not necessarily translate to a consistent and integrated approach to a patient's care. An individual patient's care network of clinical and lay participants can be conceptualised as the patient's own ‘Community of Clinical Practice’ of which they are the central member. Design Working alongside a long‐term conditions nursing team, we conducted a focused ethnography of nine ‘Communities of Clinical Practice’ in one general practice setting. Method Participant observation, in‐depth qualitative interviews with 24 participants including nine patients, and the patients’ medical records. Data were analysed using a template organising style. Findings Primary care professionals' insight into a patient's vision of care evolves through a deep knowing of the patient over time; this is shared between ‘Community of Clinical Practice’ members, frequently through informal communication and realised through respectful dialogue. These common values – respect, authenticity, autonomy, compassion, trust, care ethics, holism – underpin the development of a shared vision of care. Conclusions A patient's vision of care, if shared, provides a focus around which ‘Community of Clinical Practice’ members cohere. Nurses play an important role in sharing the patient's vision of care with other participants. Relevance to clinical practice A shared vision of care is an aspirational concept which is difficult to articulate but with attentiveness, sustained authentic engagement and being driven by values, it should evolve amongst the core participants of a ‘Community of Clinical Practice’.

Suggested Citation

  • Jessica Young & Tony Egan & Chrystal Jaye & Martyn Williamson & Anna Askerud & Peter Radue & Maree Penese, 2017. "Shared care requires a shared vision: communities of clinical practice in a primary care setting," Journal of Clinical Nursing, John Wiley & Sons, vol. 26(17-18), pages 2689-2702, September.
  • Handle: RePEc:wly:jocnur:v:26:y:2017:i:17-18:p:2689-2702
    DOI: 10.1111/jocn.13762
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    References listed on IDEAS

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    1. Ivaylo Vassilev & Anne Rogers & Christian Blickem & Helen Brooks & Dharmi Kapadia & Anne Kennedy & Caroline Sanders & Sue Kirk & David Reeves, 2013. "Social Networks, the ‘Work’ and Work Force of Chronic Illness Self-Management: A Survey Analysis of Personal Communities," PLOS ONE, Public Library of Science, vol. 8(4), pages 1-13, April.
    2. Fatima Al Sayah & Olga Szafran & Sandra Robertson & Neil R. Bell & Beverly Williams, 2014. "Nursing perspectives on factors influencing interdisciplinary teamwork in the Canadian primary care setting," Journal of Clinical Nursing, John Wiley & Sons, vol. 23(19-20), pages 2968-2979, October.
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