Cross-sectoral exchange of nurses: An intervention study.

Abstract

Background: In health policy, much attention has been paid to collaboration between the primary and secondary health care sectors, especially in relation to hospitalisation and discharge. Despite ideal plans for collaboration, the research literature shows that inadequate communication is a well-known problem that can be a barrier to a safe trajectory for the citizen. Based on the assumption that better knowledge of each other's work will lead to better collaboration, a cross-sectoral exchange program with nurses was initiated.

Aim: The aim was to investigate which barriers to good patient trajectories the involved nurses attributed to cross-sectoral collaboration and what impact the exchange to the opposite sector had for them.

Methods: Twenty-eight nurses were exchanged: 14 from a cardiology department and 14 from municipal home care. The nurses shadowed a colleague from the opposite sector in their daily work. Subsequently, six focus group interviews were conducted. The transcribed material was analysed based on Ricoeur's interpretation theory.

Results: Two main themes, including sub-themes emerged: (1) Challenging communicative conditions: (a) Inadequate digital communication, (b) Inadequate care plans and discharge reports, (c) Conversation promotes understanding, and (d) Challenging collaboration and communication with the discharge coordinators. (2) Perceived importance of the exchange: (a) Cross-sectoral relationship, prejudice and gaining respect for each other and (b) Working in two different worlds.

Conclusion: Electronic communication is inadequate, and the IT systems do not support sufficient cross-sectoral communication. The organisational model in the municipal care sector is inflexible in terms of allocations for the current needs of citizens, and professionals feel that their professional judgements are not recognised. The nurses gained insight into each other's work and working conditions and respect for each other's professionalism. The exchange has the potential to both improve the relationship and communication between the sectors for the benefit of a better and more coherent patient course.