Changing roles, changing responsibilities and changing relationships: an exploration of the impact of a new model for delivering integrated diabetes care in general practice
Authors: Johnson, Maxine; Goyder, Elizabeth
Source: Quality in Primary Care, Volume 13, Number 2, June 2005 , pp. 85-90(6)
Publisher: Radcliffe Publishing Ltd.
Abstract:Aims To explore the views and concerns of professionals after the introduction of a new and more integrated model of diabetes care. Teams consisting of a specialist physician and a diabetes specialist nurse were assigned to individual general practices to support them in delivering diabetes care to an increasing proportion of their patients with diabetes.
Methods Semi-structured interviews were conducted with 17 healthcare professionals including general practitioners, hospital-based medical specialists, practice nurses and diabetes specialist nurses involved in the pilot scheme to provide specialist support to primary care teams. The interviews were transcribed and analysed using a 'framework' approach to identify the key issues for professionals involved in changes in organisation and delivery of diabetes care.
Results All professional groups supported the overall aims of the initiative but expressed a range of concerns about the impact on workload and job satisfaction. Major themes identified included time, training and workload; collaboration, relationships and sharing information across organisational boundaries; and the impact of changing professional roles. Differences between professional groups emerged, with nurses being much more concerned about the impact of change in terms of the practical implications for their role and workload. Doctors identified the major impact as improving relationships and communication between specialists and generalists.
Conclusion Development of integrated models of diabetes care which involve professionals increasingly working across organisational boundaries have significant implications for all the professional groups involved. Understanding these implications can help ensure new service developments have positive outcomes for both patients and professionals.
Document Type: Regular Paper
Publication date: June 2005