Samenvatting
Gemeenten en zorgorganisaties kijken steeds vaker over grenzen van sectoren heen vanwege de decentralisatie van ondersteuning aan langdurig zieken en ouderen. De samenwerking bij een dergelijke integrale aanpak kent verschillende uitdagingen, die in opleiding en training kunnen worden geoefend. Dit artikel beschrijft het proces om te komen tot een serious game voor het oefenen van de belangrijkste uitdagingen bij complexe multidisciplinaire samenwerking in zorg en welzijn. Op basis van literatuuronderzoek en interviews met professionals zijn vier leerdoelen opgesteld: het onderscheiden van de meerwaarde van de verschillende professionals, het communiceren met de verschillende professionals, het ontwikkelen van en het handelen naar een teamgerichte focus en het reflecteren op de samenwerking en de eigen rol hierin. In een prototype van de serious game combineerden we deze leerdoelen met gaming elementen, zoals tijdsdruk, het omgaan met tegenstrijdige belangen, het uitwisselen van unieke informatie, cross-training en stapsgewijze spelacties. De game is in drie pilotsessies gespeeld met professionals uit zorg en welzijn. Direct na het spelen werd met behulp van een evaluatieprotocol de game geëvalueerd en aangepast. De leerdoelen werden herkend en de spelvorm sluit aan bij de wensen van de praktijk. Deze studie biedt inzicht in de bouwstenen om multidisciplinaire samenwerking te optimaliseren en laat zien hoe een laagdrempelige, praktijkgerichte simulatietraining kan worden ontwikkeld.
Abstract
Development of a serious game to improve multidisciplinary cooperation in health and social care
Decentralisation of health and social care support for older people and people with chronic conditions makes municipalities and healthcare organisations explore activities beyond their organisational borders. Such an ‘integrated approach’ builds on strong multidisciplinary cooperation, which has many challenges. To deal effectively with these challenges, training and education are necessary. This study describes the development of a serious game for practicing the most common challenges. Based on a literature review and interviews, four training objectives were determined: recognition of the added value of professionals, communication with other professionals, development of and acting according to a ‘team focus’ and reflection on the cooperation and one’s role in this. These objectives were matched with gaming elements, such as time pressure, dealing with conflicting interests, exchange of unique information, cross training and stepped play-elements. The game has been pilot-tested in three pilots with healthcare professionals. After every pilot the game was evaluated and adjusted, according to a protocol. Health and social care professionals recognized the training objectives and acknowledged that the game met their requirements. This study provides insight in the building blocks for optimizing multidisciplinary cooperation and demonstrates how low-profile training with simulation and gaming elements can be co-designed with health and social care professionals.
Literatuur
Plochg T, Keijsers JFEM, Levi MM. De ‘multimorbiditeitsdokter’ heeft de toekomst. Ned Tijdschr Geneeskd. 2012;156:A551–5.
Barr VJ, Robinson S, Marin-Link B et al. The expanded Chronic Care Model: An integration of concepts and strategies from population health promotion and the Chronic Care Model. Hospital Quart 2003;7:73–82.
Broeke J van den, Plochg T, Schreurs H et al. Wat is de werkwijze van zorg- en welzijnsorganisaties in Utrecht en Amsterdam om de hoge zorgconsumptie in achterstandswijken te verlagen? Verslag van een actiebegeleidend onderzoek. Tijdschr Gezondheidswet 2014;92:41–51.
Singer SJ, Burgers J, Friedberg M, Rosenthal MB, Leape L, Schneider E. Defining and measuring integrated patient care: promoting the next frontier in health care delivery. Med Care Res Review 2011;68:112–27.
Nolte E, Pitchforth E. What is the evidence on the economic impacts of integrated care? World Health Organisation, European Observatory on Health Systems and Policy; Policy summary 11, 201–4.
NPCF. Eerstelijnszorg voorop! Op weg naar een geïntegreerde eerstelijnszorg vanuit patiëntenperspectief. Utrecht, NPCF, 2007.
Robben S, Perry M, Nieuwenhuijzen L van et al. Impact of interprofessional education on collaboration attitudes, skills, and behavior among primary care professionals. J Contin Educ Health Prof 2012;32:196–204.
Lawn S, Lloyd A, King A, Sweet L, Gum L. Integration of primary health services: being put together does not mean they will work together. BMC Res Notes 2014;30;7:66.
Grumbach K, Bodeheimer T. Can health care teams improve primary care practice? JAMA 2004;291:1246–51.
Tannenbaum SI, Mathieu JE, Salas E, Cohen D. Teams are changing: are research and practice evolving fast enough? Ind Organ Psychol 2012;5:2–24.
Deneckere S, Euwema M, Van Herck P. Care pathways lead to better teamwork: results of a systematic review. Soc Sci Med 2012;75:264–8.
Pullon S, McKinlay Dew K. Primary health care in New Zealand: the impact of organisational factors on teamwork. Br J Gen Pract 2009;59:191–7.
Kelly DR, Crossley J, Lough M, Rushmer R, Greig GJ, Davies HT. Diagnosing a learning practice: the validity and reliability of a learning practice inventory. BMJ Qual Saf 2011;20:209–15.
Michael DR, Chen SL. Serious games: Games that educate, train, and inform. Boston, MA: Thomson Course Technology, 2005.
Harteveld C. Triadic game design: Balancing reality, meaning and play. London, UK: Springer, 2011.
Harteveld C. Making sense of Virtual Risks: a Quasi-Experimental Investigation into Game-Based Training. Amsterdam: IOS Press, 2012.
Jaruseviciene L, Liseckiene I, Valius L, Kontrimiene A, Jarusevicius G, Lapão LV. Teamwork in primary care: perspectives of general practitioners and community nurses in Lithuania. BMC Fam Pract 2013;14:11–8.
Hoof TJ van, Bisognano M, Reinertsen JL, Meehan TP. Leading quality improvement in primary care: recommendations for success. Am J Med 2012;125:869–72.
Chan BC, Perkins D, Wan Q et al. Team-link project team. Finding common ground? Evaluating an intervention to improve teamwork among primary health-care professionals. Int J Qual Health Care 2010;22:519–24.
Pullon S, McKinlay E, Stubbe M, Todd L, Badenhorst C. Patients’ and health professionals’ perceptions of teamwork in primary care. J Prim Health Care 2011;3:128–35.
Leasure EL, Jones RR, Meade LB et al. There is no "i" in teamwork in the patient-centered medical home: defining teamwork competencies for academic practice. Acad Med 2013;88:585–92.
Eggleton K, Kenealy T. What makes Care Plus effective in a provincial Primary Health Organisation? Perceptions of primary care workers. J Prim Health Care 2009;1:190–7.
Finlayson MP, Raymont A. Teamwork - general practitioners and practice nurses working together in New Zealand. J Prim Health Care 2012;4:150–5.
Kuziemsky CE, Borycki EM, Purkis ME. Interprofessional Practices Team. An interdisciplinary team communication framework and its application to healthcare ’e-teams’ systems design. BMC Med Inform Decis Mak 2009;15;9:43.
Johnson JK, Woods DM, Stevens DP et al. Joy and challenges in improving chronic illness care: capturing daily experiences of academic primary care teams. J Gen Intern Med 2010;25(Suppl 4):S581–5.
Proudfoot J, Jayasinghe UW, Holton C et al. Team climate for innovation: what difference does it make in general practice? Int J Qual Health Care 2007;19:164–9.
Mitchell GK, Tieman JJ, Shelby-James TM. Multidisciplinary care planning and teamwork in primary care. Med J Aust 2008;188(Suppl 8):S61–4.
West MA, Lyubovnikova J. Illusions of team working in health care. J Health Organ Manag 2013;27:134–42.
Mohr DC, Benzer JK, Young GJ. Provider workload and quality of care in primary care settings: moderating role of relational climate. Med Care 2013;51:108–14.
Palmer C, Bycroft J, Healey K, Field A, Ghafel M. Can formal collaborative methodologies improve quality in primary health care in New Zealand? Insights from the EQUIPPED Auckland Collaborative. J Prim Health Care 2012;4:328–36.
Goldman J, Meuser J, Lawrie L, Rogers J, Reeves S. Interprofessional primary care protocols: a strategy to promote an evidence-based approach to teamwork and the delivery of care. J Interprof Care 2010; 24(6):653–65.
Trivedi D, Goodman C, Gage H et al. The effectiveness of interprofessional working for older people living in the community: a systematic review. Health Soc Care Community 2013;21:113–28.
Wholey DR, Zhu X, Knoke D, Shah P, Zellmer-Bruhn M, Witheridge TF. The teamwork in assertive community treatment (TACT) scale: development and validation. Psychiatr Serv 2012;63:1108–17.
Salas E, Cooke NJ, Rosen MA. On teams, teamwork, and team performance: discoveries and developments. Human Factors 2008;5:540–7.
Kirkpatrick DI. Evaluating training programs: The four levels. (2nded). San Fransisco: Berett-Koehler, 1998.
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1 TNO, Leiden
2 Maastricht UMC, Maastricht
3 TNO, Leiden en Universiteit Twente, Enschede
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Marian Schoone, TNO, Postbus 3005, 2301 DA Leiden, tel. 088-8666090, e-mail: marian.schoone@tno.nl
Noten
a Een team wordt hier gezien als “een min of meer afgebakende groep van professionals met een bepaalde mate van taakafhankelijkheid en gedeelde doelen”.34
b Wij danken ZonMw voor de financiering van dit project binnen het programma “Op één lijn” (projectnummer 154031003).
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van der Klauw, D., de Koning, L., Hollander, I. et al. Ontwikkeling van een serious game voor multidisciplinaire samenwerking in zorg en welzijn. Tijdschr Gezondheidswet 94, 146–153 (2016). https://doi.org/10.1007/s12508-016-0055-9
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DOI: https://doi.org/10.1007/s12508-016-0055-9