Nigerian Hospital-Based Interprofessional Collaborative Patterns and Organizational Implications

Nigerian Hospital-Based Interprofessional Collaborative Patterns and Organizational Implications By Osaeloka Ekwueme FMCPH, National Postgraduate Medical College of Nigeria, 2004 MPH, University of Nigeria, Nsukka, 2004 MB, BS, University of Nigeria, 1992 BSc, Eastern Michigan University, USA, 1986 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Health Services Walden University November 2018 Abstract Interprofessional collaboration is recognized as the innovative, evidence-based strategy that strengthens health systems and improves performance and health outcomes. While resource-rich countries have benefitted much from the implementation of this initiative, literature is scarce regarding sub-Sahara Africa. This quantitative cross-sectional descriptive study described the extent of interprofessional collaborative practice at the tertiary care level in Nigeria and its implications on patient health outcomes, professionals’ performance, satisfaction, and healthy practice environment. The relational coordination theory (RCT) provided the conceptual framework for the study. Key research questions were on the association between the extents of interprofessional practice and each of the outcome implications. Data were collected using a questionnaire survey and were analyzed using means, standard deviations, t tests, correlation and regression statistics, and Chi-square tests. Results showed that the health professionals rated the practice of interprofessional collaboration low and perceived that the extents of the practice negatively affected patient’s mortality, professionals’ work performance, job satisfaction, and the frequency of interprofessional conflicts and strike actions. Recommendations included policy formulation and implementation, commitment and willingness by the health professionals to teamwork and patient-centered care. The implications for positive social change is that these results could be used as a tool to advocate for policy formulation and policy change for effective implementation of interprofessional collaboration; and as a database for future training intervention on collaborative practices among health professionals.Interprofessional collaboration is recognized as the innovative, evidence-based strategy that strengthens health systems and improves performance and health outcomes. While resource-rich countries have benefitted much from the implementation of this initiative, literature is scarce regarding sub-Sahara Africa. This quantitative cross-sectional descriptive study described the extent of interprofessional collaborative practice at the tertiary care level in Nigeria and its implications on patient health outcomes, professionals’ performance, satisfaction, and healthy practice environment. The relational coordination theory (RCT) provided the conceptual framework for the study. Key research questions were on the association between the extents of interprofessional practice and each of the outcome implications. Data were collected using a questionnaire survey and were analyzed using means, standard deviations, t tests, correlation and regression statistics, and Chi-square tests. Results showed that the health professionals rated the practice of interprofessional collaboration low and perceived that the extents of the practice negatively affected patient’s mortality, professionals’ work performance, job satisfaction, and the frequency of interprofessional conflicts and strike actions. Recommendations included policy formulation and implementation, commitment and willingness by the health professionals to teamwork and patient-centered care. The implications for positive social change is that these results could be used as a tool to advocate for policy formulation and policy change for effective implementation of interprofessional collaboration; and as a database for future training intervention on collaborative practices among health professionals. Nigerian Hospital-Based Interprofessional Collaborative Patterns and Organizational Implications By Osaeloka Ekwueme FMCPH, National Postgraduate Medical College of Nigeria, 2004 MPH, University of Nigeria, Nsukka, 2004 MB, BS, University of Nigeria, 1992 BS, Eastern Michigan University, USA, 1986 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Health Services Walden University November 2018 Dedication This study is dedicated to God Almighty, through whose inspiration; I was able to embark upon and completed the doctorate degree journey. I also dedicate the study to my loving wife, Mrs. Agatha Chinasa Ekwueme, who stood behind me and gave me all necessary emotional and physical support; and to my children, Munachimso, Precious, Chiemerie, and Udochukwu, that I frequently consulted in times of technical difficulties. Acknowledgments I wish to acknowledge, Dr. Warren Glenn McDonald, the able and supportive chair of my dissertation committee, for the unquantifiable supports given to me in this doctoral degree program. Words cannot fully express my heartfelt appreciation, to you, Dr. Mac for your tailored mentoring in this dissertation program. I also wish to acknowledge my dissertation committee member, Dr. Ronald Vincent Bucci, for all the expert advice; and in deed to all the members of the institution review board, for the critical review of my dissertation, so as to meet required ethical standard of research. I also wish to acknowledge the inputs of the University Research Reviewer, Dr. Suzanne Richins, whose comments and feedbacks contributed to the overall quality of this work. I will particularly remain grateful and appreciate the efforts of Dr. Tammy Root, the program coordinator; and Dr. Magdeline C. Aagard, core faculty; for their assistance in assembling such a wonderful dissertation committee members for me, when I had almost given up the research for want of professors, who were to serve in this capacity. In fact, the period of search for committee members was one of the most emotionally traumatic periods of my doctoral degree journey. I cannot appreciate Dr. Tammy Root, and Dr. Magdeline C Aagard, enough for coming to my rescue at that critical moment in this doctoral degree program.