Multiprofessional teamwork in Finnish health and social service centers, experiences of managers

Abstract Background Health and social service centers are developed for the first contact points in Finland. Long waiting times, shortage of staff and lack of coordination have been major problems in primary care. As a solution, multiprofessional teams and better collaboration between professionals have been built. This study explores, how the teams work and what challenges they have. Methods The study is based on 16 interviews (25 managers) in 5 health and social services centers. County provided specialized care in the whole area as well as primary services in two centers, one center was provided by a municipality, and two by a private firm. The managers were asked about work organization, their experiences of the team model and about well-being of employees. The interviews were analyzed using content analysis. Results The managers saw the team work as functioning rather well. They also highlighted effective digital services and task shifting. Easy consultation of GP’ was important as nurses were the first contact for clients in phone. In this call, the client’ case was tried to be handled as far as possible. The competences of new professionals, such as social workers or psychiatric nurses had high value for the team. But the service processes and team-building were in progress. Working in mutual facilities and easy consultation of professionals was seen important. In most organizations clients were separated to different teams based on their service needs (acute or chronic conditions), or earlier clientele. As a result, some teams gained a more burdensome clientele, which increased stress. Conclusions Multiprofessional work can streamline and improve the treatment process, but this requires more information which ways to collaborate work best for the clients and professionals. Key messages • Multiprofessional team work, task shifting and digital services may increase efficiency and well-being of workers at health and social centers. • Easy consultation of GP’s is required for task shifting.


Background:
Health and social service centers are developed for the first contact points in Finland. Long waiting times, shortage of staff and lack of coordination have been major problems in primary care. As a solution, multiprofessional teams and better collaboration between professionals have been built. This study explores, how the teams work and what challenges they have.

Methods:
The study is based on 16 interviews (25 managers) in 5 health and social services centers. County provided specialized care in the whole area as well as primary services in two centers, one center was provided by a municipality, and two by a private firm. The managers were asked about work organization, their experiences of the team model and about well-being of employees. The interviews were analyzed using content analysis.

Results:
The managers saw the team work as functioning rather well. They also highlighted effective digital services and task shifting. Easy consultation of GP' was important as nurses were the first contact for clients in phone. In this call, the client' case was tried to be handled as far as possible. The competences of new professionals, such as social workers or psychiatric nurses had high value for the team. But the service processes and teambuilding were in progress. Working in mutual facilities and easy consultation of professionals was seen important. In most organizations clients were separated to different teams based on their service needs (acute or chronic conditions), or earlier clientele. As a result, some teams gained a more burdensome clientele, which increased stress.

Conclusions:
Multiprofessional work can streamline and improve the treatment process, but this requires more information which ways to collaborate work best for the clients and professionals. Key messages: Multiprofessional team work, task shifting and digital services may increase efficiency and well-being of workers at health and social centers. Easy consultation of GP's is required for task shifting.

Background:
The nursing sector is the largest human resource in the healthcare system providing direct patient care. The Covid-19 pandemic has forced nursing teams into a sustained state of emergency, and with it, much uncertainty and risk taking.

Aims:
Examining the emotions, risk and threat perceptions, trust in the healthcare system and compliance with Ministry of Health (MOH) regulations among nurses at two points in time during the COVID-19 pandemic in Israel.

Methods:
Research questionnaires were distributed to nurses at the height of the pandemic's first wave (March-May 2020). Among the respondents, 140 agreed to continue with the follow-up study. During the pandemic's third wave (January 2021), the research questionnaire was re-sent to these respondents. Of these, 80 filled-in the second questionnaire. Findings: Naturally, there was a higher level of experience among the nursing staffs in dealing with the virus in the second as compared to the first period in time. During the first wave, approximately a fifth of the participants (21%) reported that they had cared for patients who had been confirmed as having COVID-19, while during the third wave, most of the participants (66%) reported caring for people who had been confirmed as having contracted the virus. The findings demonstrate significantly lower levels of compliance with regulations and risk perception, and a significantly higher level of emotions in the third wave as compared to the first. However, there was no change in the level of trust in the healthcare system or in the pandemic-related threat perception.

Conclusions:
The findings provide us with some information regarding the process the nursing staffs have undergone (and are still undergoing) in dealing with the pandemic, and may point at a 'pandemic fatigue' amongst them. This concept relates to progressively lower regulation compliance levels appearing over time, affected by the target population's emotions, experiences and perceptions. Key messages: It is important to assist the nurses' emotional regulation with the help of professionals in the organization, form colleagues' support groups and ensure management recognition of the situation.