Empowering the Team: A Grounded Theory Investigation of the Interprofessional Teams in Hospitals

Background: Interprofessional team-based collaboration (IPC) has become a mandate for healthcare delivery, and social workers often work on these collaborative teams. IPC requires teams to draw on individual expertise while emphasizing collaboration and knowledge-sharing to benefit patient care (Molyneux, 2001). Despite the long history of social work practice in hospitals, less is known about social work specific functioning within interprofessional teams (Ambrose-Miller & Ashcroft, 2016). The aim of this study was to identify the contributions of social workers to collaborative hospital care teams and propose a model of how those functions integrate together.

Methods: Seven focus groups were conducted with social workers (n=46) who were purposively sampled from six urban hospitals. These hospitals were identified due to their range of teams that included social workers and organizational focus on IPC. Each focus group was 45-65 minutes with 4-10 participants. A semi-structured interview protocol probed questions related to participant experiences in IPC teams, perspectives of IPC team functioning, and the contribution of social work to IPC. Sampling continued until theoretical saturation was achieved through no new codes or categories emerging from the data (Charmaz, 2014). Grounded theory was utilized via three independent coders using open and line-by-line coding and constant comparison within and across data until themes emerged. Thick description and an audit trail were employed as trustworthiness measures.

Results: All participants were Master-level social workers with experience ranging from 1-44 years (M=13.5 years). Most identified as female (89%, n=41), Caucasian (78%, n=36) and ranged in age from 30-66. Participants worked in mental health, cardiac care, oncology, palliative care, neurology, complex care, surgery, rehabilitation, internal medicine, intensive care, family health, and emergency care. The key finding was that social workers are Empowering Collaboration by Actively Communicating (building relationships, holding information, and filling gaps), Proactively Educating (training the team, advocating for patients, and teaching about systems) and Managing Risk (troubleshooting discharge and avoiding liability). Collaboration was ‘empowered’ by social workers, meaning that participants often identified collaborative methods to mitigate potential risks, described by participants as being effective in determining a team approach to problem-solving. Communication was identified as ‘active’ and ‘engaged’ due to participant experiences of initiating IPC conversations (e.g., advocating for patients) and focusing on problem-solving (e.g., proactive education) which contributed to overall better patient care.

Conclusions and Implications: These results have contributed to an integrated model of IPC that builds on the key functions of health social workers on interprofessional teams. Building on research that health social workers are highly skilled communicators (McCormick et al., 2007), study participants described that they actively facilitated effective communication which in turn, contributed to enhanced team functioning. Implications for social work research and education as well as practice with interprofessional teams will be provided.