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The purpose of this paper is to examine how knowledge exchange between academics and clinicians in Collaborations for Leadership in Applied Health Research and Care (CLAHRCs) is influenced by their social position based on their symbolic and social capitals, that is, their personal professional status and connections to high-status professional peers, knowledge brokers, and unfamiliar professional peers.

Using an online survey, the author triangulates the cross-sectional measurement of the effects of academic and clinicians’ social position in the initial and later phases of CLAHRCs with the longitudinal measurement of these effects over a two-year period.

First, academics and clinicians with a higher personal professional status are more likely to develop joint networks and decision making both in the early and later phases of a CLAHRC. Second, academics and clinicians who are more connected to higher status occupational peers are more likely to develop joint networks in the early phase of a knowledge exchange partnership but are less likely to become engaged in joint networks over time. Third, involvement of knowledge brokers in the networks of academics and clinicians is likely to facilitate their inter-professional networking only in the later partnership phase.

Academics and clinicians’ capitals have a distinctive influence on knowledge exchange in the early and later phases of CLAHRCs and on a change in knowledge exchange over a two-year period.

Prior research on CLAHRCs has examined how knowledge exchange between academics and clinicians can be encouraged by the creation of shared governance mechanisms. The author advances this research by highlighting the role of their social position in facilitating knowledge exchange.

In the second part of this two‐part feature, four models of inter‐professional collaboration are explored, each of them representing points on a continuum from lower to higher levels of collaboration.The four are:• Communication: interactions are confined to facilitating the exchange of information.• Co‐ordination: individuals remain in separate organisations and locations, but develop formal ways of working across these boundaries.• Co‐location: members of different professions are physically located alongside each other.• Commissioning: professionals with a commissioning remit develop a shared approach to the activity

The purpose of this paper is to explore stakeholder views on the policy of integrated health and social care for older people with complex needs in Sweden and the issue of trust in implementing the policy.

The study used a qualitative interview design and interviews with nine strategically selected stakeholders. A thematic analysis focused on trust, as defined in the theory of collaborative advantage, was used.

This study of health and social care exposed a lack of trust on political, strategic and inter-professional levels. Two opposing lines of argument were identified in the interviews. One advocated a single government authority for health and social care. The other was in accordance with recently implemented national policies, which entailed more collaboration between local government authorities, obliging them to make joint local agreements. The Swedish experience is discussed in an international context, examining the need for collaboration in integrated care services for older people.

Although the findings are important for the current adjustment in health and social care for older people, the number of interviewees are limited. Future studies will include more regions and longitudinal studies.

Sweden is currently undergoing an extensive adjustment in line with recent national government policy which involves more primary health care and a corresponding reduction in the number of hospital beds. The restructuring of the care system for older people with complex needs is a paradox, as it simultaneously increases the need for centralisation while also increasing coordination and collaboration on a local basis.

The landscape of adult social care, and in particular of adult safeguarding, has shifted considerably over the last decade. Alongside policy changes in the responses to adult abuse, there have been shifts in professional and public understanding of what falls within the remit of this area of work. This results, arguably, in differing understandings of how adult safeguarding is constructed and understood. Given the increasing emphasis on multi-agency inter-professional collaboration, service user involvement and lay advocacy, it is important to consider and reflect on how both professionals and lay people understand this area of work. The paper aims to discuss these issues.

This study employed Augusto Boal’s model of Forum Theatre to explore how a variety of professional and lay groups understood, related to and engaged with how the Care Act 2014 defines and describes “adult safeguarding”.

Lay participants responded to the scenario in a variety of ways, upholding the construct validity of “adult safeguarding” and the authority of the social worker. Social care and health practitioners sought orderly, professionalised and sometimes ritualistic solutions to the “adult safeguarding” scenario presented, seeking carefully to structure and to manage lay involvement. Inter-professional collaboration was often problematic. The role of lay advocates was regarded ambiguously and ambivalently.

This paper offers a number of practice and research recommendations. Safeguarding practitioners could benefit from more effective and reflexive inter-professional collaboration. Both practitioners and service users could benefit from the more thoughtful deployment of the lay advocates encouraged within the Care Act 2014 and associated guidance.

Financial constraints, an increase in the demand for health-care from an ageing population, multiple comorbidities in both mental and physical health and delivering care closer to the community, are amongst the factors creating a need for innovation in the NHS. The purpose of this paper is to explore leader behaviours that promote innovation in a multidisciplinary musculoskeletal (MSK) service.

Qualitative semi-structured interviews were conducted to explore the experience and views of the multidisciplinary team (MDT) members on leadership and innovation. A total of 13 MDT members participated in the study.

Inter-professional collaboration and the absence of hierarchical behaviours are associated with a positive experience. Traditionally established hierarchy and inter-professional barriers for interaction were associated with challenging experience in MDT. There was an expression of fear of and vulnerability to being “taken over” or “eaten up” by other professions. Supportiveness, consulting behaviour, provision of time, vision and inspiring and risk-taking behaviours are associated with innovation. Target drove and monitoring behaviours or hierarchical expression of authority, directive or supervisory behaviours are negatively associated with innovation.

Day to day leader’s behaviours and interactions influences the work environment for innovation. Knowledge gained through Informal interaction, understanding each other’s professional strengths and weaknesses are implicit strengths of an MDT but when a member perceives their skills as less valuable to that of another member, they hold less power and influence. Therefore, a flat hierarchy provides a more effective structure for knowledge translation and maximising MDT productivity.

MSK services are complex adaptive systems with several pathways and interactions flowing between various specialities. For improving innovation and effective functioning of the MSK MDT, it is important to provide informal training for team leads on self-awareness of the behaviours associated with innovation.

Competency-based measure is increasingly evident as an effective approach to tailoring training and development for organisational change and development. With design stage widely reckoned as being decisive for construction waste minimisation, the purpose of this paper is to identify designers’ competencies for designing out waste.

Due to paucity of research into competency for construction waste mitigation, this study corroborates verbal protocol analyses (VPA) with phenomenological research.

Combining findings from the two methodological approaches, competencies for designing out waste are grouped into five categories, three of which are largely task related and two being contextual competencies. The study suggests that design task proficiency, low waste design skills and construction-related knowledge are indispensable task competencies, while behavioural competence and inter-professional collaborative abilities are requisite contextual competencies for designing out waste. In concurrence with task-contextual theory of job performance, personality variables and cognitive abilities are found to influence one another. This suggests that both task and contextual competencies are not only important, they are less mutually exclusive with respect to designing out waste.

This study implies that apart from commitment and dedication of designers to waste minimisation, design and firm practices are expected to be adapted to the industry’s standard.

Basis for training needs of design professionals as well as redeployment criterion are further elaborated in the paper. By enhancing competencies identified in this study, construction waste would not only be significantly designed out, adequate cost saving could be made as a result of waste reduction.

This study aims to describe implementation of simulator‐based medical team training and the effect of this programme on inter‐professional working in an intensive care unit (ICU).

Over a period of two years, 90 percent (n=152) of the staff of the general ICU at Karolinska University Hospital, Huddinge, Sweden, received inter‐professional team training in a fully equipped patient room in their own workplace. A case study method was used to describe and explain the planning, formation, and results of the training programme.

In interviews, the participants reported that the training had increased their awareness of the importance of effective communication for patient safety. The intervention had even had an indirect impact by creating a need to talk, not only about how to communicate efficaciously, but also concerning difficult care situations in general. This, in turn, had led to regular reflection meetings for nurses held three times a week. Examples of better communication in acute situations were also reported. However, the findings indicate that the observed improvements will not last, unless organisational features such as staffing rotas and scheduling of rounds and meetings can be changed to enable use of the learned behaviours in everyday work. Other threats to sustainability include shortage of staff, overtime for staff, demands for hospital beds, budget cuts, and poor staff communication due to separate meetings for nurses and physicians.

The present results broaden our understanding of how to create and sustain an organizational system that supports medical team training.

This study explores nurses' views as to whether they see community pharmacists as “entrepreneurial” and what this might mean for working together in primary care. Pharmacists are expected to fully integrate with their colleagues – particularly nurses – under the New Zealand health policy. Yet, there is scarce literature that examines multidisciplinary teamwork and integration through an entrepreneurial identity lens. This is particularly important since around the world, including New Zealand, community pharmacies are small businesses.

This was an exploratory qualitative study. A total of 18 semi-structured interviews were conducted with nurses from primary care, nursing professional bodies and academics from nursing schools. Interviews were audio recorded and transcribed verbatim. Coding was undertaken through general inductive thematic analysis.

In total three key themes emerged through analysis: the entrepreneurial profile of the community pharmacist, the lack of entrepreneurship across the profession, and the role identity and value that community pharmacists hold, as viewed by nurses. There appeared to be pockets of entrepreneurship in community pharmacy; nurses did not express a blanket label of entrepreneurship across the whole sector. Nurses also discussed several forms of entrepreneurship including commercial-oriented, clinical and social entrepreneurship. The social entrepreneurship identity of community pharmacists sat most comfortably with nurse participants. Overall, nurses appeared to value community pharmacists but felt that they did not fully understand the roles that this profession took on.

This paper contributes to the academic literature by identifying three domains of entrepreneurship relevant to community pharmacy as well as multi-level barriers that will need to be jointly tackled by professional bodies and policy-makers. Improving nurses' and other healthcare professionals' knowledge of community pharmacists' role and expertise is also likely to facilitate better inter-professional integration.

There is scarce literature that attempts to understand how entrepreneurial identity plays out in health organisation and management. This study adds to the knowledge base of factors influencing integration in healthcare.

The literature on inter‐professional working has not generally yielded evidence of great success, and this has led some to lose patience with the interprofessional enterprise. This article reports the findings of an evaluation of an ambitious programme to integrate social workers, district nurses and housing officers on a locality basis in Sedgefield, County Durham. It articulates an ‘optimistic model’ of inter‐professional collaboration and suggests that the findings of the Sedgefield evaluation offer some support for the validity of the model.

The purpose of this paper is to present an inter-agency practice integrated within a police intervention model which was developed for police officers and their partners in Montréal.

The Integrated Police Response for Abused Seniors (IPRAS) action research project (2013-2016) developed, tested, and implemented a police intervention model to counter elder abuse. Two linked phases of data collection were carried out: a diagnostic of police practices and needs (year 1) and an evaluation of the implementation of the intervention model and the resulting effects (years 2 and 3).

The facilitating elements to support police involvement in inter-agency practices include implementing a coordination structure regarding abuse cases as well as designating clear guidelines of the roles of both the police and their partners. The critical challenges involve staff turnover, time management and the exchange of information. It was recognised by all involved that it is crucial to collaborate while prioritising resource investment and governmental support, with regards to policy and financing, as well as adequate training.

The IPRAS model is transferable because its components can be adapted and implemented according to different police services. A guideline for implementing the model is available.

In the scientific literature, inter-agency collaboration is highly recommended but only a few models have been evaluated. This paper presents an inter-agency approach embedded in an evaluated police intervention model.