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This paper investigates the prospects and difficulties of multi-professional teamwork in human services from a professional identity perspective. The purpose of this paper is to explore the mutual interplay between professional identity formation and team activities.

This is a process study of two cases of multi-professional teamwork in family care. Data were collected through in-depth interviews with team members and managers. The analysis follows a stepwise approach alternating between the individual and team levels.

In showing the mutual interplay between teamwork processes and individual identity formation, the study contributes knowledge on professional identity formation of mature professionals; in particular showing how unique individual identification processes have different consequences for multi-professional team activities. Further, alternative shapes of interplay between individual identity formation and team-level processes are identified.

Despite the fact that the sample is small and that collaboration intensity was relatively low, the paper succeeds in conceptualising the links between professional identity formation and multi-professional teamwork.

In managing multi-professional teams, team composition and the team’s early developments seem determining for whether the team will reach its collaborative intentions.

This paper is original in its exploration of the ongoing interplay between individual identity formation and multi-professional team endeavours. Further, the paper contributes knowledge on mature professionals’ identity formation, particularly concerning individual variation within and between professional groups.

The purpose of this paper is to investigate opportunities and challenges for multi-professional paramedic-firefighter units in small municipalities in Finland.

The data were collected by means of four focus group interviews conducted with managers (N =12) and a questionnaire comprising open-ended questions for the personnel working in the units (n =73). Data from both sources were analyzed using inductive content analysis.

The empirical results suggest that the use of multi-professional units (MPUs) may be one means of providing a better standard of service in rural areas. However, the working practices and different professional backgrounds in MPUs are considered challenging by the personnel. Managers had a broader perspective; during the interviews they raised matters such as citizen characteristics, legal issues like varying working hours, and economic aspects. Both the personnel and the managers agreed on the strengths and weaknesses of the MPU model in principle.

The results of this study may clarify the opportunities and challenges posed by MPUs in rural areas from the perspectives of personnel and managers.

The study provides novel information on MPUs comprising paramedics and firefighters, who function at the interface of emergency medical services and rescue services and who have new tasks in rural areas, including home healthcare support and accident prevention.

The purpose of this paper is to propose a theoretical framework for researching gender equality implications of Clinical Microsystems, a new public management‐based model for multi‐professional collaboration and improvement of health care delivery.

The paper draws on literature from gender in organizations, new public management, multi‐professional collaboration and organizational control to critically analyze the Clinical Microsystem model.

While on the surface an egalitarian and consensus‐based model, it nevertheless risks reinforcing a gendered hierarchical order. The explicit emphasis on social competencies, on being collaborative and amenable to change risks, paradoxically, disfavoring women. A major reason is that control becomes more opaque, which favors those already in power.

The paper calls for researchers as well as practitioners to incorporate concerns of equality in the work place when introducing new work practices in health care. For research, the authors propose a useful theoretical framework for empirical research. For practice, the paper calls for more transparent conditions for multi‐professional collaboration, such as formalized merit and advancement systems, precisely formulated performance expectations and selection of team members based strictly on formal merits.

A gender analysis of a seemingly anti‐hierarchical management model is an original contribution, adding to the literature on Clinical Microsystem in particular but also to critical studies on new public management. Moreover, the paper makes a valuable practical contribution in suggesting ways of avoiding the reproduction of gender inequalities otherwise implied in the model.

The purpose of this paper is to describe a Finnish pilot project aiming to support high-needs clients in their everyday lives by developing an integrated care approach based on the multi-sectoral collaboration of care professionals. The Help Team for school-aged children will be described as an example of the integrative practices developed on the project.

Altogether 250 professionals from primary and secondary health care and social care and from the education sector were designated to collaborate in 37 local, multi-sectoral teams, aiming to develop integrated care practices for high-needs clients. Teamwork was supported by coaches and project seminars, the Breakthrough method and other LEAN methods. The project was evaluated internally by means of a survey and interviews with the participants.

As a result of the project, all 37 teams developed a specific collaboration model for their selected target group comprising different kinds of high-needs clients.

The sustainability of the outcomes of the project depends on how managers and decision-makers are committed to applying the collaboration models in future.

Many of the collaboration models developed in the project will be implemented in practice in a wider area.

The project highlighted the need to pay attention to the problems of people with multiple care needs and the challenges they pose for integrated care.

The project was based on the client-centered development work done by frontline professionals. Due to the high level of involvement of the professionals themselves, the project proved highly instructive for them. It is extremely important to engage frontline level professionals in development work and support them in collaborating beyond the traditional “silos”.

An intervention “Continuum of care for frail elderly people” was designed to create an integrated care from the hospital emergency department (ED) to home. The purpose of this paper is to evaluate longitudinal effects in terms of self-determination in daily life for community-living frail older persons.

A non-blinded, controlled trial with participants randomised to the intervention group or a control group with follow-ups at three, six and 12 months. The intervention involved collaboration between a nurse with geriatric competence at the ED, the hospital wards and a multi-professional team in the community with a case manager as the hub. The intervention’s person-centred approach involved the older persons in all decisions. Inclusion criteria: 80 years and older or 65-79 years with at least one chronic disease and dependent in at least one daily activity. Analyses were made on the basis of the intention-to-treat principle and outcome measure experienced self-determination in daily life measured by Impact on Participation and Autonomy for Older persons (IPA-O). The analysis was made using Svenssons’ statistical method.

There were significant differences in favour of the intervention at three months in self-determination concerning activities at home and at three and six months concerning social relationships.

Self-determination seems to deteriorate over time in both groups, and the intervention “Continuum of care for frail elderly people” seemed to slow the rate of decline in two dimensions; activities in and around the house at three-month follow-up, and at three and six months concerning social relationship. Thus, the intervention has the means to support them in exercising self-determination and aging in place, a valuable benefit both for the individual and for society.

Intermediate care is emerging as performing an increasingly‐significant function in bridging the care gap between hospital and home. It does not emerge from a policy or service vacuum. Relationships between statutory health and social care services and the voluntary sector have their roots in past practices and separate agendas. The findings from this study indicate that any partnership between the statutory and voluntary sectors in delivering packages of intermediate care will inevitably encounter challenges associated with multi‐level, multi‐professional and multi‐agency collaboration. This article explores these challenges and provides some insight on how to meet them.

The purpose of this paper is to explore interprofessional collaboration during ward rounds on a Finnish emergency and infection ward from the viewpoint of three central professional groups: physicians, nurses and secretaries.

The authors utilise an ethnographically informed approach, with observations and interviews as the data collection devices. The data comprise ten interviews with staff members and ten hours of observations. The data were analysed using qualitative thematic analysis.

The ward rounds were found to be rather physician- and medicine-centred, and mostly not interprofessional. Nurses and secretaries in particular expressed dissatisfaction with many of the current ward rounds work practices. Ward rounds are an essential part of collaboration in implementing the emergency-natured operational aim of the ward, yet we found that the ward rounds are complicated by diverging professional views and expectations, variable work practices and interactional inequality.

This study makes a contribution to the research of collaboration in emergency care and ward rounds, both of which are little-studied fields. Further, context-specific studies of collaboration have been called for in order to eventually create a model of shared expertise. The findings of this study can be utilised in studying and developing emergency care contexts.

Integrated healthcare is a central tenant of the NHS Long Term Plan (NHS, 2019). NICE in 2019 published guidelines; advising the integration of multidisciplinary professionals which may lead to an improvement in conservative treatment methods of pelvic organ prolapse. Therefore, current literature on the conservative treatments for pelvic organ prolapse needs to be reviewed to ascertain if an integrated approach would improve the symptoms and quality of life for women.

A systematic review of the literature between 2013 and 2018 was implemented. Papers included were written in English, peer-reviewed and consisted of treatments of pelvic organ prolapse in women. Papers containing surgical interventions, postpartum participants, reviews, evaluations, guidelines, follow-up studies, focusing on cost effectiveness, sexual function were excluded.

Seven studies in total were included, and two overarching themes were identified: quality of life after treatment and the effect of conservative treatment on pelvic organ prolapse symptoms. The literature suggested that integrating care had a more positive outcome on pelvic organ symptoms and quality of life.

To develop a robust enhanced model of care for conservative treatment of pelvic organ prolapse through more mixed method or qualitative research, that incorporates integrative treatment methods with collaboration from multidisciplinary professionals.

The practical implications of integrating the conservative management of pelvic organ prolapse is the communication between the multidisciplinary team must be exceptional to ensure everyone understands and agrees the treatment that is being provided to patient. Also, effective teamwork is important to ensure the patient receives the best care with input from the correct disciplines. The multi-professional team will need to have regular meetings to discuss and implement care plans for patients that might prove difficult to schedule due to differing commitments and priorities. This must be overcome to insure a successful and effective integrated approach to pelvic organ prolapse is delivered.

The social implications of integrating the professional approach to women's care of pelvic organ prolapse involves reducing the severity of the symptoms therefore, increasing the quality of life. This may result in the reduction of surgical intervention due to the patient being satisfied with the conservative management. Through integrating the management of the prolapse the patient will receive an accessible individualised care plan pathway that focuses on treating or reducing the impact of the symptoms that are bothersome to the patient whilst managing patient expectations. Patients will also, be reassured by the number of multi-disciplinary professionals involved in their care.

Global integration of conservative treatments and multidisciplinary-professionals specialising in pelvic organ prolapse and pelvic floor dysfunction is needed.

The purpose of this paper is to investigate the regulator's attempt at redesigning the patient care process (PCP) – a core business process in public hospitals – by introducing dichotomous process performance indicators as an innovative management tool intended to align the State health care policy with the everyday management of operations at a hospital ward.

The paper presents an ethnographic case study of redesigning the PCP according to the strategy originating outside the organization. The study employs competing theories that represent alternative epistemological and ontological views of the world in order to produce a tentative explanation of why the intended redesign of the PCP has not fully eventuated. Observational data and opportunistic interviewing are used to answer the research question of whether and how the information and operational flows on the ward were affected by introduction of process performance indicators. A business process redesign framework was employed for data analysis since it better reflects the objectives of the State‐wide initiative and offers a convenient tool in dealing with data complexity.

Introduction of the process performance indicators did not result in redesigning of the PCP as intended by health care authorities. Out of four process performance indicators, only one was consistently implemented, which merely produced a duplication of the previously collected information, therefore adding no value to the PCP. On a theoretical level, the results indicate that the emergent theory rather than the rational agent theory demonstrated a greater fidelity to the empirical observations.

The paper assessed the feasibility of using innovative dichotomous process performance indicators as a tool for redesigning the business process at the ward level, in order to achieve macro‐level policy objectives. The failure to successfully implement a top‐down universal approach to redesigning business processes in health care is likely to reflect a lack of appreciation of emergent rationality that characterizes essential aspects of the PCP.