Using Loose Coupling Theory to Understand Interprofessional Collaborative Practice on a Transplantation Team
DOI:
https://doi.org/10.22230/jripe.2014v3n3a112Keywords:
Team communication, Interprofessional collaboration, distributed teams, Ethnography, Organizational theoryAbstract
Background: A central paradox dwells at the heart of interprofessional care: the tension between autonomy and interdependence. This report uses an ethnographic study to understand how this tension shapes collaborative practice on a distributed, interprofessional transplant team in a Canadian teaching hospital.
Methods & Findings: Over four months, two trained observers conducted an ethnography through 162 observation hours, 30 field interviews and 17 formal interviews with 39 consented participants. Data collection and inductive analysis proceeded iteratively. Loose coupling theory was used as a resource to make sense of key themes. We describe the transplant team as a constellation made up of core, inter-service, and outside hospital dimensions. Next, we trace the nature of coupling activities within and across these dimensions of the team constellation, focusing on recurring communication challenges which can signal the relationship between autonomy and interdependence in collaborative acts.
Conclusions: We conclude that coupling is fluid and subject to human agency, and that the tension between autonomy and interdependence can be highly productive. Team members, including patients, may negotiate and construct their relations on an autonomy/interdependence axis for strategic purposes. Far from being trapped in a paradox, team members use autonomy and interdependence as resources to achieve complex goals in collaborative settings.
Downloads
Published
Issue
Section
License
JRIPE publishes original research in Interprofessional Practice and Education. It allows authors to maintain copyright in exchange for a limited term exclusive license to make the article publicly available; followed by a permanent non-exclusive licence to continue making the article available to users; and the right to make the article available through databases. It asks for 50 percent of any commercial fees payable for usage. Authors may, at any time, archive the work on their own site or that of their institution. Authors must indemnify the journal against damage; obtain any necessary permissions; and attest to the article’s originality and legitimate legal status.
Users have the right to read, download, copy, distribute with the acknowledgement that this aricle was first published by the Journal of Interprofessional Practice and Education, print, search, or link to the full texts of the articles in this journal.