Willingness to Collaborate

While all of the above mentioned qualities are essential, a willingness to collaborate could be viewed as the precipitating factor for IPC to take place. As this collaboration is around patient centred practice, the patient is an integral player on this team. It would thus take a willingness by both the patient and the health care providers to engage in IPC. The "best experience" stories of the participants were followed by the question; "why was this the best experience?" and the responses targeted benefits to the patient and benefits to the other health care providers. The key motivating factors to engage in collaborative patient centred practice from a patient's perspective would be improved quality of care and this could arise from the "collaborative" aspect of the care and/or the "patient centred" adjective. The box below describes respondents' opinions about patient benefits. Three major themes emerged and these were convenience (with numerous mentions of a one stop shopping analogy), multiple perspectives improving the quality of care and better access (again mentioned numerous times). Benefits most closely associated with patient centredness are also noted here. Although risks associated with IPC weren't probed, three that were mentioned included a blurring of roles and responsibilities, a perception that allied health care providers are less authoritative than medical doctors and the chance that some patients receive too much information.

In addition to the patients, the care providers need to do a cost/benefit analysis regarding IPC to gauge their own willingness to collaborate. As this sample was drawn purposively from those with a positive inclination towards IPC and success stories were the focus of the question, it is not surprising the benefits noted below far outweigh the risks.

As noted in the table above, four recurring themes appeared to feed into a care provider's willingness to collaborate. The strongest was probably a firm belief in the end goal, which was that quality of care is indeed improved with IPC. The opportunity for IPE, which is part and parcel of IPC, was also a strong motivator. Regardless of whether the IPE was formalized into workshops or was part of the informal day to day IP learning that takes place on the job, the opportunity to learn with, from and about each other was repeatedly characterized with words such as "hugely satisfying" or "wonderful opportunity". Participants also believed IPC was efficient and cost effective, particularly with complex patients and this factor weighed into their commitment to the model. The cost effectiveness was noted in the discussions with the NorWest Community Health Centre when the group reflected on a "success story" of a particularly challenging and complex case.

The final subtheme underlying the willingness to collaborate theme is increased job satisfaction. This was expressed in various ways and for various reasons throughout the focus group discussions. In more than one setting, and despite significant challenges, individuals noted that they "loved" their job. It is no doubt a combination of motivators that drive any individual towards a collaborative care model. On a related question one participant was asked if, in general, it was the younger practitioners that were embracing IPE and IPC and the older ones preferring to stick to silos. The response was noteworthy:

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