Dr Priya Saravanakumar is a lecturer in the School of Clinical Sciences, Faculty of Health and Environmental Sciences at Auckland University of Technology. Priya has a rich clinical, educational and leadership experience having practiced, taught and led teams in adult and older person nursing in various care settings in India, Sri Lanka, Seychelles, Australia and New Zealand. Priya was a recipient of ‘Australian Leadership Award’ in 2010 which led to her PhD in Nursing from the University of Newcastle, Australia. Her PhD research involved exploring complementary and alternative therapies (CAM) for health and wellbeing outcomes for frail older adults in residential aged care settings using mixed methods research. Her primary research interests include exploring applications of CAM and other non-western modalities in improving health outcomes and wellbeing in older adults. Her research endeavours focus on vulnerable groups such as older adults from culturally and linguistically diverse backgrounds, residential aged care settings, Indigenous communities and with complex and chronic health conditions. Priya currently leads research projects with interdisciplinary scholars and stakeholders, in an attempt to find solutions to complex problems faced by the ageing population. Her other research and service affiliations include New Zealand Association of Gerontology, Auckland University of Technology Centre for Active Ageing, Nursing Research Section, New Zealand Nurses Organisation and Victoria University of Wellington.
Development of an interprofessional care pathway in a New Zealand primary care setting
Padmapriya Saravanakumar, Auckland University of Technology, New Zealand
The World Health Organisation emphasises the need for an integrated people-centred approach in primary health care and a reorientation of existing care models towards family and community responsive Interprofessional collaborative care practice (IPCP) to improve access and outcomes. This is especially relevant for older adults in the community who are required to navigate through several complexities in their ageing, health, and wellbeing domains. Research evidence consistently points to lack of resources to support interprofessional collaborative practices in primary health care. Research also suggests advantages of feasibility and sustainability of care when involving students in implementing this approach. There are few studies that report the inclusion of clients, students and wider health representatives in the planning and implementation of the care services. This suggests the need to engage in a cultural shift toward a person and family centred, client-led approach to designing and implementing primary health care services for older adults by including a wider range of stakeholders. In seeking a long-term, sustainable, client led and person-centred IPCP in a university primary health care setting in New Zealand, this research gathered perspectives of clients, staff, students, and Primary health care representatives.
This study used a qualitative descriptive approach to explore participants’ views and feedback on a draft care pathway from workshop-style focus groups. Ethics approval was obtained from AUT Ethics Committee. The study was conducted at New Zealand University Integrated Health Centre that serves the health needs of the local community and the educational needs of a range of health care students. In this centre, students work alongside clinical educators in the provision of person and family centered care for vulnerable clients. A wide range of internal and external stakeholders were invited to participate. The workshop-style focus groups were held separately for students, clients and caregivers, external stakeholders and staff involved in the university centre. The researchers conducted a thematic analysis by coding the data collaboratively and then collectively deciding on emergent sub-themes and themes.
There were six clients, four external primary health care stakeholders, twelve students and fourteen staff members who participated in this study. We identified three main themes namely stratification, inclusivity, and adaptability. Stratification referred to the complexity of the IPCP, which involves several levels of individual and collective interactions and expectations of the stakeholders. Inclusivity referred to the valuing of all stakeholders (clients, clinicians, professional and community) whose involvement is instrumental in optimising health outcomes. The third theme ‘adaptability’ referred to the alignment of the care service with contemporary health care priorities.
This research draws from the perspectives of a range of stakeholders and reports the relevance of the interprofessional collaborative care practice approach in a primary health care setting.
The findings will inform a trial implementation of this approach in the health centre and will impact on the service delivery, improving care for older adult clients. This research also contributes to the development of a feasible care model that could be adapted for implementation in other primary care settings.