Importance of effective collaboration between health professionals for the facilitation of optimal community diabetes care
Jo Melville-Smith A and Garth E. Kendall A B
+ Author Affiliations
- Author Affiliations
A School of Nursing and Midwifery, Faculty of Health Sciences, Curtin University, GPO Box U 1987, Perth, WA 6845, Australia.
B Corresponding author. Email: g.kendall@curtin.edu.au
Australian Journal of Primary Health 17(2) 150-155 https://doi.org/10.1071/PY10020
Submitted: 27 May 2010 Accepted: 1 December 2010 Published: 7 June 2011
Abstract
Diabetes places a significant burden on the individuals concerned, their families and society as a whole. The debilitating sequelae of diabetes can be limited or prevented altogether through strict glycaemic control. Despite the seemingly uncomplicated nature of the disorder, effective management can be elusive, as the impact of having to deal with diabetes on a daily basis can be profound and appropriate professional support is not always readily available. As the roles of general practitioners (GPs) and allied health professionals have evolved, a major issue now facing all is that of developing and maintaining effective collaborative relationships for the facilitation of optimal community diabetes care. Using a simple survey methodology, the present exploratory study investigated the referral patterns of GPs to diabetic educators (DEs) working for a community health service in an Australian town, and reasons for referral and non-referral in order to identify factors that contribute to a sound and sustainable collaborative relationship. The results provide some evidence that GPs and DEs in this town do work collaboratively towards achieving client-centred goals and highlight the need to inform GPs who are new to communities, such as this one, of the available DE services. Most importantly, the study identified that there are many opportunities to strengthen collaboration so as to facilitate optimal community diabetes care. This information is valuable, because there is limited empirical evidence either nationally or internationally about the process of collaboration between health professionals in the management of chronic diseases, such as diabetes.
References
Australasian Paediatric Endocrine Group (2005) ‘Clinical practice guidelines: Type 1 diabetes in children and adolescents.’ (National Health and Medical Research Council: Canberra)Australian Institute of Health and Welfare (2009) ‘Insulin-treated diabetes in Australia 2000–2007.’ (Australian Institute of Health and Welfare: Canberra)
Beaulieu M, Dory V, Pestiaux D, Pouchain D, Rioux G, Gay B, Boucher L (2009) What does it mean to be a family physician? Exploratory study with family medicine residents from 3 countries. Canadian Family Physician Medecin de Famille Canadien 55, 14
Berendsen A, Kuiken A, Benneker W, Meyboom-de Jong B, Voorn T, Schuling J (2009) How do general practitioners and specialists value their mutual communication? A survey. BMC Health Services Research 9, 143
| How do general practitioners and specialists value their mutual communication? A survey.Crossref | GoogleScholarGoogle Scholar | 19664238PubMed |
Booth K, Cooper H, Gill G (2008) A trial of empowerment-based education in type 2 diabetes-Global rather than glycaemic benefits. Diabetes Research and Clinical Practice 82, 165–171.
| A trial of empowerment-based education in type 2 diabetes-Global rather than glycaemic benefits.Crossref | GoogleScholarGoogle Scholar | 18804887PubMed |
Bryant W (2006) What does ‘diabetes guidelines’ mean in practice? Diabetes Management 17, 24
Chew D (2009) A comparative study of the implementation of the Chronic Disease Management (CDM) System for diabetes in primary care. Australian Diabetes Educator 12, 26
Cramp G (2006) Development of an integrated and sustainable rural service for people with diabetes in the Scottish Highlands. Rural and Remote Health 6, 422
Cusack M, Asyo N, Frost C, O’Brien K, O’Kane G (2008) Does intervention by the dietitian and diabetes educator of a More Allied Health Services program improve glycosylated haemoglobin levels those with type 2 diabetes? Implications for rural dietetic practice. Nutrition & Dietetics 65, 292–296.
| Does intervention by the dietitian and diabetes educator of a More Allied Health Services program improve glycosylated haemoglobin levels those with type 2 diabetes? Implications for rural dietetic practice.Crossref | GoogleScholarGoogle Scholar |
Department of Health and Aging (2009) ‘Building a 21st century primary health care system: A draft of Australia’s first national primary health care strategy.’ (Commonwealth of Australia: Canberra)
Desai J, Solberg L, Clark C, Reger L, Pearson T, Bishop D, Roberts M, Sniegowski R, O’Connor P (2003) Improving diabetes care and outcomes: the secondary benefits of a public health-managed care research collaboration. Journal of Public Health Management and Practice Suppl., S36–S43.
Egede LE (2005) Effect of depression on self-management behaviors and health outcomes in adults with type 2 diabetes. Current Diabetes Reviews 1, 235–243.
| Effect of depression on self-management behaviors and health outcomes in adults with type 2 diabetes.Crossref | GoogleScholarGoogle Scholar | 18220600PubMed |
Eigenmann C, Colagiuri R, National Diabetes Services Scheme (Australia), Diabetes Australia (2007) ‘Outcomes and indicators for diabetes education: a national consensus position.’ (National Diabetes Services Scheme, Diabetes Australia: Canberra)
Faulks K, Flack J (2008) Type 1 diabetes is increasing in Australia. Diabetes Management 25, 24
Grimmer-Somers K, Dolejs W, Atkinson J, Worley A (2008) Integrated GP and allied health care for patients with type 2 diabetes. Australian Family Physician 37, 774–779.
Harris P, Mann L, Marshall P, Phillips P, Webster C (Eds) (2008) ‘Diabetes management in general practice 2008/2009.’ 14th edn. (Pinnacle Print: Norah Head, NSW)
Hill P, Clark R (2008) The Australian DE’s skills and readiness for the tsunami of diabetes in the 21st century. The Australian Journal of Advanced Nursing 26, 55–65.
Hiss R, Armbruster B, Gillard M, McClure L (2007) Nurse care manager collaboration with community-based physicians providing diabetes care: a randomized controlled trial. The Diabetes Educator 33, 493–502.
| Nurse care manager collaboration with community-based physicians providing diabetes care: a randomized controlled trial.Crossref | GoogleScholarGoogle Scholar | 17570880PubMed |
Jones L, Green J (2006) Shifting discourses of professionalism: a case study of general practitioners in the United Kingdom. Sociology of Health & Illness 28, 927–950.
Kaner EF, Haighton CA, McAvoy BR (1998) ‘So much post, so busy with practice–so, no time!’: a telephone survey of general practitioners’ reasons for not participating in postal questionnaire surveys. The British Journal of General Practice 48, 1067–1069.
Medicare Australia (2005) ‘Allied health initiative.’ Available at http://www.medicareaustralia.gov.au/provider/incentives/allied-health.jsp [Verified 28 August 2008]
National Health and Hospitals Network (2010) ‘A National Health and Hospitals Network for Australia’s Future – Delivering better health and better hospitals (No. 6620).’ (Commonwealth of Australia: Canberra)
National Health and Medical Research Council (2005) ‘Clinical practice guidelines: Type 1 diabetes in children and adolescents.’ (Commonwealth of Australia: Canberra)
Northhouse PG, Northhouse LL (1985) ‘Health communication: a handbook for health professionals.’ (Prentice-Hall Inc: Englewood Cliffs, NJ)
Paterson B (2001) Myth of empowerment in chronic illness. Journal of Advanced Nursing 34, 574–581.
| Myth of empowerment in chronic illness.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3M3pvVyjtQ%3D%3D&md5=bc018e59be2fc4b96e679e6d2bf0c75fCAS | 11380725PubMed |
Pike A (1991) Moral outrage and moral discourse in nurse-physician collaboration. Journal of Professional Nursing 7, 351–362.
| Moral outrage and moral discourse in nurse-physician collaboration.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK387htlWltQ%3D%3D&md5=8c67a1ad28a75312dc91b13a8245803cCAS | 1765615PubMed |
Polger S, Thomas S (1995) ‘Introduction to research in the health science.’ 3rd edn. (Churchill Livingstone: London)
Pullon S (2008) Competence, respect and trust: key features of successful interprofessional nurse-doctor relationships. Journal of Interprofessional Care 22, 133–147.
| Competence, respect and trust: key features of successful interprofessional nurse-doctor relationships.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1c7mtFKntQ%3D%3D&md5=ecff7c09e72a8c8d071c1542031d32a2CAS | 18320449PubMed |
Reed R, Revel A, Carter A, Saadi H, Dunn E (2001) A clinical trial of chronic care diabetic clinics in general practice in the United Arab Emirates: a preliminary analysis. Archives of Physiology and Biochemistry 109, 272–280.
| A clinical trial of chronic care diabetic clinics in general practice in the United Arab Emirates: a preliminary analysis.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD38Xmt12hsLk%3D&md5=f298322da4d49e383db532a42f08c469CAS | 11880932PubMed |
Rodgers D (2008) Diabetes self management. Diabetes Educator 11, 37
Shaw JE, Chisolm DJ (2003) Epidemiology and prevention of type 2 diabetes and the metabolic syndrome. The Medical Journal of Australia 179, 379–383.
Skinner TC, Carey ME, Craddock S, Dallosso HM, Daly H, Davies MJ, Doherty Y, Heller S, Khunti K, Oliver L (2008) Educator Talk’ and patient change: some insights from the DESMOND (Diabetes Education and Self Management for Ongoing and Newly Diagnosed) randomised controlled trial. Diabetic Medicine 25, 1117–1120.
| Educator Talk’ and patient change: some insights from the DESMOND (Diabetes Education and Self Management for Ongoing and Newly Diagnosed) randomised controlled trial.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1M7htVyhtg%3D%3D&md5=e099dac30adb0f524e02847b1bb89dccCAS | 19183318PubMed |
South Australian Department of Health (2009) ‘Better health for people through GP plus health care centres.’ Available at http://www.health.sa.gov.au/Default.aspx?tabid=265 [Verified 5 October 2009]
Sturmberg J, Overend D (1999) General practice based diabetes clinics. An integration model. Australian Family Physician 28, 240–245.
Taylor K, Oberle K, Crutcher R, Norton P (2005) Promoting health in type 2 diabetes: nurse-physician collaboration in primary care. Biological Research for Nursing 6, 207–215.
| Promoting health in type 2 diabetes: nurse-physician collaboration in primary care.Crossref | GoogleScholarGoogle Scholar | 15583361PubMed |
Wagner E, Glasgow R, Davis C, Bonomi A, Provost L, McCulloch D, Carver P, Sixta C (2001) Quality improvement in chronic illness care: a collaborative approach. The Joint Commission Journal on Quality Improvement 27, 63–80.
Wellard S, Rennie S, King R (2008) Perceptions of people with type 2 diabetes about self-management and the efficacy of community based services. Contemporary Nurse 29, 218–226.
Zwar N (2007) General Practice incentives and diabetes care. Diabetes Management Journal 19, 24
