AN ASSESSMENT OF THE KNOWLEDGE AND ATTITUDES OF HEALTH CARE WORKERS TOWARDS INTER-PROFESSIONAL COLLABORATION IN UNIVERSITY OF BENIN TEACHING HOSPITAL

CHAPTER ONE

INTRODUCTION

Background of the Study

Collaboration is an arrangement in which multiple people work together to accomplish a task or achieve a shared objective (Marinez-Moyano & Schuman, 2018). Collaboration, as described by Opele and Okunoye (2019), encompasses the act of sharing, forming partnerships, exercising authority, relying on one another, and engaging in various activities. Collaboration in health institutions involves the cooperation of multiple healthcare professionals with diverse training backgrounds to deliver comprehensive services. This collaboration extends to working with patients, family members, carers, and communities to ensure the highest quality of care across different healthcare facilities (Vanderwielen et al., 2019). However, attaining this goal necessitates inter-professional coordination among the entities concerned (Nissen, Evald, & Clarke, 2018). Inter-professional collaboration is essential for achieving the objective of delivering patient-centered, safe, and effective treatment that addresses the increasing and complex demands of a healthcare organisation (Kenaszchuk et al., 2021; De Vet, Terwee, Mokkink, & Knol, 2021). Inter-professional collaboration not only promotes information exchange but also improves the delivery of sustainable health services (Kaini, 2018). Inter-professional collaboration necessitates the clear and effective communication of knowledge inside an organisation for the aim of collaboration (Bienkowski et al., 2018).Interprofessional collaboration (IPC) in healthcare refers to a cooperative relationship between different healthcare professionals with the goal of delivering high-quality treatment to patients, their families, and carers (WHO, 2020; Busari, Moll & Duits, 2018). IPC harnesses the combined expertise and capabilities of team members, enabling them to operate with greater efficiency and provide a superior standard of care compared to working alone (Franklin et al., 2019). Patients are most likely to receive optimal care when healthcare personnel have a comprehensive understanding of one other's duties and a genuine appreciation for each other's skills. Interprofessional collaboration (IPC) encompasses the essential elements of responsibility, accountability, coordination, communication, cooperation, assertiveness, autonomy, and mutual trust and respect among healthcare professionals (Bridges, 2019). 

The World Health Organisation (WHO) framework offers strategies and models to help professionals design and implement a team-based approach. The Interprofessional Education Collaborative (IPEC) core competency document has contributed to the national discussion on the importance of interprofessional education and practice in improving team-based patient care and enhancing population health outcomes. Nevertheless, IPEC has put forward four fundamental abilities that are essential for achieving successful Interprofessional Collaborative Practice: Values/Ethics, Roles/Responsibilities, Interprofessional Communication, and Teams and Teamwork. 

The want for efficient teams is crucial as a result of the escalating prevalence of co-morbidities and the growing intricacy of patient care (Nancarrow et al., 2023). Integrated Primary Care (IPC) enhances healthcare outcomes for elderly individuals with chronic illnesses by minimising hospitalisation duration and expenses, reducing hospitalisation and readmission rates. This improvement is supported by studies conducted by Smith et al. (2019), Lee & Patel (2020), and Thompson & Clark (2021). Interprofessional collaboration (IPC) not only improves patients' satisfaction but also decreases the occurrence of medical errors, leading to enhanced health outcomes and improved quality of care (Tsou, Shih & Ho, 2020; Wagner, 2021; Gougeon, Johnson & Morse, 2022). In addition, IPC enhances the utilisation of healthcare services by enhancing care coordination, minimising redundant services, and fostering communication among the healthcare team. Additionally, it promotes a clearer understanding of individual responsibilities and improves the level of contentment and overall welfare of team members (Bosch & Mansell, 2018). Furthermore, IPC provides suitable referral patterns, enhanced continuity and coordination of treatment, and improved collaborative decision-making with patients (Wagner, 2021; Epstein, 2019). An essential element of every healthcare system is the efficacy of Infection Prevention and Control (IPC). This can be determined by assessing certain elements, such as communication and coordination. A study conducted by the California Academy of Family Physicians revealed that just over 50% of primary care physicians expressed satisfaction with their interactions with hospitalists (Pantilat et al., 2021). A significant number of individuals expressed dissatisfaction with the discharge summaries, deeming them excessively comprehensive and frequently sent tardily following the patient's initial post-discharge consultation. The lack of timely communication posed challenges for the primary care physicians in addressing patients' enquiries and delivering sufficient healthcare. A recent comprehensive review demonstrated that clinical coordination enhances the quality of care and leads to cost savings. One of the first steps in evaluating the success of collaboration is to examine the attitudes and prior experience of healthcare professionals towards Interprofessional Collaboration (IPC). While numerous studies have thoroughly investigated the viewpoints of respondents regarding interprofessional education (IPE) in educational settings, such as those conducted by Vernon et al. (2018), Tolle et al. (2019), Tsou, Shih, and Ho (2020), Wagner (2021), and Gougeon, Johnson, and Morse (2022), it is crucial to prioritise comprehending the perspectives of healthcare professionals on interprofessional collaboration (IPC) in specific healthcare settings. This understanding is essential for overcoming the obstacles that hinder effective IPC. Given the importance of this function, this study aims to assess the knowledge and attitudes of health care workers towards inter-professional collaboration in University of Benin Teaching Hospital.

Statement of the Problem

Inter-professional collaboration is essential for achieving the objective of delivering patient-centered, safe, and effective treatment that addresses the increasing and complex demands of a healthcare organisation (Kenaszchuk et al., 2021; De Vet, Terwee, Mokkink, & Knol, 2021). Inter-professional collaboration will not only facilitate the exchange of knowledge but also improve the provision of sustainable health services (Kaini, 2018). Inter-professional collaboration necessitates the clear and explicit articulation of knowledge inside an organisation for the goal of collaboration (Bienkowski et al., 2018). Poor inter-professional collaboration and knowledge management methods across Nigeria's clinical workforce have hindered the health sector's ability to accomplish sustainable health service delivery in recent decades (Corwin et al., 2022; Olajide et al., 2018; Ojo & Akinwumi, 2018). An additional obstacle to ensuring sustainable health service delivery in Nigeria is the challenge of finding individuals who are willing to contribute their valuable knowledge and skills (Awodoyin et al., 2019; Opele & Iyanda, 2018). 

Inter-professional collaboration in healthcare enables the team to effectively combine the various abilities and experience of its members, resulting in improved performance compared to working individually (Vanderwielen et al., 2019; Breitbach & Richardson, 2019). Additionally, collaboration among healthcare professionals leads to enhanced patient outcomes and increased levels of satisfaction (Wong et al., 2018). Hence, it is imperative for health care institutions to comprehend that inter-professional collaboration entails not only mere cooperation, but also effective cooperation with individuals from different disciplines. Hence, it is in the light of these that the study seeks to assess the knowledge and attitudes of health care workers towards inter-professional collaboration in University of Benin Teaching Hospital.

 1.3  Objectives of the Study

The main purpose of this study is to assess the knowledge and attitudes of health care workers towards inter-professional collaboration in University of Benin Teaching Hospital. Specifically, the study will;

Evaluate the level of knowledge of healthcare workers regarding inter-professional collaboration in the University of Benin Teaching Hospital.

Assess the attitudes of healthcare workers towards inter-professional collaboration in their daily practices.

Assess the factors that influence healthcare workers' knowledge and attitudes towards inter-professional collaboration.

1.4  Research Questions

The following questions have been prepared for the study:

What is the level of knowledge among healthcare workers regarding inter-professional collaboration at the University of Benin Teaching Hospital?

How do healthcare workers perceive and engage in inter-professional collaboration in their daily practices?

What factors influence the knowledge and attitudes of healthcare workers towards inter-professional collaboration at the University of Benin Teaching Hospital?

1.5 Research Hypotheses

H0: Health care workers at the University of Benin Teaching Hospital do not have a significant level of knowledge and positive attitudes towards inter-professional collaboration.

Ha: Health care workers at the University of Benin Teaching Hospital have a significant level of knowledge and positive attitudes towards inter-professional collaboration.

1.6 Significance of the Study

The study findings will provide a foundation for specialized training initiatives. The ultimate goal of these initiatives is to raise the standard of patient care by fostering teamwork. Moreover, the study will function as a standard for other medical facilities aiming to evaluate and enhance their cooperative procedures.

Nevertheless, subsequent researchers will use it as a literature review. This means that other students who may decide to conduct studies in this area will have the opportunity to use this study as available literature that can be subjected to critical review.

1.7 Scope of the study   

The scope of this study is boarded on the knowledge and attitudes of health care workers towards inter-professional collaboration in University of Benin Teaching Hospital. Empirically, the study will evaluate the level of knowledge of healthcare workers regarding inter-professional collaboration, attitudes of healthcare workers towards inter-professional collaboration in their daily practices and the factors that influence healthcare workers' knowledge and attitudes towards inter-professional collaboration.

Geographically, the study will be delimited to University of Benin Teaching Hospital.

1.8 Limitation of the study

In the course of carrying out this study, the researcher experienced some constraints, which included time constraints, financial constraints, language barriers, and the attitude of the respondents. In addition, there was the element of researcher bias. Here, the researcher possessed some biases that may have been reflected in the way the data was collected, the type of people interviewed or sampled, and how the data gathered was interpreted thereafter. The potential for all this to influence the findings and conclusions could not be downplayed. More so, the findings of this study are limited to the sample population in the study area, hence they may not be suitable for use in comparison to other schools, local governments, states, and other countries in the world.

 1.9 Definition of Terms

Inter-professional Collaboration: The process by which healthcare professionals from various disciplines work together to achieve better patient outcomes and improve the quality of healthcare delivery.

Attitudes: the feelings, beliefs, and predispositions of healthcare workers towards working with other professionals from different disciplines within the hospital.

Health Care Workers: All individuals working in hospital who are involved in patient care, including doctors, nurses, pharmacists, and other allied health professionals.