Improving the primary-secondary care interface in Scotland: a qualitative exploration of impact on clinicians of an educational complex intervention.

OBJECTIVES: To determine the impact on clinicians and any consequent influence on patient care of taking part in the bespoke interface-focused educational intervention.

DESIGN: Qualitative design.

SETTING: Primary and secondary care centres in NHS Highland health board area, Scotland.

PARTICIPANTS: 33 urban-based clinicians (18 general practitioners and 15 hospital specialists) in NHS Highland, Scotland.

INTERVENTION: An interface-focused educational intervention was carried out in primary and secondary care centres in NHS Highland health board area, Scotland. Eligible clinicians were invited to take part in the intervention which involved facilitated small group work, and use of a bespoke educational module. Subsequent one-to-one interviews explored the impact of the intervention. A standard thematic analysis was used, comprising an iterative process based on grounded theory.

RESULTS: Key themes that emerged included fresh insights (in relation to those individuals and processes across the interface), adoption of new behaviours (eg, being more empowered to directly contact a colleague, taking steps to reduce the others workload and changes in professional approach) and changes in terms of communication (including a desire to communicate more effectively, with use of different modes and methods).

CONCLUSION: The study highlighted key areas that may serve as useful outcomes for a large-scale randomised trial. Addressing issues identified in the study may help to improve interface relationships and benefit patient care.