Abstract
Introduction: The necessity of intersectoral information exchange is well-establish, because the complexity in health-related issues are increasing world-wide, and solving complex problems is beyond the capacity of single sector or specialty. The exchange of written information is the most commonly used communication strategy to share information across specialties and care services.
Problem: Written information exchange calls for caution, as texts can be read and interpreted differently across locations. Further, particular discourses shape a shared consciousness about a person, and it is known that stigmatising language may negatively influence professionals’ attitudes on a client/patient. Despite the importance and extend of intersectorally shared written information, little attention has been given to the writing practises that happens across sectors. More knowledge is therefore needed order to support intersectoral care.
Context: Intersectoral care provision is a cornerstone in the Danish care systems,which is why the Danish system is a good case for exploring practises of written intersectoral information exchange.
Aim: In this qualitative study, we identified textual and discursive practises of two forms used for the purpose of exchange information between social care and health care professionals (GPs) in pathways of clients from a job centre in a large city in Denmark in 2023. The research was aimed at professionals who participate in these practises.
Involvement: The study design was decided in collaboration with researchers, healthcare professionals and social care professional. Social care decided the method of data collection, and they assisted and supported the concrete data collection. Further, the social workers acted as gatekeepers to the clients’/patients’ enrolment. Clients/patients collected themselves the part of their personal health journal that would be included as data.
Methods: Data were collected from seven clients/patients unemployed ethnic minorities with complex problems. A critical text analysis was conducted to identify the linguistic elements. The textual practise was analysed in the frame of institutional ethnography using Dorothy E. Smith’s “text-reader-conversation” methodology. We analysed each forms separately, and then analysed the forms in pairs related to each of the seven pathway.
Preliminary results: Our on-going analyses have revealed writing practices, which per see aimed at sharing intersectoral knowledge in complex cases. However, these practices followed an institutionalised course of action, and, at best, they functioned as written administrative processes to support a course of action, which have already been decided at a macro-level.
Lessons learned: This study outlined that intersectoral information exchange is not equivalent to increased coordination in care. In fact, the findings in this study indicates that some written information exchange, as the forms scrutinised in this study, are so standardised that they become more a piece of one sector’s mandatory work rather than support intersectoral pathways. This is important knowledge to the international audience, because it can increase the attention towards better writing practices and better use of shared information.
Next step: This study is a part of a PhD project, which aims at developing a prototype tool to assess the risk of complexity in intersectoral pathways for vulnerable persons. Thus, the modeling continues.