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Reading: Clinical Genomics: Integrated teamworking across the sociotechnical divide

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Conference Abstracts

Clinical Genomics: Integrated teamworking across the sociotechnical divide

Authors:

Stephanie Best ,

Centre of Health Resilience and Implementation Science, AIHI, Macquarie University, Sydney, NSW; Australian Genomics Health Alliance, Parkville, Vic,, AU
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Janet. C Long,

Centre of Health Resilience and Implementation Science, AIHI, Macquarie University, Sydney, NSW, AU
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Jeffrey Braithwaite,

Centre of Health Resilience and Implementation Science, AIHI, Macquarie University, Sydney, NSW, AU
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Zornitza Stark,

Australian Genomics Health Alliance, Parkville, Vic, 3052; 3: Victorian Clinical Genetics Service, Melbourne, Vic; University of Melbourne, Melbourne, Vic; Murdoch Childrens Research Institute, Melbourne, Vic, AU
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Clara Gaff,

Australian Genomics Health Alliance, Parkville, Vic, University of Melbourne, Melbourne, Vic, Australia; Murdoch Childrens Research Institute, Melbourne, Vic; Melbourne Genomics Health Alliance, Melbourne, Vic, AU
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Melissa Martyn,

University of Melbourne, Melbourne; Melbourne Genomics Health Alliance, Melbourne, Vic, AU
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Helen Brown,

Melbourne Genomics Health Alliance, Melbourne, Vic, AU
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Belinda McClaren,

Australian Genomics Health Alliance, Parkville; University of Melbourne, Melbourne, Vic; Murdoch Childrens Research Institute, Melbourne, Vic, AU
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Larissa Ng,

University of Melbourne, Melbourne, Vic, AU
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Kushani Hewage,

University of Melbourne, Melbourne, Vic, AU
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Sharon Williams,

Swansea University, Swansea, Swansea, Wales, GB
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Natalie Taylor

NSW Cancer Council, Sydney, NSW, AU
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Abstract

Introduction: Clinical genomics, reading a person’s entire genetic material for healthcare benefit, is a complex transformative approach to patient care offering the potential for diagnosis and changes in treatment plans for patient groups who have few conventional diagnostic and treatment options available. However, the promise of this new technology can only be delivered with the close interaction of a range of scientists and healthcare practitioners. This cross-discipline collegial expectation is challenged by the speed at which the field of genomics is evolving, with new discoveries and technological advances unbalancing the delicately emerging status quo.

To identify the challenges and benefits of team working for clinical genomics, we drew on three qualitative datasets to investigate how these professional groups manage the necessity of integrated working to maximise clinical outcomes.

Theory/method: Interviews examining the determinants of implementation and improvement of clinical genomics were undertaken in 2018/19 with laboratory scientists, genetic and other medical specialists’ (n=56). Group 1 interviews provided in depth findings of the experience from identifying patients for whom this test is appropriate to communicating results back to patients; Group 2 interviews explored the relationship between the laboratory and the genetic clinician; Group 3 interviews focused on perceptions from one clinical area (acutely unwell children). Interviews were audio recorded with participants’ permission, fully transcribed and managed in NVivo 12. We used the Framework approach (Ritchie & Lewis, 2003) to analyse all three datasets to identify themes of integrated teamworking in an evolving sociotechnical healthcare context.

Results:Three themes were identified; i) Knowledge: e.g. the capacity to cope with the speed of evolving knowledge and the importance of external links for knowledge development, ii) Professional Identity: e.g. the ability to recognise and value the skills of others and ‘stepping up’ as needed, and finally iii) Team Dynamics: e.g. the importance of external representation and managing the ‘emotional load’.

Discussion: For integrated teams in a new disruptive healthcare discipline, Knowledge, Professional Identity and Team Dynamics all play a vital role in establishing, maintaining and progressing the functioning of the team. Inter-theme contribution occurs to promote teamworking that serves to improve patient care.

Conclusion: As scientific technology progresses, and plays an increasing role in healthcare, it is essential we understand how teams straddling the scientist/clinical divide negotiate the interaction of Knowledge, Professional Identity and Team Dynamics. Learnings from the experience in clinical genomics can be used in other emerging technologies to maximise the experience for team members and clinical benefit for patients.

Lessons:Understanding how the themes of Knowledge, Professional Identity and Team Dynamics interact is essential to facilitate teamworking in novel sociotechnical healthcare fields. Using evidence-based approaches to promote theme-related concepts may act to support the functioning of teams.

Lmitations: These data were gathered from three different datasets focused on implementation/improvement.

Further study is required in this field to explore how the three key themes interact longitudinally as knowledge progresses. Future research also needs to focus on how more recently emerging professions (such as bioinformaticians and genetic counsellors) establish their role in these dynamic teams.

How to Cite: Best S, Long JC, Braithwaite J, Stark Z, Gaff C, Martyn M, et al.. Clinical Genomics: Integrated teamworking across the sociotechnical divide. International Journal of Integrated Care. 2021;20(S1):32. DOI: http://doi.org/10.5334/ijic.s4032
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Published on 26 Feb 2021.

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