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Roles of Health Professionals Involved in Insulin Initiation

´╗┐Roles of Health Professionals Involved in Insulin Initiation


Moving away from a vertical hierarchy is required to facilitate the collaborative, multidisciplinary care which is recommended for chronic disease management. This will require a change in focus away from historical and gendered roles and professional silos to one which celebrates a common commitment/shared goals and a focus on performance, positive intent and mutual respect for each other and the setting in which each works. This study has shown that whilst insulin initiation is generally recognised as acceptable in general practice, the role of the DNE and PN in this space and improved communication between health professionals are factors which need to be addressed. This will require a combined effort to evolve practices so that these are more closely aligned with the population's changing clinical requirements. Failure to do so may result in barriers to the implementation of new models of care to the detriment of patients.

Creating structures which facilitate increased relational coordination may be important for the sustainability of models of care which have a core role for DNE to support and mentor practice nurses and also to support GPs. This may include clarification of practice nurse training and roles, increased co-location to encourage interaction between health professionals, utilising the DNE as boundary spanner to facilitate coordination across different locations and levels of care and to consider different funding structures to encourage mentoring and support of health professionals in addition to the fee for service consultations which are the basis for health professional payments in Australia.

Overcoming the current barriers to relational coordination has the ability to create improved coordination, increased work satisfaction, and lastly, to benefit patients that attend general practice for care of their type 2 diabetes.

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