| Impact | Representative quote* |
|---|---|
| Development of the 5As Team team | "[Dietitian X] said she started seeing more patients jointly and that it helps her learn more, and the patient." (field notes, session 4) "One other thing that came up was that afterwards [nurse Y] came up to X and pointed out that her and another dietitian are doing a new prenatal class in French around weight management. A goal they set." (field notes, session 5) "[Nurse X] shared how her and [dietitian X] piggyback on each other's appointments and do the pass-off in front of the patient." (field notes, session 12) "I actually like the interaction between all team members because I found we all have slightly different perspectives which is super, it's great." (nurse 7) |
| Provider empowerment | "Since I've done it, I can talk more comfortably and not be so afraid to kind of challenge some of the physician's statements and opinions so that's been helpful to feel a little bit more, more assertive I guess in that and have something to back it up with." (mental health worker 6) "I was really excited. … The first morning back I went around to all the doctors and gave them a copy of each of the tear-offs saying, you know … this is finally actually on one piece of paper, the approach we've been using with weight." (nurse 20) "[X] gave an example of a doctor who is telling patients that walking is not physical activity and they should aim for something different if they want to be active. She disagrees strongly and asked for the group's advice. She is going to speak to the doctor and bring a source that [X] mentioned in her talk about the benefits of walking." (field notes, session 8) |
| Interprofessional relations | |
| Areas for improvement | "The hardest thing I find obviously is the coordination with the physicians because they sort of have a different mindset and it's not that we have sort of sit-down meetings about our patients and that sort of thing." (nurse 7) "[X] said she sees in clinic all the time - that when they weigh people the MOA [medical office assistant] will yell the weight out loud - she doesn't know what to say to make it stop." (nurse 3) "What do you do when you have a problem with one of the doctors? What do you do when it is the person on the top of the chain doing these things? [Referring to the slide (X) gave about physicians:] She was nodding on every point as she has a provider and this is everything he believes. She has tried to challenge it especially in the area of mental health. But the doctor is set in his ways and his comments make her feel sad and helpless." (mental health worker 6) |
| Strengths | "Very good. Yeah, my doctors are very supportive, receptive, you know they're, they're really great to work with and very appreciative so yeah it couldn't be better." (nurse 8) "We have a really good relationship, Dr. [X] and I. We're on the same page with managing patients, great communication." (nurse 21) "Oh yeah. It's great working here. Oh yeah, we get along. It's wonderful. I can talk to Dr. [Y] across the hall. If I come up with something from a patient that I don't understand, he'll explain it to me, like, I don't feel that he would criticize me for not knowing anything or not knowing that." (nurse 19) |
| Importance of context | "Oh boy, complicated. It depends on what clinic you go to. Some, some are very dysfunctional. They see me more as someone to talk about diabetes but not weight management. They wouldn't, you know, they would probably tell their patient to go to Weight Watchers before they would refer to me and then my home clinic, the environment is excellent and they're very open, and I think if I said 'Why don't you start telling people to come see me for weight management,' I think they would do that." (nurse 26) "They have never had nurses before and we're really just working through it and trying to figure out, like, they've been together for over 30 years so they can't just have me coming in and saying 'This is how we're going to do it now,' so it's something that I will probably bring up." (nurse 26) |
| Impacts within different disciplines | [In response to the question "Is weight management important in your practice?"] "No. No it's not. … Often sometimes they'll bring it up to me, you know, because they've, you know, when they go into the … downward spiral of depression, they often get quite sedentary, sometimes they put on a lot of weight, sometimes it's exact opposite, they're not eating and they're losing a lot of weight so, I mean, there is that aspect of it and I think that maybe it has brought me to a place where I'll tick it off in, in terms of addressing it which maybe I didn't necessarily do before, I would only look at the symptoms of depression or anxiety or, or whatever so I think that, that has been helpful but again it's not their primary concern ever when they're coming to see me." (mental health worker 3) |
*Quotes were edited to improve readability.