053165
2021
APHXXX10.1177/10105395211053165Asia Pacific Journal of Public HealthZhuang et al
Short Communication
Interprofessional Collaboration During
COVID-19: A Case Study of a Shanghai
Quarantine Center for Medical
Observation
Jie Zhuang, MSW1* , Lili Ma, MN2*, Yan-Yan Chen, PhD3,
and Yifei Wu, MBA4
Introduction
Since the outbreak of the COVID-19, China’s infection rate is
0.0066%.1 “Avoiding external input and internal diffusion” is
one of the most important public health policy to minimize
the impact on socio-economic operations. Quarantine centers
are the main gatekeepers to stem the spread of the COVID-
19. Shanghai, as the biggest international city in China, set up
quarantine centers for medical observation (hereafter referred
to as quarantine centers) immediately, and makeshift inter-
professional teams were formed. Interprofessional collabora-
tion has been increasingly applied to deliver health care
services. This report introduces the effective process of oper-
ation and collaboration within the interprofessional teams at
quarantine centers, which can be a reference for pandemic
control in other countries and regions.
Effective collaboration needs more than combining dif-
ferent disciplines.2 Essential elements include effective com-
munication, supportive relations, and collective goals.3 The
process of team operation is dynamic, as Tuckman4 indicated
that groups can go through different stages of development.
Existing studies seem insufficient to explain the complex
dynamics in interprofessional teams at quarantine centers.
This study is the first to explore the practice of interprofes-
sional teams at COVID-19 quarantine centers based on
Tuckman’s framework.
Methods
This qualitative study focused on the interprofessional team
at the X quarantine center in Shanghai, which has nearly 500
rooms. The interprofessional team consisted of 21 staff
members: a medical team from a general hospital (one team
leader, one medical social worker, 10 nurses, and four doc-
tors), two CDC staff, two government officials, and hotel
staff. Each staff worked on a 3-shift schedule and work cycle
lasted for three to four weeks. A total of 15 team members
participated in individual interviews and one focus-group
interview during the study in 2020. Six members declined
the invitations. The study obtained the approval for ethical
Asia Pacific Journal of Public Health
2022, Vol. 34(1) 134­–136
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treatment of human participants by the Department of Social
Work at Fudan University.
The first two authors worked as a social worker and a
nurse leader, respectively. They observed the teamwork pro-
cess, recorded interactions in specific scenarios, and col-
lected minutes. An inductive data-driven form of thematic
analysis was employed.
Results
The interprofessional team at the quarantine center has gone
through five stages.
Stage 1 Forming: Build the Team (Days 1–-3)—
Workers were selected and dispatched to form the team.
During the orientation, the new members were assigned
specific job responsibilities.
Stage 2 Storming: Deal with Differences (Days 4-6)—
Due to different professional backgrounds, overlapping
responsibilities, and role ambiguity, interprofessional
teams experienced conflicts, in particular with database
management. The team leader initiated joint consultation
with members and optimized previous workflows. This
underscored the importance of responsibilities and effi-
cient workflows, so the team moved onto the next stage.
Stage 3 Norming: Improve Working Systems (Days
7-10)—The core task of the norming stage was to improve
1
Department of Social Work, Shanghai East Hospital, Shanghai, China
2
Department of Nursing, Shanghai East Hospital, Shanghai, China
3
Department of Social Work, School of Social Development and Public
Policy, Fudan University, Shanghai, China
4
Discipline Inspection and Audit Office, Shanghai East Hospital, Shanghai, China
*co-first authors.
Corresponding Author:
Yan-Yan Chen, Department of Social Work, School of Social
Development and Public Policy, Fudan University, 220 Handan Road,
Shanghai 200433, China.
Email: chenyanyan@fudan.edu.cn
Zhuang et al
Table 1. Division of Labor in the Interprofessional Team.
Profession
Team leader
District government officers
CDC staff
Medical team
Hotel staff
Abbreviations: CDC, Centers for Disease Control and Prevention.
the key systems. First, professional roles were gradually
clarified (see Table 1). Second, the team focused on close
cooperation in overlapping work. For instance, the quar-
antine center was responsible for transferring close con-
tacts. The CDC staff notified the team leader. The medical
team informed residents, provided mental support, con-
tacted ambulances, and made transportation arrange-
ments. District government officials arranged the
logistical staff to disinfect the area under the CDC super-
vision. Third, a 3-dimensional communication mecha-
nism was developed with both vertical and horizontal
systems. The team members reported to both the team
leader and their original supervisors. WeChat groups were
set up. Urgent meetings were held to handle emergencies,
and regular work shifts changed twice a day.
Stage 4 Performing: Return to the Person-Centered
Approach (Days 10-24)—As the team developed, the
shared goal was to enhance the well-being of residents
(overseas students, vulnerable people, foreigners) and staff.
Team members gradually gained a deeper understanding of
bio-psycho-social needs of residents and provided holistic
care including health inspections, daily medical care, hand-
ing out mental health flyers, and counseling. Peer support
groups were formed for the self-care of the team members.
Stage 5 Adjourning: Legacy (Days 25-28)—The team
members bid farewell to each other by sharing pictures
and videos about their work. The team summarized their
experiences and wisdom for a smooth transition.
Discussion and Implication
The following features of the interprofessional team opera-
tion in a quarantine center are part of effective prevention
measures.
A Clear Work Mechanism as the Institutional
Foundation for Cooperation
Despite existing guidelines, setting up quarantine centers
was a new practice. Operational collaboration was
135
Job responsibilities
•• Manage and lead the work
•• Liaise with governments, hotel, the third-party cleaning and disinfection
company to provide logistical support
•• Data management
•• Daily protection and sanitation supervision
•• Check-in and check out
•• Medical observation
•• Health care
•• Psychological counseling
•• Logistical services
developed through ongoing exploration and improvement.
For occupational health, the work cycle was set as three to
four weeks. Clarifying professional responsibilities and
workflows, focusing on collaboration, and constructing
3-dimensional communication mechanism have contrib-
uted toward building mutual respect, trust, and timely
communication. External changes required the team
to strike a balance between stability and flexibility.
Meanwhile, all must follow strict self-protection require-
ments. As the interprofessional teamwork faced challeng-
ing epidemic situations, updated policies, and frequent
emergencies, the storming stage and the norming stage
oscillated.
Person-Centered Approach as the Fundamental
Value of Teamwork
The successful operation of the quarantine center was built
on shared values, such as pro-life and well-being. Integrated
health care is promoted. The team implemented a person-
centered approach5 when meeting the bio-psycho-social
needs of residents. The findings suggest that policy makers
provide more comprehensive resources to facilitate interpro-
fessional teams to safeguard their own well-being and offer
excellent services to residents.
The special nature of the COVID-19 outbreak has led to
tremendous efforts toward disease prevention. Unlike other
countries preferring home-isolation, China has implemented
“precise prevention and control（精准防控）” public health
policy. The quarantine centers act as gatekeepers, targeting
infected and high-risk persons to prevent community out-
breaks, thereby maximizing social and economic operations,
saving healthcare resources, and protecting people’s
wellbeing.
At present, the experience of the interprofessional team at
the quarantine centers has also been applied to China’s inter-
national airports and communities to prevent imported and
local outbreaks. This study could be a useful reference for
large cities like Shanghai, which are densely populated,
aging, and have a high mobility rate, to meet the epidemic
challenges.
136
Acknowledgment
We wish to acknowledge all the interprofessional team members
because of whom we have been able to record this valuable and
special experience, and share it with other colleagues in different
regions to pursue a common goal of fighting against the pandemic.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect
to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, author-
ship, and/or publication of this article.
ORCID iD
Jie Zhuang https://orcid.org/0000-0002-5290-5210
Asia Pacific Journal of Public Health 34(1)
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