An Overview of Reviews on Interprofessional Collaboration in Primary Care: Barriers and Facilitators

Abstract

Introduction: Interprofessional collaboration (IPC) is becoming more widespread in primary care due to the increasing complex needs of patients. However, its implementation can be challenging. We aimed to identify barriers and facilitators of IPC in primary care settings.Methods: An overview of reviews was carried out. Nine databases were searched, and two independent reviewers took part in review selection, data extraction and quality assessment. A thematic synthesis was carried out to highlight the main barriers and facilitators, according to the type of IPC and their level of intervention (system, organizational, inter-individual and individual).Results: Twenty-nine reviews were included, classified according to six types of IPC: IPC in primary care (large scope) (n = 11), primary care physician (PCP)-nurse in primary care (n = 2), PCP-specialty care provider (n = 3), PCP-pharmacist (n = 2), PCP-mental health care provider (n = 6), and intersectoral collaboration (n = 5). Most barriers and facilitators were reported at the organizational and inter-individual levels. Main barriers referred to lack of time and training, lack of clear roles, fears relating to professional identity and poor communication. Principal facilitators included tools to improve communication, co-location and recognition of other professionals' skills and contribution. Conclusions:The range of barriers and facilitators highlighted in this overview goes beyond specific local contexts and can prove useful for the development of tools or guidelines for successful implementation of IPC in primary care.

A novel perspective of Australian primary care dietetics: Insights from an exploratory study using complex adaptive systems theory

“…Power imbalances between professionals were identified in a thematic synthesis as a barrier to interprofessional collaboration. 25 In the current study, dietitians described collaboration as being driven by the GP, with some experiencing good engagement and others receiving no engagement beyond the referral. Communication and competence have been identified as important in addressing power imbalances and trust.…”

“…Access to practice software facilitated collaboration in the current study, but few participants described formal processes for engaging with the care team, even when co‐located with the referring practitioner. Power imbalances between professionals were identified in a thematic synthesis as a barrier to interprofessional collaboration 25 . In the current study, dietitians described collaboration as being driven by the GP, with some experiencing good engagement and others receiving no engagement beyond the referral.…”

“…26 GPs in the current study described dietitian competence, as determined by communication and consumer feedback, as important. Financial incentives also impact collaboration, 25 with one instance of formalised collaborationa group program for diabetesdescribed in the current study as viable due to Medicare funding. Collaboration between care team members is key to quality care, but the effectiveness of collaboration is affected by organisational, professional, and financial factors.…”

Novel approach for tracking interdisciplinary research productivity using institutional databases

“…Despite the widespread agreement on the importance and promises of interdisciplinary research teams (IDRT), barriers for effective IDRT implementation remain significant. Prior studies across a wide range of academic disciplines have identified several common barriers to IDRT including (1) university organization that favors mono-disciplinary departmental structure; [26] (2) tenure and promotion system that favors individual productivity; [27] (3) additional challenges posed by distance between collaborators (e.g., time spent in transit, scheduling conflict) [28], (4) difference in cultural norms across disciplines (e.g., ranking of research journals, importance of extramural funding, teaching/clinical responsibilities) [29], and (5) lack of experience in teamwork among researchers and research administrators (effective communication, team role vs organizational hierarchy, resource sharing, contract negotiations, identifying common goals/shared mental model) [30]. Overall, it is more difficult, expensive, and time consuming to work in research teams vs. solo research [5].…”

Untitled

“…So kann dem mangelnden Wissen übereinander mit berufsübergreifenden, gemeinsamen Aus-, Weiter-und Fortbildungen (Ulrich, Amstad et al 2020) entgegen gewirkt werden. Gemeinsame Arbeitsplätze (Co-Location) etwa in Primärversorgungszentren (Rawlinson, Carron et al 2021) fördern eine niedrigschwellige Änderung der Kooperationskultur. Der Austausch zwischen Professionen und Einrichtungen kann bereits jetzt durch die Möglichkeiten eines "asynchronen Informationsaustauschs" ohne die Notwendigkeit gleichzeitiger Verfügbarkeit verbessert und gefördert werden (Philipps, Scheible et al 2021).…”