Interprofessional collaboration and diabetes care in Switzerland: A mixed-methods study

Abstract

To face the increasing prevalence of diabetes in Switzerland, a cantonal programme has been implemented. One of its goals is to promote collaborative approaches among healthcare professionals (HCPs). The objectives of the current study were to examine HCPs' perceptions about the collaboration they experience in diabetes care and to determine whether perceptions differed among professional groups. A mixed-methods study was conducted. First, a total of 332 HCPs comprising diabetes specialists and non-specialists participated by completing a questionnaire on interprofessional collaboration. Focus groups were then led in order to deepen the understanding and complement the interpretation of quantitative results. Quantitative results showed a perception of a moderate level of collaboration. Mean scores for specialists were systematically worse than those of non-specialists and more prominently in the "level of conflict dimension," which means that specialists generally perceived a lower level of collaboration and a higher level of possible conflict associated with it. Qualitative results highlighted the vagueness in role definition and emphasised a form of reluctance by general physicians to collaborate with specialists, as the physicians felt that they were losing their responsibilities. The findings suggest that it is not the need to collaborate that encourages HCPs involved in collaborative schemes to desire or to know how to successfully initiate, promote, or conduct interprofessional collaboration. This study highlights the important perceptions about collaboration that could be taken into account when planning future collaborative programmes. ARTICLE HISTORY

Optimising care coordination strategies for physical activity referral scheme patients by Australian health professionals

“…Examining the inter(organisational) mechanisms and relational coordination among health professionals revealed a complex coordination of care PARS process. Enhanced functionality of PARS would require further insights into the roles of EPs and improved accessibility to their services [ 18 , 42 ]. These issues could be addressed through ongoing professional interaction among health professionals such as GPs and EPs, particularly during the foundational training years to become a healthcare professional and in-service training via workshops or seminars [ 46 ].…”

“…However, current evidence calls into question the effectiveness of care coordination between health professionals. This is ascribable to time constraints, lack of knowledge, shared understanding of common goals and role clarity, cost implications and weak collaborations influenced by organisational culture and structure [ 14 – 18 ]. For example, studies on the coordination of care for patients have shown that the stewardship of some health professionals such as GPs is essential [ 19 ].…”

A qualitative study exploring strategies to improve the inter-professional management of diabetes and periodontitis

“…Miscommunication between physicians and other allied health professionals in the context of diabetes has also been reported, with barriers relating to uncertainty of role and distrust of inter-professional working [44][45][46]. Schweizer studied interprofessional collaboration and diabetes care in Switzerland and suggested that perception about collaboration is important and the negative experiences of communication are likely to influence team-working [46].…”

“…Miscommunication between physicians and other allied health professionals in the context of diabetes has also been reported, with barriers relating to uncertainty of role and distrust of inter-professional working [44][45][46]. Schweizer studied interprofessional collaboration and diabetes care in Switzerland and suggested that perception about collaboration is important and the negative experiences of communication are likely to influence team-working [46]. The findings of the current study are consistent with the literature and suggest that despite the continued publica-tion of international guidance documents advocating the benefits of inter-professional communication, the implementation of these recommendations offer a significant challenge for dental and medical clinicians and additional strategies are needed to change clinical practice.…”

Financial Barriers Decrease Benefits of Interprofessional Collaboration within Integrated Care Programs: Results of a Nationwide Survey

“…In turn, organisational improvements in care settings has been associated with improved patient care in terms of safety, and fewer adverse events or complications [17,18]. Despite the acknowledgement that IPC is beneficial for both patients and professionals, and despite supportive policy recommendation for its implementation [7,[19][20][21][22], IPC remains difficult to operationalize [23][24][25] and is poorly explored when interorganisational aspects are at stake [26], as it is the case in integrated care. Implementing and maintaining integrated care and IPC initiatives is a complex systemic challenge [27,28] which involves overcoming barriers at three levels: professional, patient and financing [28,29].…”