Interprofessional practice in primary care: development of a tailored process model

Abstract

PurposeThis study investigated the improvement of interprofessional practice in primary care by performing the first three steps of the implementation model described by Grol et al. This article describes the targets for improvement in a setting for children with complex care needs (step 1), the identification of barriers and facilitators influencing interprofessional practice (step 2), and the development of a tailored interprofessional process model (step 3).MethodsIn step 2, thirteen qualitative semistructured interviews were held with several stakeholders, including parents of children, an occupational therapist, a speech and language therapist, a physical therapist, the manager of the team, two general practitioners, a psychologist, and a primary school teacher. The data were analyzed using directed content analysis and using the domains of the Chronic Care Model as a framework. In step 3, a project group was formed to develop helpful strategies, including the development of an interprofessional process through process mapping.ResultsIn step 2, it was found that the most important barriers to implementing interprofessional practice related to the lack of structure in the care process. A process model for interprofessional primary care was developed for the target group.ConclusionThe lack of a shared view of what is involved in the process of interprofessional practice was the most important barrier to its successful implementation. It is suggested that the tailored process developed, supported with the appropriate tools, may provide both professional staff and their clients, in this setting but also in other areas of primary care, with insight to the care process and a clear representation of “who should do what, when, and how.”

District nurses' perspectives on detecting mental health problems and promoting mental health among community‐dwelling seniors with multimorbidity

“…However, because of the current organisation of home care and home health care, it seems reasonable to focus on providing these patients with integrated care. Thus, patients with complex, comprehensive care needs within primary care should be managed using collaborative care models involving inter-professional competencies (Stans et al 2013). In addition, a comprehensive continuum of care intervention may be successful if it includes care planning in the patients' homes and with case managers and a multi-professional team (Berglund et al 2013).…”

Children’s complex care needs: a systematic concept analysis of multidisciplinary language

“…The multidimensional care required to manage multiple condition-related needs [12,15,19,23,25,35,42,44,46,51,61,76,82,86,96,99,107,122,123,125,128,131,133,145,150], in the context of developmental, social, and psychological needs, emerged as a key feature of children's CCNs [46,54,61,63,71,149]. Heterogeneous combinations of high-intensity needs [25,33,40,42,45,51,54,76,79,96,98,99,103,128,131,145] spanned a wide range of care, including nutritional [1,10,11,21,25,32,69,76,…”

“…This concept analysis on CCNs found multiple structural weaknesses across international healthcare systems [5,16,20,31,35,42,52,78,90,93,122]. Pressure on those systems emerged as a dominant consequence of trying to cope with increasing number of children with CCNs [3,12,26,48,55,69,71,73,77,89,92,94,122,143]. This included high resource utilization, hospital admission, and readmission rates [11,33,54,148].…”

“…This included high resource utilization, hospital admission, and readmission rates [11,33,54,148]. CCNs increasingly seem to drive clinical and research agendas, and there was strong cross-disciplinary consensus that increased investment in community supports for integrated services could ameliorate families' care burden [1,16,30,33,40,47,51,54,55,69,72,78,81,94,122,143]. Mental health services [37,69,73,114,115,126] and workforce development, especially staff training and recruitment [16,17,46,61,69,95,133], emerged as in particular need of attention as the preventable nature of many aspects of families' struggles was apparent across all disciplines [55,71,133,142].…”

Key constituents for integration of care for children assisted with long-term home ventilation: a European study

“…The data highlights key issues in terms of gaps in care integration. The challenges with integrated care delivery are supported internationally, often due to lack of the fundamental resources that are required to meet the needs of a growing population of children with CCNs and challenges with interagency coordination [17][18][19]. A further challenge identified is the persistent lack of respite care and the need for an enhanced provision of this service in the home.…”