Abstract
As life expectancy has increased, a growing number of people experience conditions, including cancers, that carry complex health and social needs. Palliative care services have the potential to address these needs but face significant obstacles. One major obstacle is suboptimal interprofessional collaboration. This study’s goal was an in-depth exploration of interactional and organizational barriers and supports of collaboration in palliative care in Switzerland. We sought the perspectives of health care professionals, patients’ family members and leaders and experts in oncology/palliative care delivery (key informants) through interviews and focus groups with fifty HPs and key informants and ten patients’ family members. Qualitative analyses of interviews and focus groups used framework analysis. We identified three major themes of interaction: personal characteristics, communication, and connectedness with other health care professionals; and three major organizational themes: service characteristics, standardized communication and processes, and service coordination and promotion. Based on our findings, we recommend that health care professionals consider strategies to increase their collaboration and communication skills and opportunities to interact. We advocate the implementation of methods for coordinating services, standardization of consultation/referral procedures and communication between health care professionals, and the promotion of underutilized services to foster successful, sustainable collaboration.
Highlights
Life expectancy has increased considerably in recent decades [1] and is predicted to continue increasing in industrialized countries [2]
Our sample comprised health professionals (HPs), KIs, as well as family members of recently deceased cancer patients
Our sample of HPs included professionals employed in primary, oncology and palliative care (PC) settings to provide a comprehensive picture of interprofessional collaborative processes
Summary
Life expectancy has increased considerably in recent decades [1] and is predicted to continue increasing in industrialized countries [2]. Effective collaboration between HPs has consistently been shown to play a central role [7,8,9]. In this context, a major barrier is an unfavorable attitude towards collaboration [6]. A major barrier is an unfavorable attitude towards collaboration [6] This barrier can be a consequence of poor communication skills [8] or the lack of a culture of engaging in collaboration [10]. These can arise from personal reasons [11], organizational culture, or resource constraints [8], all of which may encourage working alone and discourage cooperation
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