A Scoping Review of Facilitators of Multi-Professional Collaboration in Primary Care.

Monica Sørensen,Lisa Garnweidner-Holme,Una Stenberg

doi:10.5334/ijic.3959

Abstract

Introduction:Multi-professional collaboration (MPC) is essential for the delivery of effective and comprehensive care services. As in other European countries, primary care in Norway is challenged by altered patient values and the increased expectations of health administrations to participate in team-based care. This scoping review reports on the organisational, processual, relational and contextual facilitators of collaboration between general practitioners (GP) and other healthcare professionals (HCPs) in primary care.Methods:A systematic search in specialist and Scandinavian databases retrieved 707 citations. Following the inclusion criteria, nineteen studies were considered eligible and examined according to Arksey and O’Malley’s methodological framework for scoping reviews. The retrieved literature was analysed employing a content analysis approach. A group of stakeholders commented on study findings to enhance study validity.Results:Primary care research into MPC is immature and emerging in Norway. Our analysis showed that introducing common procedures for documentation and handling of patient data, knowledge sharing, and establishing local specialised multi-professional teams, facilitates MPC. The results indicate that advancements in work practices benefit from an initial system-level foundation with focus on local management and MPC leadership. Further, our results show that it is preferable to enhance collaborative skills before introducing new professional teams, roles and responsibilities. Investing in professional relations could build trust, respect and continuity. In this respect, sufficient time must be allocated during the working day for professionals to share reflections and engage in mutual learning.Conclusion:There is a paucity of research concerning the application and management of MPC in Norwegian primary care. The work practices and relations between professionals, primary care institutions and stakeholders on a macro level is inadequate. Health care is a complex system in which HCPs need managerial support to harvest the untapped benefits of MPC in primary care. As international research demonstrates, local managers must be supported with infrastructure on a macro level to understand the embedding of practice and look at what professionals actually do and how they work.

Highlights

Multi-professional collaboration (MPC) is essential for the delivery of effective and comprehensive care services
Two of the stakeholders emphasised the need for formalised structures and leadership in creating integrated municipal healthcare services and two stakeholders argued that the lack of experience, skills and resources in municipalities in taking charge of research projects is an obstacle to implementing new collaborative practices
We suggest applying the existing knowledge from the numerous evidence-based frameworks that have been developed to diagnose the level of maturity of healthcare systems and to guide actions of improvement for inter-professional collaboration [86,87,88], integrated care [89, 90] and person-centred care [91]

Summary

Introduction

Multi-professional collaboration (MPC) is essential for the delivery of effective and comprehensive care services. As in other European countries, primary care in Norway is challenged by altered patient values and the increased expectations of health administrations to participate in team-based care. This scoping review reports on the organisational, processual, relational and contextual facilitators of collaboration between general practitioners (GP) and other healthcare professionals (HCPs) in primary care. It is envisioned that multi-professional team-based care approaches, in which professionals from different disciplines benefit from each other’s complementary skills and work towards common goals, will improve patient and provider satisfaction and the standards of care for persons with complex medical needs, such as mental illness, disabilities, multimorbidity or addictions [3,4,5,6]. It is crucial to supply primary care, and general practice in particular, with the necessary resources, technology and leadership, permitting the provision of coordinated and comprehensive care services

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