Characteristics, barriers and facilitators of initiatives to develop interprofessional collaboration in rural and remote primary healthcare facilities: a scoping review.

Abstract

Despite strong evidence supporting interprofessional collaboration (IPC) and the documented need for collaborative practice in primary health care (PHC), initiatives to promote IPC in rural and remote PHC facilities have not been extensively studied. The purpose of this article is to map interprofessional education (IPE) and interprofessional practice (IPP) initiatives implemented to promote IPC in rural and remote PHC facilities, and identify barriers and facilitators to their implementation. A scoping review was conducted. After two reviewers filtered titles and abstracts, 94 retained articles were subsequently screened. Finally, 23 articles were selected and analyzed using a directed content analysis approach in NVivo v12. Only 10 articles focused on the implementation of initiatives to improve IPC, while the majority reported barriers and facilitators. The most common IPE initiatives were workshops, courses, discussion groups and simulations, while IPP initiatives fell into two main categories: clinical or technological tools. Limited human resources, understanding of roles, and knowledge of context as well as traditional roles, were identified as barriers. Team size, past experience and relationships, connection to community, flexibility and openness, and financial support were facilitators to developing IPC. Deployment of IPC in rural and remote PHC facilities is critical given the various challenges faced in these clinical settings. The facilitators identified in this literature review are specific to rural and remote clinical settings and provide hope that new initiatives more tailored to rural and remote settings will be implemented and evaluated in the future to improve IPC and care delivery.