Collaborative pathways for physiotherapists: A community action research project to identify barriers and facilitators to Interprofessional Collaboration in Home Healthcare

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Amélie Zosso, Nicole Jaunin-Stalder, Liliane Staffoni, Alessia Camponovo, Veronika Schoeb
Purpose:

The aim of this study was (1) to evaluate the needs of patients, their informal caregivers and health professionals regarding care coordination in community care; (2) to identify barriers and facilitators for interprofessional teamwork; and (3) to propose a model of care that can improve the coordination within primary healthcare teams. The aim of this study was (1) to evaluate the needs of patients, their informal caregivers and health professionals regarding care coordination in community care; (2) to identify barriers and facilitators for interprofessional teamwork; and (3) to propose a model of care that can improve the coordination within primary healthcare teams. 

Methods:

Members of a community healthcare agency (patients and health professionals), physiotherapists and medical doctors in French-speaking Switzerland were included in this study. The two-phase community-based action research included 8 semi-structured interviews with patients and their informal caregivers and 3 focus groups with 10 health professionals (Phase 1), followed by an interactive workshop with health professionals (Phase 2). Interviews and focus groups were transcribed ‘ad verbatim’ and analysed thematically.  

Results:

The analysis of Phase 1 identified six themes: Difficulties in team communication, important role of care givers, health professionals’ adaptations to interprofessional difficulties, health professionals’ roles and responsibilities, tools and interfaces, and context-specific aspects. During the workshop in Phase 2 potential solutions were proposed: (1) political lobbying for system change to reduce barriers for interprofessional collaboration, (2) set-up of meeting place for primary care teams, (3) systematic integration of physiotherapists in the community healthcare teams, (4) information sharing within same IT system, and (5) reimbursement scheme to incentivise interprofessional collaboration. 

Conclusion(s):

The community-based participatory action research study allowed to identify needs and concerns perceived by patients, their informal caregivers and healthcare teams. Based on the analysis of the first phase (interviews and focus groups), health professionals proposed actions to improve interprofessional collaboration and coordination of care. Physiotherapists in particular were seen as “outside of the system”, both from a team perspective as well as from a reimbursement perspective, yet all stakeholders perceive their role as important. Political skills and lobbying, as well as appropriate tools and incentives for collaboration were identified as useful measures to develop the current model into a performing community healthcare team.

Implications:

The role of physiotherapists in community care is undervalued. The importance of home healthcare will increase in the future due to an aging population and increased complexity. Physiotherapists need to be part of an interprofessional healthcare team requiring an adaptation to their independent practice. For a community healthcare team to be functioning well, barriers related to organisation and reimbursement schemes need to be removed. 

Funding acknowledgements:
The study was funded by the College of Primary Care Medicine and the Swiss Physiotherapy Association.
Keywords:
interprofessional collaboration
home healthcare
older population
Primary topic:
Community based rehabilitation
Second topic:
Older people
Third topic:
Professional issues
Did this work require ethics approval?:
No
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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