Interprofessional collaboration between general practitioners and primary care nurses in Belgium: a participatory action research

ABSTRACT

Given the sociodemographic challenges facing the Belgian primary care system, it is essential to strengthen interprofessional collaboration (IPC) between healthcare providers. Therefore, our aims for this study were to assess IPC between general practitioners (GPs) and nurses; identify target priorities for improving IPC; and facilitate the planning and implementation of the proposed improvement strategies. Based on diversity criteria, six groups of GPs and nurses were chosen for a participatory action research. Participants performed a SWOT analysis of their IPC to identify strengths and weaknesses of their collaboration practice configurations. Main factors limiting IPC were related to the type of financing system which impeded or facilitated multidisciplinary team meetings, a weak functional integration, and a lack of interprofessional education. Overall, communication and task delegation were co-identified as common priorities. Actions prioritized by each group were related to these two priorities and accounted for local, specific needs. Communication could be supported through improved tools and dedicating time for multidisciplinary team meetings. Task delegation was more challenging and raised questions related to nurses’ training, legislation, and payment systems. IPC seems to be easier to achieve when healthcare professionals belong to the same organization and consider themselves a team.

KEYWORDS:

• Interprofessional collaboration
• primary care
• communication
• task delegation
• participatory action research

Supplemental Material

Supplemental data for this article can be accessed on the publisher’s website

Acknowledgments

The authors would like to thank all participants, including the professionals, steering committee and experts who were consulted for this research.

Declaration of interest statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Additional information

Funding

This research was supported by the Ministry of Public Works, Social Action, Health and Heritage of the Walloon Region in Belgium.

Notes on contributors

Marlène Karam

Marlène Karam is an assistant professor at Université de Montréal, Faculty of Nursing, and a researcher at the Institute of Health and Society (IRSS), Université catholique de Louvain (UCL), Brussels. She has a nursing background. Marlène completed her PhD thesis on interprofessional collaboration and continuity of care at the UCL. She had several projects associated with integrated care, strengthening primary healthcare level, and nursing care coordination for patients with complex health and social care needs. Email addresses: [email protected]; [email protected]

Jean Macq

Jean Macq is a professor at the Faculty of Public Health, Université catholique de Louvain (UCL), teaching healthcare services organization, system thinking in public health, healthcare system coordination and networks organization. He is also a senior researcher at the Institute of Health and Society (IRSS). He is coordinating research and evaluation projects in the field of integrated care, inter-organizational network analysis, chronic care and primary care organization in Belgium and Africa. Email address: [email protected]

Christiane Duchesnes

Christiane Duchesnes is a GP and a senior researcher at the Department of family medicine, Université de Liège, Belgium. She has specialised in qualitative research and conducted research projects on interprofessional collaboration and its daily application in primary care in Belgium. Christiane will soon be enjoying retired life. Email address: [email protected]

André Crismer

André Crismer is a GP practicing in a multidisciplinary primary care center in Seraing, Belgium.  He is also a Public Health physician. His publications addressed the conceptual clarity of primary healthcare and the growing necessity of strengthening primary healthcare level. Email address: [email protected]

Jean-Luc Belche

Jean-Luc Belche is a GP practicing in a multidisciplinary primary care center and lecturer at the Department of family medicine, Université de Liège. His PhD thesis focused on integration within primary care level and across levels of care.  His main research fields are related to integrated care and interprofessional collaboration; and he has extensive experience in action-research methods.  He is currently involved in an interdisciplinary primary care Chair in Belgium (be.hive) aimed to strengthen  primary care level. Email address: [email protected]