Barriers and Enablers to Implementing Collaborative Teams in Primary Care

Background

In Canada, interprofessional collaborative teams have been introduced in primary care to enhance accessibility and quality of services. However, the implementation of these teams has faced challenges, resulting in delays that hinder the desired improvements. This research aimed to identify and categorize the barriers and enablers to team implementation using an implementation framework in primary care settings.

Methods

A narrative review was conducted, prioritizing systematic reviews and evidence syntheses. A search was performed using predefined terms in Ovid MEDLINE, and additional relevant grey literature was identified through Google searches and manual searches of health organization websites. The Consolidated Framework for Implementation Research (CFIR) was used to categorize the barriers and enablers into five domains: (1) Features of Team Implementation, (2) Government, Health Authorities, and Health Organizations, (3) Characteristics of the Team, (4) Characteristics of Team Members, and (5) Process of Implementation.

Results

Data were extracted from 19 out of 435 articles that met the inclusion/exclusion criteria. The majority of identified barriers and enablers fell into two CFIR domains: Characteristics of the Team and Government, Health Authorities, and Health Organizations. Key themes within the Characteristics of the Team domain included effective team leadership, clear governance structures, technology support for information sharing and communication, and a combination of formal and informal communication methods. Key themes within the Government, Health Authorities, and Health Organizations domain included professional remuneration plans, regulatory policies, and interprofessional education that promotes and integrates interprofessional competencies and values.

Conclusions

Through the application of the CFIR framework, this research identified barriers and enablers to implementing collaborative teams in primary care. These findings empower stakeholders and teams to tailor the implementation of teams at the local level, thereby improving accessibility and quality of primary care. Addressing issues related to team leadership, governance, technology support, communication, professional remuneration, regulatory policies, and interprofessional education can contribute to the successful implementation of collaborative teams and positively impact primary care services.

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