Unpacking the black box of interprofessional collaboration within healthcare networks: a scoping review.

Abstract

Health systems are facing increasingly complex healthcare challenges, including system fragmentation, silos culture, lack of accountability, budgetary constraints and epidemiological transitions. Many governments adopted healthcare networks as a new strategy to address the complex healthcare challenges (eg, multidisciplinary care) by fostering effective clinical and interprofessional collaboration (IPC) across clinical pathways. Yet, limited evidence exists on how IPC is fostered within healthcare networks (ie, happening <i>inside</i> the structure of the network-including processes, systems, communication and practices). This review aims to identify the underlying processes and drivers for effective IPC within healthcare networks, as well as facilitators and barriers. We followed the scoping review guidance developed by the Joanna Briggs Institute and Preferred Reporting Items for Systematic Review and Meta-Analysis for Scoping Reviews reporting guidelines. We searched five databases (PubMed (Medline), Scopus, Web of Science, Research4Life and BDSP). We included peer-reviewed articles published between 2010-2024 in French or English that addressed IPC within healthcare networks. Data charting included the general characteristics of included studies, IPC characteristics, barriers and facilitators and implications for policy and practice. Thematic analysis was guided by the levels of IPC at individual, professional, interactional and organisational levels. 29 studies were included in this review. Most scholars from the included studies indicated that IPC is a complex, socially stratified process that includes four levels: individual, interactional, professional role and organisational characteristics. The main barriers were poor communication, lack of shared knowledge and decision-making, hierarchy and power imbalances. Key facilitators included clarifying roles, building formal structures for IPC, enhancing communication and promoting interprofessional education and training. Promoting IPC necessitates systemic interventions that target multiple levels, including the individual, interactional, professional and organisational dimensions. Additional research is needed to understand how to foster effective IPC and develop strategies to ensure high-quality patient care.