Interprofessional Collaborative Culture and Interprofessional Collaborative Care Processes in Practice in a Transitional Care Program for Older Adults: A Qualitative Study

Purpose. The purpose of this study was to describe interprofessional collaborative competencies in practice, and barriers to competency enactment, in the setting of a transitional care program for older adults. Background. The care for older adults with multiple comorbidities is complex, requiring collaboration between multiple health professionals in various settings, creating problems with communication and coordination that result in avoidable readmissions. Interprofessional collaborative competencies have been identified as key skills for health and social services professionals to address quality and safety gaps, particularly in the hospital to home transition for older adults. Methods. This study was a descriptive qualitative study using a hybrid, deductive-inductive thematic analysis method. The setting was the Community-based Care Transitions Program, a transitional care program for older adults organized around an Area Agency on Aging collaborating with health systems. Research participants were nursing, pharmacy, and public health professionals at the director, manager and clinical staff levels involved with the care transition intervention. The conceptual framework for Core Interprofessional Collaborative Competencies, developed by the Interprofessional Education Collaborative, was used to frame the interview questions and develop the initial deductive coding scheme. This was followed by an inductive thematic analysis.Results. Overarching interprofessional collaborative processes, such as interprofessional care planning, were described that encompassed multiple previously identified competencies. System factor barriers to interprofessional collaborative competency enactment were defined at the micro level (interactional), meso level (organizational), and macro level (city, county, state and national level). In addition, interprofessional collaborative culture was defined and posited as a facilitator to interprofessional collaboration at the meso level. A new conceptual model of interprofessional collaboration in the context of transition care for older adults emerged from the study findings that combined previously described conceptual models.Conclusion. This study described interprofessional collaborative culture and interprofessional collaborative processes that added to the understanding of interprofessional collaboration in practice in the context of transition care for older adults. System factor barriers that were identified and described could be proactively addressed to facilitate interprofessional collaboration. Interprofessional collaborative culture could be proactively cultivated within organizations with the goal of promoting health among the older adult population