Exploring Hospital Healthcare Providers' Approaches to Multidisciplinary Initiatives and Complex Care Collaboration: A Qualitative Study

探索医院医疗服务提供者对多学科合作和复杂病例诊疗协作的态度:一项定性研究

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Abstract

BACKGROUND: Despite well-documented factors influencing collaboration, healthcare providers' perspectives remain limited. These perspectives are key for understanding how they manage complex patient care effectively. This study explores hospital healthcare providers' views on multidisciplinary collaboration and their openness to an intervention for managing complex care in patients with diabetes and multiple chronic conditions. METHODS: An interview study. The Interpretive Description approach was employed as the research methodology, with Boundary Work as the analytical framework. Purposive sampling was utilised, with data consisting of 22 semi-structured, face-to-face individual and two focus group interviews with nurses, junior physicians, and physicians at Aarhus University Hospital, Denmark. RESULTS: Three main themes emerged: Wide Support and Need for Multidisciplinary Collaboration; Existing Collaboration Between Clinics - and Their Limitations; and Introducing a Collaborative Initiative: the Intervention. The informants agreed that collaboration and coordination - both broadly and in relation to the specific intervention - are important and could improve care coordination, enhance patients' sense of security, clarify professional roles, enrich expertise, and streamline resource use. However, organisational structures and professional dynamics often hinder such efforts. A key challenge related to the intervention was identifying patients with complex cases for referral. CONCLUSION: This study highlights hospital healthcare providers' recognition of the critical need to strengthen collaboration across specialties to manage complex cases effectively. Significant barriers, such as siloed specialisation and heavy workloads, call for targeted political and managerial action. Challenges in identifying complex cases point to the need for methods that adopt a holistic, patient-centred approach to gain a nuanced understanding of the challenges individuals face in living with multiple chronic conditions and receiving care across different hospital clinics. In the future, this approach could streamline the referral of complex cases, with additional research required to explore the potential of flexible multidisciplinary team meetings in enhancing collaboration within complex care pathways.

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