Barriers and Enablers to Implementing Interprofessional Collaborative Family Practice Teams with a Focus on Improving Access to Primary Care

Background

Interprofessional collaborative family practice teams or collaborative practice teams, bring together different types of health care professionals who provide health care usually under one roof. The composition of these collaborative practice teams varies, but they typically include one or more family doctors, nurse practitioners, and may include other allied health care providers, such as social workers and pharmacists. Collaborative practice teams working in a coordinated, collaborative way can improve access to primary care and have been shown to enhance health care and health outcomes, particularly for patients with complex needs. 

In Nova Scotia, collaborative practice teams were formally introduced at four pilot sites in 2000, and in 2016-17, targeted funding was provided to establish additional collaborative practice teams. As of January 2020, there were 85 collaborative practice teams in Nova Scotia. Although there is growth in the number of teams, continued work is needed to strengthen existing teams and promote primary care access and attachment. 

About the project

Nova Scotia Health and the Nova Scotia Department of Health and Wellness (NS DHW) sought to understand the barriers and enablers to implementing collaborative practice teams. By understanding these barriers and enablers, existing teams can strengthen their practice and new teams can be formed with the best evidence available.

This topic was explored at the Maritime SPOR SUPPORT Unit (MSSU) NS Bridge Event in June 2018. Following these initial discussions, the MSSU supported the creation of a multidisciplinary research project to explore this topic further.

Phase 1: Literature Review of Interprofessional Collaborative Family Practice Teams

A literature review was done to examine the barriers and enablers to interprofessional collaborative family practice teams, with focus on improving access to primary care. The Consolidated Framework for Implementation Research (CFIR) was used to group the barriers and enablers identified in the literature into five broad categories or 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. A visual summary was also created to share important findings.

Phase 2: Engagement of Nova Scotia Interprofessional Collaborative Family Practice Teams 

In July 2019, the research team was awarded a Level 1 Translating Research into Care (TRIC) grant from Nova Scotia Health to build on the first phase of the project by using the findings from the literature review to explore local perspectives and experiences of barriers and enablers to forming and successfully implementing collaborative practice teams. To do this, the research team will engage with collaborative practice teams to: 

  • Validate and prioritize the barriers and facilitators categorized in Phase I and; 
  • Co- create plans for one or more interventions such as education, training and tools that can mitigate priority barriers and/or enhance priority enablers. 

The MSSU will also help the research team to apply for more funding to support the implementation of strategies and interventions designed to reduce barriers and/or enhance enablers for collaborative practice teams across the province.

Project Leads

  • Ruth Martin-Misener, Professor and Director, School of Nursing, and Assistant Dean Research, Faculty of Health, Dalhousie University
  • Susan Philpott, Senior Policy Analyst, Primary & Acute Care Branch at Nova Scotia Department of Health and Wellness
  • Heidi Ryer, MSSU Patient Partner (Phase 1)
  • Tara Sampalli, Senior Scientific Director,  Nova Scotia Health 
  • Amy Grant, Senior Health Policy Research, Maritime SPOR SUPPORT Unit, Nova Scotia Health Authority

Contact

Elizabeth Jeffers
Research Manager
Elizabeth.Jeffers@nshealth.ca
902-473-7607