چکیده (انگلیسی):

Background:Interprofessional Primary Care Teams (IPCTs) have been shown to benefit health systems and
patients, particularly those patients with complex care needs. The literature suggests a wide range of factors that
may influence collaboration in IPCTs, however the evidence base is unclear for many of these factors. To target
improvement efforts, we identify studies that demonstrate an association between suggested factors and
collaborative processes in IPCTs.
Methods:A systematic review of 25 years of peer-review literature was conducted to identify studies that test
associations between policy, organizational, care team and individual factors, and collaboration in IPCTs. We
searched Medline, ProQuest subject, ProQuest abstract, CINAHL, HealthSTAR, and Embase electronic databases
between January 1990 to June 2015 and hand-searched reference lists of identified articles.
Results:The electronic searches identified 1421 articles, nine of which met inclusion criteria.
Eighteen factors were significantly associated with collaboration in at least one article.
We present the findings within a proposed conceptual model of interrelated‘gears’. The model offers a taxonomy
of factors that policy makers (macro gear), organizational managers (meso gear), care teams (micro gear) and health
professionals (individual gear) can adjust to improve interprofessional collaboration in IPC teams. Thirteen of the
eighteen identified factors were within the micro gear, or team level of decision-making. These pertained to formal
processes such as quality audits and group problem-solving; social processes such as open communication and
supportive colleagues; team attitudes such as feeling part of the team; and team structure such as team size and
having a collaboration champion or facilitator. Fewer policy (eg governance), organizational (eg information
systems, organizational culture) or individual (eg belief in interprofessional collaboration care and personal flexibility)
level factors were identified.
Conclusions:The findings suggest that individual IPCTs have opportunities to improve collaboration regardless of
the organizational or policy context within which they operate. Evidence supports the importance of having a team
vision and shared goals, formal quality processes, information systems, and professionals feeling part of the team.
Few studies assessed associations between collaboration and macro and meso factors, or between factors across
levels, which are priorities for future research.