The VHA Interprofessional Collaboration Competency Framework for Home Healthcare: Development and Implementation Requirements in Ontario, Canada

There is a heightened focus on the need for interprofessional collaboration (IPC) to improve person-centered care. The unique challenges of the home healthcare context are not reflected in existing frameworks. The purpose of this work was to develop an interprofessional competency framework for home healthcare and to identify enablers and barriers to implementation. The framework was co-designed with home healthcare clients, providers and leaders through a 5-step process: a rapid literature review, “Design Day,” iterative co-design, shareback meetings, and refinement. Seven competencies were identified around the core value of patient-centered care, supported by 4 guiding principles. The framework was designed to promote individual-, team- and organization-level competency through identifying required elements at each level. Three months after clinical leaders were introduced to the IPCC Framework, 38 participated in workshops in which they provided insights on enablers and barriers to implementation. These were analyzed thematically with reference to the COM-B theory of change model. Major themes reflected capabilities to implement practice changes, opportunities enabling the integration of IPC, barriers to implementing IPC, and motivation to practice interprofessionally. Most identified barriers existed structurally at the team and organizational levels, limiting or disincentivizing interprofessional collaboration. This framework provides an approach that home healthcare organizations can use to guide the advancement of IPC, identifying how competencies may be enacted at the individual, team, and organizational levels within the relatively autonomous and geographically disparate context of home healthcare.