Bridging gaps in primary care: Insights and future perspectives from participatory action research

Background: Interprofessional collaboration (IPC) is the key to effi cient patient care in the community and home care settings. Against a backdrop of staff shortages and reduced hospitalisation, primary healthcare teams are faced with increasingly complex care situations. The objectives of this participatory action research was to assess the needs of patients and their informal caregivers, to identify barriers and facilitators of IPC in primary care as perceived by healthcare professionals, and to co-create an intervention to improve collaboration in primary care. Methods A participatory action research method was used and included general practitioners, physiotherapists, patients and health and social care professionals from a Home Care Agency in Western Switzerland. Phase 1 included eight semi-structured interviews with patients and their informal carers, and three focus groups with primary healthcare providers were conducted. Data were transcribed and analysed using thematic analysis. Phase 2 entailed a workshop with healthcare providers during which results from Phase 1 were discussed and solutions proposed. Results: Analysis of patient interviews and focus groups with health professionals (Phase 1) revealed diffi culties of team communication in primary care, the importance of informal carers, the lack of integration of physiotherapy providers into primary care teams, health professionals’ adaptations to interprofessional challenges, their roles and responsibilities, the need for tools and interfaces, and context-specifi c aspects. Solutions proposed in the workshop (Phase 2) were as follows: (1) political advocacy for system change to reduce barriers for IPC, (2) set-up of a shared place/space for primary care teams, (3) systematic integration of physiotherapists into the community healthcare teams, (4) information exchange with a shared IT system; and (5) a reimbursement scheme to incentivize IPC. Conclusion: These results proposed by primary care stakeholders revealed the importance of integrating all professionals (including physiotherapists) into interprofessional primary care teams, as well as sharing spaces under one roof. Physiotherapists should learn to become part of primary care teams while at the same time collaboratively advocate for fi nancial incentives and adequate reimbursement systems. The future of a sustainable Swiss healthcare system lies in the interprofessional and intersectoral integration of all health and social care professionals into eff ective primary care teams.