Facilitators and barriers for wider implementation of the integrated health care model

Abstract Background Home dwelling frail older adults with complex long-term care needs are a particularly vulnerable group in the healthcare system, facing increased risks of receiving duplicated, fragmented, and uncoordinated care. To address these challenges, Akershus University Hospital, in collaboration with municipalities within its catchment area, has developed and piloted an integrated and person-centred healthcare (IHC) model, aimed at enhancing care coordination across providers, settings and sectors. This study seeks to assess healthcare providers’ (HCP) experiences to identify critical areas for consideration in future implementation. Methods 18 individual qualitative semi-structured interviews were conducted with nurses, geriatricians and general physicians (GPs). The data were analysed using reflexive thematic analysis. Results The analysis revealed essential areas for effective implementation, emphasizing the significance of trust and collaborative team relationships, along with provider commitment and shared objectives for the intervention. Our findings indicate that relational continuity among HCPs facilitates trust across diverse professions and sectors, which in turn enhances team dynamics positively. Furthermore, successful implementation requires active cognitive participation and engagement from HCPs, as well as a shared understanding of the intervention. Conclusions The results indicate that differing values and perspectives across professions and sectors create barriers to the implementation process. A critical aspect is the involvement of GPs, as the lack of relational continuity, combined with varying levels of understanding and engagement in the intervention, results in challenges Main messages By taking the HCP experiences into consideration, this study provides new information on areas that are crucial for successful implementation of an integrated health care intervention for frail older adults.