Barriers and enablers to implementing Interprofessional Collaborative Teams in Primary Care: A narrative review of the literature using the Consolidated Framework for Implementation Research

Abstract

Background Interprofessional collaborative teams (teams) have been introduced across Canada to improve access to and quality of primary care. However, the quality and speed of team implementation has been challenging and has not kept pace with increasing access issues. The aim of this research was to use an implementation framework to categorize and describe barriers and enablers to team implementation in primary care. Methods A narrative review that prioritized systematic reviews and evidence syntheseswas conducted. A search using pre-defined terms was conducted using Ovid MEDLINE, and potentially relevant grey literature was identified through ad hoc Google searches and hand searching of health organization websites. The Consolidated Framework for Implementation Research (CFIR) was used to categorize barriers and enablers into five 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 ofImplementation. Results Data were extracted from 19 of 435 articles that met inclusion/exclusion criteria. Most barriers and enablers were categorized into two domains of the CFIR: Characteristics of the Team and Government, Health Authorities, and Health Organizations. Key themes identified within the Characteristics of the Team domain were team-leadership, including designating a manager responsible for day-to-day activities and facilitating collaboration; clear governance structures, technology supports and tools that facilitate information sharing and communication; and a combination of formal and informal methods of communication. Key themes within the Government, Health Authorities, and Health Organizations domain were professional remuneration plans, regulatory policy, and interprofessional education that encourage and incorporate interprofessional competencies and values. Conclusions Barriers and enablers to implementing teams using the CFIR were identified, which enables stakeholders and teams to tailor implementation of teams at the local level to impact the accessibility and quality of primary care.