Interprofessional collaboration and barriers among health and social workers caring for older adults: a Philippine case study

Abstract

Background There is limited information on how the barriers to interprofessional collaboration (IPC) across various professionals, organizations, and care facilities influence the health and welfare of older adults. This study aimed to describe the status of IPC practices among health and social workers providing care for older adults in the Philippines; investigate the perceived barriers to its implementation and perceived effects on geriatric care; and identify possible solutions to address the barriers limiting collaborative practice. Methods A case study approach was utilized employing 12 semi-structured in-depth interviews and 29 focus group discussions with care workers from selected primary health care units, public and private hospitals, and nursing homes that are directly involved in geriatric care delivery in two cities in the Philippines. Overall, 174 health and social workers consented to participate in this study. All interviews were audio-recorded and transcribed verbatim. An inductive thematic analysis using NVivo 12® was used to identify and categorize relevant thematic codes. Results Interprofessional geriatric care provided by health and social workers was observed to be currently limited to ad hoc communications typically addressing only administrative concerns. This limitation is imposed by a confluence of barriers such as personal values and beliefs, organizational resource constraints, and a silo system care culture which practitioners say negatively influences care delivery. This in turn results in inability of care providers to access adequate care information, as well as delays and renders inaccessible available care provided to vulnerable older adults. Uncoordinated care of older adults also led to reported inefficient duplication and overlap of interventions. Conclusion Geriatric care workers fear such barriers may aggravate the increasing unmet needs of older adults. In order to address these potential negative outcomes, establishing a clear and committed system of governance that includes IPC is perceived as necessary to install a cohesive service delivery mechanism and provide holistic care for older adults. Future studies are needed to measure the effects of identified barriers on the potential of IPC to facilitate an integrated health and social service delivery system for the improvement of quality of life of older adults in the Philippines.

Improving Community Health Workers’ Attitudes toward Collaborative Practice in the Care of Older Adults: An In-Service Training Intervention Trial in the Philippines

“…However, multivariate statistical models presented a negative association between social support roles and positive attitudes toward collaboration after adjusting for age, group, and years in occupation. This can be explained by the fact that CHWs in social support roles may experience barriers in attending team meetings and, therefore, view collaboration as something that is time consuming, complicates their work, and hinders them from meeting the demands of their job [ 21 , 39 ].…”

“…Studies on interprofessional education (IPE) interventions have reported positive outcomes, including changes in learner perceptions/attitudes toward IPC and the value of collaboratively working with healthcare teams [ 16 , 17 ]. Though IPE and IPC improve cohesion and collaborative work within healthcare teams, the existence of soloing between different personnel, organizations, and care settings restricts formal IPC implementation [ 21 ]. The tension arising from a display of negative attitudes toward other professions contributes to poor communication among health care professionals and leads to dissatisfaction with teamwork [ 22 ].…”

In-service training programme for health and social care workers in the Philippines to strengthen interprofessional collaboration in caring for older adults: a mixed-methods study

“…Both cities had experience developing health promotion programmes focusing on IPC with the research team. The percentage of older adults aged ≥ 60 years in Marikina was 7.8%, and in Tagaytay was 6.9% [ 5 ] . These cities are composed of barangays (i.e.…”

“…4 Department of Health Policy and Administration, College of Public Health, University of the Philippines Manila, Manila, Philippines. 5 Technology Transfer and Business Development Office, University of the Philippines Manila, Manila, Philippines. 6 Institute on Aging, National Institutes of Health, University of the Philippines Manila, Manila, Philippines.…”

“…Building on existing academic partnerships and expertise, formative research was conducted in the Philippines and Viet Nam that included 70 focus group interviews with 348 health and social care professionals. A common theme that emerged from both countries was that a growing number of older adults require complex care for geriatric syndromes and noncommunicable diseases, but comprehensive, equitable and high-quality approaches to care are perceived to be inadequate and non-holistic, largely due to separation between the health and social welfare sectors [ 5 ]. Interviews showed that IPC practices are generally considered to be administrative in both the Philippines and Viet Nam [ 5 ].…”