Dib Kaoutar, Belrhiti Zakaria
Moroccan Knowledge Center, Mohammed VI International School of Public Health, Mohammed VI University of Sciences and Health, Casablanca, Morocco.
Direction of Hospitals and Ambulatory Care, Ministry of Health and Social Protection, Rabat, Morocco.
BMJ Open. 2025 Jun 13;15(6):e101702. doi: 10.1136/bmjopen-2025-101702.
Health systems are facing increasingly complex healthcare challenges, including system fragmentation, silos culture, lack of accountability, budgetary constraints and epidemiological transitions. Many governments adopted healthcare networks as a new strategy to address the complex healthcare challenges (eg, multidisciplinary care) by fostering effective clinical and interprofessional collaboration (IPC) across clinical pathways. Yet, limited evidence exists on how IPC is fostered within healthcare networks (ie, happening the structure of the network-including processes, systems, communication and practices).
This review aims to identify the underlying processes and drivers for effective IPC within healthcare networks, as well as facilitators and barriers.
We followed the scoping review guidance developed by the Joanna Briggs Institute and Preferred Reporting Items for Systematic Review and Meta-Analysis for Scoping Reviews reporting guidelines.
We searched five databases (PubMed (Medline), Scopus, Web of Science, Research4Life and BDSP).
We included peer-reviewed articles published between 2010-2024 in French or English that addressed IPC within healthcare networks.
Data charting included the general characteristics of included studies, IPC characteristics, barriers and facilitators and implications for policy and practice. Thematic analysis was guided by the levels of IPC at individual, professional, interactional and organisational levels.
29 studies were included in this review. Most scholars from the included studies indicated that IPC is a complex, socially stratified process that includes four levels: individual, interactional, professional role and organisational characteristics. The main barriers were poor communication, lack of shared knowledge and decision-making, hierarchy and power imbalances. Key facilitators included clarifying roles, building formal structures for IPC, enhancing communication and promoting interprofessional education and training.
Promoting IPC necessitates systemic interventions that target multiple levels, including the individual, interactional, professional and organisational dimensions. Additional research is needed to understand how to foster effective IPC and develop strategies to ensure high-quality patient care.
卫生系统正面临日益复杂的医疗保健挑战，包括系统碎片化、筒仓文化、缺乏问责制、预算限制和流行病学转变。许多政府采用医疗保健网络作为一种新战略，通过促进跨临床路径的有效临床和跨专业协作（IPC）来应对复杂的医疗保健挑战（如多学科护理）。然而，关于如何在医疗保健网络中促进IPC（即在网络结构内发生，包括流程、系统、沟通和实践）的证据有限。
本综述旨在确定医疗保健网络内有效IPC的潜在过程和驱动因素，以及促进因素和障碍。
我们遵循了乔安娜·布里格斯研究所制定的范围综述指南以及系统综述和元分析扩展综述的首选报告项目报告指南。
我们搜索了五个数据库（PubMed（Medline）、Scopus、科学网、Research4Life和BDSP）。
我们纳入了2010年至2024年期间发表的、以法语或英语撰写的、涉及医疗保健网络内IPC的同行评审文章。
数据图表包括纳入研究的一般特征、IPC特征、障碍和促进因素以及对政策和实践的影响。主题分析以个人、专业、互动和组织层面的IPC水平为指导。
本综述纳入了29项研究。纳入研究中的大多数学者表明，IPC是一个复杂的、社会分层的过程，包括四个层面：个人、互动、专业角色和组织特征。主要障碍包括沟通不畅、缺乏共享知识和决策、等级制度和权力不平衡。关键促进因素包括明确角色、建立IPC的正式结构、加强沟通以及促进跨专业教育和培训。
促进IPC需要针对多个层面的系统性干预措施，包括个人、互动、专业和组织层面。需要进一步研究以了解如何促进有效的IPC并制定确保高质量患者护理的策略。
