Facilitators and barriers to interprofessional collaboration in the hospital setting: a scoping review

Background Successful interprofessional collaboration (IPC) will contribute to improvement of health outcomes, as stated by the WHO. However, the IPC initiatives that have been undertaken in hospitals show mixed results in terms of both the success of the implementation and the health outcomes. Knowledge of facilitating factors and barriers of IPC is essential for successful implementation in health systems. The aim of this scoping review is to identify facilitating factors and barriers to effective IPC in the hospital setting. Methods Three major databases (Medline, CINAHL, Embase) were systematically searched from 2010 to 7 November 2023. Studies were included if they explicitly reported on IPC, included factors in the hospital setting, and were published after the 2010 WHO framework on IPC. Studies were excluded if they focused on education or research. A thematic synthesis was conducted to identify facilitating factors and barriers. Results Fifty-three reports were included. 44 studies describe facilitating factors, while 47 studies mention barriers. Factors were categorised as relational, organisational, processual or contextual, following the framework for interprofessional teamwork. Relational factors are, by far, the most frequently and extensively described. Most factors are complementary (e.g. familiarity a facilitating factor, lack of familiarity a barrier). However, some factors were only described as barriers: legal responsibility, workload/other tasks, and gender. Interestingly, studies in other fields have found that gender diversity leads to better team performance and occupational well-being, which is different from the findings in IPC. Conclusions and implications This scoping review provided a comprehensive overview of facilitating factors and barriers to IPC. Many facilitating factors and barriers were found, most of which were different sides of the same coin. Key factors for effective IPC include: obtaining a shared goal; facilitating interprofessional identity; reducing dysfunctional hierarchies; reducing medical dominance; overcoming personal differences such as gender and race. These factors should be taken into account when designing IPC.