Keywords: Implementation, Collaborative care, Persistent somatic symptoms, Strategies, World Café
Introduction:
Persistent somatic symptoms and functional disorders (PSS/FD) are complex conditions requiring care from multiple disciplines. Collaborative care is one route to provide this care with multiple disciplines working together. One challenge lies in dealing with barriers to implementation of collaborative care. We therefore aim, with the use of expert knowledge, to develop realistic strategies for overcoming a number of implementation barriers in PSS/FD care.
Method:
The Research World Café method is a single-session expert-based method with multiple focus-groups forming and reforming to answer a set of interrelated questions, under the guidance of moderators. In this case, the experts were professionals involved in PSS/FD care across different areas of healthcare in the Netherlands. The strategies were developed in response to implementation barriers derived from a Delphi study in which quality indicators were identified by 86 healthcare professionals in the Netherlands. The strategies developed, with the framework of the SMART model, were grouped based on similarities into strategy targets.
Results:
Thirty-three participants took part, representing ten different disciplines, most commonly physiotherapists, psychologists and physicians. A total of 54 strategies, grouped into eight strategy targets, were identified in response to ten barriers, with a range of three to nine strategies for each barrier. The strategy targets that address the most barriers relate to professional education, communication, care coordination, and joint consults.
Conclusions:
A number of useful strategies are identified for dealing with implementation barriers for collaborative care, primarily in PSS/FD. These results provide specific ideas for each implementation stategy, as well as ways to deal with multiple barriers at one. This can ease the implementation process for collaborative care in PSS/FD and other areas such as multi-morbidity. These results will need application and testing, and may have significant policy implications when seeking to apply collaborative care.
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