NSG 426 Week 4 – Assignment: Examine Barriers to Collaborative Models
NSG 426 Week 4 – Assignment Examine Barriers to Collaborative Models
Frequently Asked Questions |
| What does a Collaborative Care Model (CCM) represent from a healthcare dimension? |
| The current health practice is multidimensional. Thus, health practitioners from different disciplines must work together to optimize patient outcomes. To achieve this goal, CCM promotes collaborative care, where primary care providers, mental health professionals, and other practitioners share resources, knowledge, and experience to ensure that diverse patients receive patient-centered, cost-effective care (Rugkåsa et al., 2020; Aragonès et al., 2022). The model also ensures that patients receive healthcare services at a convenient location from the right provider. |
| Which are the essential components of a collaborative model that enable it to achieve the desired goals? |
| Critical components include cooperative relationships with clear professional roles, interprofessional communication, and structured organization and follow-up. The implication is that collaborating teams should work together without conflicting roles and embrace interprofessional communication. Besides, Rugkåsa et al. (2020) emphasized the importance of co-location, where collaborative team members share the same physical location to minimize coordination barriers. Care coordination is also important for CCM to be effective. |
| What are the main barriers and challenges that healthcare professionals face when using a Collaborative Care Model? |
| Challenges vary with the composition of teams, the type of work, and the intensity of patient care involved. Barriers and challenges can be categorized into three groups: staff-centered issues, practical issues, and structural problems. |
Staff-Centered Issues |
| These include problems related to the healthcare staff, including interaction, knowledge, and how healthcare professionals embrace care coordination. They include stakeholders’ attitudes to collaboration, how the collaborating team understands each other’s roles, and how responsibilities are shared (Rugkåsa et al., 2020). The other barrier in this category is training issues since it affects nurses’ knowledge to implement collaborative care. |
Practical Issues |
| Broadly, these are barriers that deny the collaborative care team the ample time required to engage in patient care while enjoying the assigned roles. Such barriers affect commitment and nurses’ attitudes toward team-based roles. Such barriers include inadequate space for extra staff and lack of reimbursement (Rugkåsa et al., 2020). How doctors and nurses view collaborative care also affects its effectiveness and overall implementation. As Aragonès et al. (2022) mentioned, doctors and nurses are less committed to collaborative care if they view the assigned roles as outside their area of responsibility. In this case, a CCM cannot be effectively implemented if it results in a high workload or denies healthcare professionals adequate time to engage in activities besides meeting patients’ regular demands. |
Structural Problems |
| These implementation barriers are primarily of organizational nature and how the organizational management prepares healthcare professionals to work as a team. For instance, staff shortages and high turnover rates hamper workflow and collaboration between nurses and doctors (Mathisen et al., 2021). The other huge structural barrier is the timing of the implementation and the approach. For instance, doctors and nurses resist new initiatives if they are launched simultaneously and create more work (Aragonès et al., 2022). Projects, programs, and activities that compete with healthcare professionals’ time and attention face resistance. Aragonès et al. (2022) further mentioned the possibility of nurses resisting collaborative models that have been imposed top-down. In this case, resistance and the implementation approach are correlated. |
| How does nurses’ expertise affect collaborative care and the implementation process? |
Nurses are primary care providers centrally involved in routine patient care. Their attitude, knowledge, and skills affect their preparedness and overall health outcomes. In the same view, nurses’ expertise affects collaborative care and the implementation of collaborative care models. As Rugkåsa et al. (2020) noted, effective collaboration requires healthy communication between providers and skillful use of information technology (IT) systems. If not skilled, nurses cannot use communication and IT systems effectively in care coordination. As a result, the implementation process would be low or fail to materialize if nurses do not have the essential skills. It is also important to note that nurses feel insecure and uneasy about participating in collaborative projects if they lack the essential skills, knowledge, and training (Aragonès et al., 2022). The insecurity and unease feelings undermine their participation and attitude toward collaborative care.
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How do patients affect collaborative care model’s implementation? |
| The main role of a CCM is to promote patient-centered care. However, the desired goals cannot be achieved without patient engagement and cooperation. Aragonès et al. (2022) noted that patients’ resistance is a key barrier to the implementation of collaborative care. Like nurses, they resist participation depending on how they perceive care coordination and the team members involved. |
What are the implications of these challenges and barriers in health practice? |
| Healthcare teams should always work together to share roles and expertise. Implementation barriers and challenges imply that healthcare organizations might not achieve CCM’s goals, or their achievement might take longer to attain. Research shows that collaborative care is instrumental to patient satisfaction, promoting team mentality and the achievement of comprehensive patient care (Rosen et al., 2018). As a result, implementation barriers prevent healthcare organizations from achieving these goals. Besides, collaborative care helps team members to share skills as they work to achieve a common goal (Wittenberg et al., 2019). The barriers prevent them from learning from each hence the need for effective responses that vary with the type and severity of the barriers. |
How can these problems be addressed in healthcare settings? |
| Interventions in response to the challenges and barriers are multifaceted due to the multi-layered nature of the problems experienced by healthcare agencies when trying to integrate services by collaborating across disciplines. Appropriate interventions include skills development, engagement of nurses during implementation, adherence to collaborative care principles, and reducing nurse turnover. Each recommendation achieves different outcomes, and CCM’s implementers should be adequately aware of their purpose. |
Skills development and collaborative care |
| Healthcare agencies should continually assess healthcare teams’ skills and their preparedness to engage in collaborative practice. Inadequate skills and knowledge make nurses and doctors feel uneasy and insecure about engaging in collaborative programs (Aragonès et al., 2022). As a result, skills development through appropriate training is necessary to improve the interdisciplinary team’s knowledge and skills and ensure they do not feel uneasy to insecure. |
Nurses’ engagement and collaborative care |
| Many healthcare projects fail when stakeholders are not actively engaged in the implementation process. The same applies to CCM’s implementation since nurses must be sufficiently involved to accept new roles (Aragonès et al., 2022). Such engagement changes nurses’ attitudes toward collaborative programs and reduces possible resistance from stakeholders. |
Adherence to collaborative care principles |
| Collaborative teams should work with clarified roles and goals. The main guiding principles of collaborative care include working with shared plans, incorporating patient goals, and evidence-based care (Unützer et al., 2020). Adhering to these principles prevents conflicts among healthcare teams and ensures that they work seamlessly as their roles obligate. |
Preventing nurse turnover |
| Collaborative care teams should work together consistently. A high staff turnover implies working with one person and then with another, which hampers the team’s stability (Aragonès et al., 2022). Consequently, nurse turnover should be prevented to optimize a team’s stability. Dewanto and Wardhani (208) also found that there is a possibility for replacement nurses’ skills failing to meet the expected performance standards. Since teams require consistency and stability, healthcare agencies should implement appropriate measures for nurse turnover prevention. They include career development opportunities, a manageable workload to prevent nurse turnover, and nurse motivation. Leadership support is also vital to offer guidance and moral support to healthcare teams. |
What should healthcare agencies look forward to as they address these challenges and barriers? |
| There are many benefits of a collaborative care model in healthcare agencies for patients and healthcare practitioners. Through collaboration, patients can receive patient-centered care, implying that healthcare services are tailored to meet patients’ needs (Rugkåsa et al., 2020; Kuipers et al., 2019). Besides, collaborative care promotes teamwork among diverse teams, increasing job satisfaction and empowering nurses to address complex patient demands more effectively. Communication gaps also reduce through care coordination and dialogue among healthcare professionals. |
NSG 426 Week 4 – Assignment: Examine Barriers to Collaborative Models References
Aragonès, E., López-Cortacans, G., Cardoner, N., Tomé-Pires, C., Porta-Casteràs, D., & Palao, D. (2022). Barriers, facilitators, and proposals for improvement in the implementation of a collaborative care program for depression: a qualitative study of primary care physicians and nurses. BMC Health Services Research, 22(1), 1-11. https://doi.org/10.1186/s12913-022-07872-z
Dewanto, A., & Wardhani, V. (2018). Nurse turnover and perceived causes and consequences: a preliminary study at private hospitals in Indonesia. BMC Nursing, 17(2), 1-7. https://doi.org/10.1186/s12912-018-0317-8
Kuipers, S. J., Cramm, J. M., & Nieboer, A. P. (2019). The importance of patient-centered care and co-creation of care for satisfaction with care and physical and social well-being of patients with multi-morbidity in the primary care setting. BMC Health Services Research, 19(1), 1-9. https://doi.org/10.1186/s12913-018-3818-y
Mathisen, J., Nguyen, T. L., Jense, J. H., Rugulies, R., & Rod, N. H. (2021). Reducing employee turnover in hospitals: Estimating the effects of hypothetical improvements in the psychosocial work environment. Scandinavian Journal of Work, Environment & Health, 47(6), 456–465. https://doi.org/10.5271/sjweh.3969
Rosen, M. A., DiazGranados, D., Dietz, A. S., Benishek, L. E., Thompson, D., Pronovost, P. J., & Weaver, S. J. (2018). Teamwork in healthcare: Key discoveries enabling safer, high-quality care. The American Psychologist, 73(4), 433–450. https://doi.org/10.1037/amp0000298
Rugkåsa, J., Tveit, O. G., Berteig, J., Hussain, A., & Ruud, T. (2020). Collaborative care for mental health: a qualitative study of the experiences of patients and health professionals. BMC Health Services Research, 20(1), 1-10. https://doi.org/10.1186/s12913-020-05691-8
Unützer, J., Carlo, A. D., & Collins, P. Y. (2020). Leveraging collaborative care to improve access to mental health care on a global scale. World Psychiatry: Official Journal of the World Psychiatric Association (WPA), 19(1), 36–37. https://doi.org/10.1002/wps.20696
Wittenberg, E., Goldsmith, J. V., Ragan, S. L., & Parnell, T. A. (2019). Communication in palliative nursing: The COMFORT model. Oxford University Press.