[Towards sustainable medical care for older people with complex multimorbidity by interprofessional collaboration: lessons from experiences in the long term care].

Abstract

Background: delivering medical care of appropriate quality to older people with complex multimorbidity will be challenging in the next few decades and is already under pressure in the long term care setting. Interprofessional collaboration between elderly care physicians, nurse practitioners and physician assistants can contribute to the sustainability of this care.

Objective: to describe the experience with interprofessional collaboration of physicians, nurse practitioners and physician assistants in long term care and get insight in facilitators and challenges for it.

Methods: focus group interviews were conducted with elderly care physicians, nurse practitioners and physician assistants from several long term care organisations were conducted, who collaborated as professionals for some time.

Results: interprofessional collaboration was valued positively. Themes emerging from the interviews were: 'scarcity of physicians as reason employing nurse practitioners and physician assistants'; 'unfamiliarity with competencies of nurse practitioners and physician assistant among physicians'; 'trust'; 'added value'; 'absence of protocols/formats' and 'legal and regulation barriers'.

Discussion/conclusion: the emerging themes fit within an existing theoretical model about development of interprofessional collaboration. The development of interprofessional collaboration in long term care fits in the first phases of this model. Important steps for realizing further interprofessional collaboration in daily practice is being aware of and valuing each other's competencies. Also formats that describe competencies and collaboration procedures are considered helpful. Positive for further development is the recent formal support of the three professional organisations together, offering perspective for sustainability of medical care for older people with complex multimorbidity in the coming decades.].