Care managers' experiences of interprofessional collaborative practice with physicians in community-based integrated care: a qualitative study.

Abstract

Objective: Under Japan's Long-term Care Insurance system, care managers (CMs) are expected to function as coordinators in the community-based integrated care system. However, few studies have focused on inter-professional collaboration between medical and non-medical professionals. The aim of this study was to identify CMs' perspectives on enablers and barriers to successful collaboration between care managers and physicians within the community.

Patient/materials and methods: We targeted care managers with ample experience working as CMs in the community and recruited 12 CMs using snowball sampling. Online interviews were conducted from January to May 2023 using an open-ended questionnaire concerning participants' experiences of collaborating with physicians and integrating medical services into care management. Qualitative data were analyzed through inductive manual coding using a qualitative content analysis approach.

Results: Four main themes were identified as enablers and barriers to successful CM-physician collaboration in the community: medical knowledge, professional attitudes, communication skills, and the professional culture of medicine. Equipping CMs with practical medical knowledge is essential for effective communication. Professional attitudes among CMs are imperative to fostering collaborative relationships. Effective communication skills are another critical factor, emphasizing the need for clarity, specificity, and utilization of nurses as key mediators in physician-care manager dialogue. Recognizing and navigating the professional culture of medicine is essential to overcome barriers stemming from differences in norms, beliefs, and practices between CMs and medical professionals.

Conclusion: This study underscores the significance of interprofessional education focusing on cultural differences and the development of systematic learning approaches to enhance CMs' medical knowledge of CMs. Furthermore, the findings highlight the need for clarity in defining CMs' roles within healthcare teams and addressing physicians' misperceptions regarding their contributions and responsibilities.