Understanding barriers and enablers to collaborative eye care in Queensland, Australia.

Abstract

Clinical relevance: Collaborative eye care, where the skills of health professionals are utilised to their maximum capability, enhances patient outcomes. Optometrists are highly skilled eye care practitioners and yet their involvement in collaborative care is relatively limited.

Background: The aim was to understand the barriers and enablers to optometrists working in collaborative eye care within Queensland and identify key factors that affect optometry involvement.

Methods: A mixed-methods approach comprised three parts. A) Survey of optometrists working in Queensland asking for their opinion on collaborative eye care. B) Interviews with optometrists working in public hospitals in Queensland. C) Responses from both the survey and interviews were deductively coded to the Theoretical Domains Framework (TDF) to identify barriers and enablers to collaborative eye care. The survey included 21 Likert-scaled questions and 9 free-text questions. Structured interviews asked questions about working in a collaborative eye care environment, transcripts were downloaded and checked for accuracy. Key TDF domains were mapped to the Capability, Opportunity, Motivation-Behaviour (COM-B) model and Behaviour Change Wheel (BCW) to identify potential intervention functions to support collaborative eye care.

Results: Survey responses were received from 41 optometrists and 10 interviews were conducted. The Likert section of the questionnaire demonstrated strong internal consistency (Cronbach's alpha = 0.837) and response variation to individual questions (Friedman Chi-Square = 233, p = 0.001). Key enablers included optometrists having strong professional networks, effective communication pathways, high confidence in clinical skills and proximity to specialist care. Collaboration was constrained by inadequate referral pathways, lack of recognition of the role of optometrists and inadequate remuneration. Identified intervention strategies include enhancing capability through mentorship, restructuring environments to include shared information platforms, appropriate renumeration, and professional development opportunities.

Conclusion: Critical enablers and barriers to collaborative eye care amongst Queensland optometrists were identified. Addressing the lack of infrastructure, professional recognition, and financial incentives could strengthen collaborative practices.