Social and healthcare professionals' work to establish coherent rehabilitation pathways for people with inflammatory arthritis: a qualitative study.

Background: Professionals in health and social care are challenged by the complexity and fragmentation across primary and secondary levels of care. To study coherent rehabilitation pathways, we focused on people with inflammatory arthritis admitted to a specialised rehabilitation stay as these pathways will involve a myriad of different professionals from primary and secondary levels of care. This study aimed to explore how health and social care professionals establish coherent rehabilitation pathways for people with inflammatory arthritis across primary and secondary levels of care and how organisational factors influence on workflow.

Methods: Twenty-four situations between professionals and clients were observed during an inpatient rehabilitation stay. In addition, semi-structured interviews with 26 health and social care professionals from primary and secondary levels of care were conducted. An abductive approach guided the analysis and applied person-centred and integrated care concepts.

Results: Three themes were derived from the analysis: (1) Person-centred interactions with clients, highlighting that professionals wanted to respond to clients' preferences; (2) inter-dependent interactions between professionals, reflecting dependence on collaboration across primary and secondary level of care; and (3) economic and cultural frameworks influence professionals' work.

Conclusion: Professionals strive to take a person-centred approach and must coordinate and communicate with other professionals to create coherent rehabilitation pathways. However, economic and cultural frameworks influenced by the logic of public management and medical professionalism may hinder these intentions.

Clinical trial number: Not applicable.