Introducing a conceptual framework for reflective team dialogue to foster interdisciplinary collaboration in community health centers in Flanders & Brussels

Short intro:  By facilitating a reflective team dialogue on key elements of interdisciplinary care, the framework “Complementary Care” supports primary care teams in shifting from multidisciplinary to interdisciplinary collaboration.

Abstract: The Association of Community Health Centers (CHC) overarches a diverse set of 37 interdisciplinary primary care practices in Flanders and Brussels. The centers are funded  via a needs based capitation model. Although team collaboration is facilitated by practical and financial factors, there was a need for strengthening interdisciplinary collaboration. 

A reflective framework was developed by an interdisciplinary group of primary care professionals. It was described that the CHCs wanted to evolve from task shifting towards task sharing. In task shifting, care tasks are delegated from one team member to another team member. Task sharing however is a the uptake of integrated care by the whole team in shared responsibility and based on a shared vision of care, via the acknowledgment, recognition and optimal usage of the qualities in the interdisciplinary  team. A participative trajectory, including 47 primary care professionals from 11 different disciplines, led to the identification of six essential buildings stones to work towards task sharing: (1) the acknowledgment of other team members in their expert role, (2) the composition of the team, (3) self care, (4) shared ownership, (5)  speaking a common language and (6) a sense of equality within the team. The developed framework has been tested as a discussion tool in 5 interprofessional teams. Preliminary evaluation shows that it has led to the implementation of quick wins and more profound transitions towards integrated care. A further dissemination of the framework is planned trough in-site visits of CHCs.