TABLE 1.
Overview of the 32 articles included in the literature review
Study | Aim | Study design and method | Subject | Main results | Theme |
---|---|---|---|---|---|
Adekpedjou et al. (2020) (Canada) |
To assess home care providers' intentions to engage in interprofessional shared decision‐making in relation to a parent study on the training of interprofessional shared decision‐making | A quantitative questionnaire study |
Education and training Intervention Shared decision‐making |
Intentions to engage in interprofessional shared decision‐making decreased and their associated factors changed during the study. Discouraged engagement, as well as increased staff workload and turnover, can be a result of a significant increase in extra clients per care provider and major changes in the health and social care systems. Intentions are often associated with moral norms but can also be driven more by practical issues than morally acceptable or desirable ones |
Teamwork around a specific task or problem Organisational learning Organisational change |
Berggren et al. (2017) (Sweden) |
To ‘evaluate, by profession, the effectiveness of an interprofessional educational intervention for district nurses and general practitioners on three areas of nutritional care for patients in a palliative phase’ (Berggren et al., 2017, p. 1) | A quantitative questionnaire study |
Education and training Intervention Nutritional care |
Significant positive effects were identified for the district nurses and general practitioners in the areas of perceived familiarity and perceived collaboration. For the third area, levels of knowledge, the effects were only significant for general practitioners |
Teamwork around a specific task or problem Organisational learning |
Bjornsdottir (2018) (Iceland) |
To ‘… enhance our knowledge and understanding of the nature of good home care nursing as practice’ (Bjornsdottir, 2018, p. 178) | A qualitative interview and shadowing study |
Nature of home care nursing Community home care Facilitate care relations |
Nurses perceive good care as dependent on connections and coordination between care participants. Home care nursing is largely a matter of teamwork where responsibilities and expertise are fluid. Values and ideas develop and change over time. It is important to give time to staff engaged in home care to develop a common understanding of each caring situation and authority to decide what needs to be done and when |
Descriptive studies of teamwork characteristics Teamwork around a specific task or problem Team skills |
Castor et al. (2017) (Sweden) |
To ‘explore health care professionals' conceptions of caring for sick children in home care services’ (Castor et al., 2017, p. 2786) | A qualitative focus group study | Paediatric home care | A pre‐requisite for caring for children at home is to give healthcare professionals enough time and flexibility when organising visits, well‐functioning teamwork in home care services and sufficient time for debriefing | Teamwork around a specific patient group |
De Groot et al. (2018) (Netherlands) |
‘To gain in‐depth knowledge about which aspects home care nurses find attractive about their work’ and ‘to explore whether these aspects vary for home care nurses with different levels of education’ (De Groot et al., 2018, p. 95) | A qualitative online focus group study | Work attractiveness | Nurses find being ‘linchpins’ in the community, having autonomy over care decision‐making, freedom in work schedule, working in self‐directed teams and having a variety of patient situations and nursing activities are important contributors to making work attractive | Teamwork and work environment |
Dhollander et al. (2019) (Belgium) |
‘To explore the existing barriers to early integration as perceived by the palliative home care teams’ (Dhollander et al., 2019, p. 2) | A qualitative focus group study | Oncology home care | Lacking financial resources, cross‐sectional collaboration, interdisciplinary communication, and existing societal perceptions of palliative care as terminal care counteract early involvement of palliative care for cancer patients at home | Teamwork around a specific patient group |
Fløystad et al. (2018) (Norway) |
To “…describe aspects of collaboration during interprofessional medication review processes…” (Fløystad et al., 2018, p. 83) and explore how they can strengthen service delivery for elderly home care patients | A qualitative focus group study | Medication management | Team leadership responsibilities for planning and running interprofessional medication reviews as well as involving different professionals are important to create good overviews of elderly home care patients. Professionals need opportunities to meet, communicate, and clarify their respective competencies | Teamwork around a specific task or problem |
Fujita et al. (2017) (Japan) |
To ‘define the team type by collaboration relationship among’… ‘the three core healthcare professionals’ … ‘doctors, home‐visiting nurses and care managers’ and ‘to clarify the factors that contributed to the successful care by the team types’ (Fujita et al., 2017, p. 1944) | A quantitative questionnaire study | Team types | The following were found to affect collaborative relationships within teams: patient conditions, team members' previous experiences working with each other, doctors' understanding of other professionals, nurses' experience of end‐of‐life care and collaborative practices, training background of care managers as well as the use of communication tools | Descriptive studies of teamwork characteristics |
Gonghom and Tantivitayatan (2018) (Thailand) |
To ‘propose a model for home health care which provides safety, quality care, and efficiency in the Thai context together with means to assess team collaboration’ (Gonghom & Tantivitayatan, 2018, p. 2) | A digital communication study | Digital communication | Virtual teams in home healthcare are capable of pursuing continuity of care. Technology can help solve problems related to access to services. It can also function as an alternative strategy to address the medical staff shortage. However, the team studied still favoured making medical decisions through synchronous rather than asynchronous communication | Teamwork and digitalisation |
Gudnadottir et al. (2019) (Iceland) |
To ‘…explore the impact of the integration of home care nursing and social services…’ (Gudnadottir et al., 2019, p. 75). More specifically, they investigate how ‘…home care nursing and social services work together’ (Gudnadottir et al., 2019, p. 75) | A qualitative interview and focus group study | Integrated home care nursing and social service | Despite strong and efficient interdisciplinary coordination between team management in social services and home care nursing, weaknesses in collaboration among care workers were identified. Full integration requires attention to providing members from different groups with opportunities to meet, develop mutual understandings of their specific roles and the care they provide and to create a shared vision. Integration is an active process requiring active leadership to develop | Teamwork around a specific task or problem |
Hoff and Scott (2017) (U.S.A.) |
To understand “how primary care physicians and staff perceive, experience, and use certain types of patient‐centered medical home work for adapting to new demands…” to gain “…insights into patient‐centered medical home implementation at the workplace level.” (Hoff et al., 2017, p. 226) | A qualitative interview study | Patient‐centered medical home care model | Physicians and health care workers are highly proactive and strategic by nature. They push change forward within organisations irrespective of factors in the work environment such as culture, payment, and leadership if they are provided with positive experiences that reinforce how PCMH activities can be perceived and found to be useful | Teamwork around a specific task or problem |
Josefsson and Peltonen (2015) (Sweden) |
To “explore district nurses' experiences of working in home care after the transfer of home care to municipals from county councils.” (Josefsson & Peltonen, 2015, p. 2) | A qualitative interview study | Care responsibility transfer | District nurses experience better patient conditions in municipal home care compared to the former county council home care. Simultaneously, their work has become more difficult because of organisational barriers. Municipal organisations do not fully meet the requirements to carry out home care and need to address shortcomings to enable district nurses to work satisfactorily and promote competence development | Organisational change |
Karlsson et al. (2015) (Sweden) |
To ‘explore home healthcare teams' experiences of pain assessment among care recipients with dementia’ (Karlsson et al., 2015, p. 192) | A qualitative interview study |
Pain assessment Dementia home care |
Pain assessment in dementia patients is challenging. The assessment is guided by obtaining an understanding of behavioural changes in which team coherence aids the procedure. Complementary experience‐based methods are used and motivated by concerns for ethics and responsibility |
Teamwork around a specific task or problem Teamwork around a specific patient group |
Klarare et al. (2020) (Sweden) |
To ‘describe team leaders' experiences of facilitators and barriers of leadership in specialist palliative home care teams’ (Klarare et al., 2020, p. 104) | A qualitative interview study | Leadership | Team leadership is complex and demanding. It is also challenging in relation to organisational issues, feelings of responsibility and team size. Multilevel demands influence team leaders' vision and leadership, from assignments and leadership tasks to involvement in interpersonal discussions and relationships | Team skills |
Klarare et al. (2019) (Sweden) |
Identifying team types in Swedish specialist palliative care and exploring connections between the type, maturity and effectiveness in home care teams | A quantitative questionnaire study |
Team types Team maturity Team effectiveness |
The teams investigated varied predominantly between inter‐ and trans‐professional types. More mature teams tend to work in an integrated manner rather than in parallel, with reportedly higher effectiveness | Descriptive studies of teamwork characteristics |
Larsen et al. (2017) (Sweden) |
To illustrate how professionals in homemaker services, municipal home care, and hospital‐based care services experience interprofessional collaboration in caring for older people with multimorbidity | A qualitative interview study |
Collaboration Geriatric home care |
Collaboration across organisations in home health care is complex and influenced by the environment, expectations, roles, and cultures. Simple solutions are rare and instead often based on regulations and structure. Organisational interdependence, close staff interactions, flexibility, and improvisation are identified as key features; not erecting boarders between basic and specialised care |
Descriptive studies of teamwork characteristics Teamwork a around specific patient group |
Lee et al. (2019) (Australia) |
Exploring medication management processes, and describing perceived barriers and challenges by community nurses, pharmacists, and general practitioners providing medication management services for home nursing clients | A qualitative focus group, interview and stakeholder consultation meeting study | Medication management | Client safety, workforce productivity and interprofessional relationships are negatively affected by insufficiencies in interdisciplinary communication, team functionality, organisational or workplace policies, processes and systems. Evidence‐based strategies are needed to improve interdisciplinary medication management and medication safety | Teamwork around a specific task or problem |
Légaré et al. (2013) (Canada) |
To ‘evaluate healthcare providers' intentions to engage in interprofessional shared decision‐making and to identify factors associated with their intentions’ (Légaré et al., 2013, 215) | A mixed method study based on questionnaires, interviews and a focus group | Shared decision‐making | Home healthcare providers demonstrate positive intentions, but of different underlying factors, to engage in interprofessional decision‐making. It is important to translate interprofessional shared decision‐making into clinical practice for each type of care provider. Lack of time, poor team cohesion and high staff turnover are identified as barriers to avoid | Teamwork around a specific task or problem |
Lindblad et al. (2018) (Sweden) |
To ‘explore how patient safety is described and addressed in specialised home healthcare from the perspectives of multidisciplinary teams and clinical managers’ (Lindblad et al., 2018, p. 2) | A qualitative interview study | Patient safety | Patient safety in home healthcare is based on a team ideology of enhancing care co‐creation through patient autonomy, competence and relatedness. Efforts to keep patients safe while also improving care are a never‐ending battle where patient behaviour and preferences are in contrast to standardisations and quality assessments | Teamwork around a specific task or problem |
Maurits et al. (2017) (Netherlands) |
To examine if working in self‐directed teams influences nurses' job satisfaction, assess mediating effects of perceived autonomy over patient care and investigate how education moderates the association between autonomy over patient care and job satisfaction | A quantitative questionnaire study | Job satisfaction | Nurses working in highly self‐directional teams are more satisfied with their jobs. Self‐direction is significantly related to job satisfaction. Autonomy over patient care is positively related to job satisfaction but partly mediated. Registered nurses with bachelor's degrees and certified nursing assistants show a positive relationship between autonomy over patient care and job satisfaction, while registered nurses with associate degrees do not show this significant relationship | Teamwork and work environment |
Mertens et al. (2019) (Belgium) |
To ‘explore how community nurses experience the collaboration with the general practitioner and the palliative home care team nurse in palliative home care…’ and ‘…the perceived factors influencing this collaboration’ (Mertens et al., 2019, p. 3862) | A qualitative interview study | Collaboration | Team member approachability and acquaintance positively influence collaboration. Community nurses need to be highly adaptable during interprofessional home care collaboration. Doctor–nurse dynamics are still influenced by traditions of old, affecting communication. Specialist palliative home care team nurses' function as experts and mediators when community nurses disagree with general practitioners. Interprofessional education and early socialisation can help improve interprofessional relations and teamwork | Descriptive studies of teamwork characteristics |
Nasarwanji et al. (2015) (U.S.A.) |
‘To better understand the hospital to skilled home health care transition and workflow challenges…’ (Nasarwanji et al., 2015, p. 187) | A qualitative contextual inquiry and shadowing study |
Care transition Geriatric home care |
Information access, coordination, communication and teamwork are important factors when transitioning older adult patients from hospital to skilled home healthcare. Skilled home healthcare coordinators need to be able to create referrals using information from the whole team and seamlessly transition the information across healthcare settings |
Teamwork around a specific task or problem Teamwork around a specific patient group |
Neergaard et al. (2010) (Denmark) |
To describe experiences and views of health professionals on interprofessional collaboration in basic‐level palliative home care | A qualitative group interview study | Cooperation | Problems are indicated at both the organisation level and among health professionals regarding work culture. The main issues to improve care delivery are task distribution, information exchange, availability, respect and personal acquaintance within the team | Descriptive studies of teamwork characteristics |
Noguchi‐Watanabe et al. (2019) (Japan) |
To evaluate long‐term ‘…effects of an interprofessional collaboration promotion program among community healthcare professionals’ (Noguchi‐Watanabe et al., 2019, p. 660) | A quantitative questionnaire study |
Collaboration Education and training Intervention |
Interprofessional collaboration, familiarity and meeting and talking improved significantly for those attending the program. Improvements were not significantly different between one‐ and two‐time workshop participants |
Descriptive studies of teamwork characteristics Organisational learning |
Perron et al. (2019) (Switzerland) |
To explore home care professionals' practices and perceptions regarding written interprofessional communication | A qualitative communication and focus group study | Written communication skills | Interprofessional written communication is rarely explicit. Health professionals write about different topics based on their profession. A lack of clarity exists about what to document and for whom. Openly accessible notebooks at home make health professionals unsure of how to manage confidential information sharing among themselves vis‐à‐vis the desire to actively involve patients and families | Team skills |
Pype et al. (2015) (Belgium) |
To describe ‘the evaluation of a training program for palliative home care team nurses to act as facilitators of general practitioners' workplace learning’ (Pype et al., 2015, p. 459) | A mixed method interview, progress report and video recording study |
Education and training Intervention Workplace learning |
A feasible but complex intervention is to train palliative home care team nurses to facilitate general practitioners' workplace learning. Careful and individualised mentoring is required where personal characteristics, interpersonal relationships and contextual variables need to be accounted for |
Organisational change Organisational learning |
Pype et al. (2014) (Belgium) |
The study aims ‘…to identify what, how and from whom health care professionals learn…’ (Pype et al., 2014, p. 1) during interprofessional collaboration in palliative home care | A quantitative questionnaire study |
Collaboration Education and training Workplace learning |
General practitioners and palliative home care team nurses learn a lot from collaboration in primary palliative care. Learning activities, content and from whom they learn to depend on their profession. General practitioners learn equally from the discussion, reflection, listening and observation, whereas nurses learn more from listening and observation. Learning from discussion and reflection is less prevalent for nurses even though they share expertise with professionals and non‐professionals alike |
Descriptive studies of teamwork characteristics Organisational learning |
Ree and Wiig (2019) (Norway) |
To explore ‘Employees' perceptions of patient safety culture in Norwegian nursing homes and home care services (title), and to assess how cultural dimensions contribute to the overall perceptions of patient safety | A quantitative questionnaire study | Patient safety | The investigated nursing homes and home care services had higher incident reporting and non‐punitive mistake responses than other international studies. Even though perceived differently, both view staffing and teamwork as being important to patient safety. Mutual trust and collaboration in home care teams as well as enabling open communication and value assurance about ideas and suggestions given in nursing homes are considered important to improve patient safety |
Teamwork around a specific task or problem |
Shaw et al. (2016) (Canada) |
To explore ‘…views of an interprofessional group of home care providers…regarding a pilot project encouraging’ (Shaw et al., 2016, p. 262) interprofessional teamwork in palliative home care services | A qualitative interview study |
Education and training Intervention |
Three key strategies are identified to maximise interprofessional palliative care: giving time and space for service providers to share experiences and foster common goals, establishing a clear team leader that emphasises sharing power among team members and encouraging mutual emotional support during team interactions |
Organisational change Organisational learning |
Sun et al. (2019) (Canada) |
To ‘explore the barriers and enablers of deprescribing from the perspectives of home care nurses, as well as to conduct a scalability assessment of an educational plan to address the learning needs of home care nurses about deprescribing’ (Sun et al., 2019, p. 2) | A qualitative focus group study |
Medication management Patient safety |
Safe polypharmacy management and deprescription challenges for older home care patients are associated with a lack of open communication, inconsistent medication reconciliation practices, inadequate partnerships and ineffective interprofessional healthcare provider collaboration. Home care nurses have a vital role in medication management and polypharmacy reduction, emphasising the need for more consistent and standardised approaches in educating healthcare providers, informal caregivers and patients alike | Teamwork around a specific task or problem |
Tourangeau et al. (2014) (Canada) |
‘To identify factors affecting Canadian home care nurse intention to remain employed’ (Tourangeau et al., 2014, p. 1015) | A qualitative focus group study | Staff retention | Job satisfaction is not shown to affect home care nurses' intentions to remain employed. Factors of autonomy; flexibility; workload; supportive work relationships with patients, families, nursing colleagues and supervisors; opportunities for orientation and education; personal safety; travel demands; clinical support and physical resource availability; employment status and pay were found to be influential | Teamwork and work environment |
Vaartio‐Rajalin et al. (2019) (Finland) |
To ‘describe nurses' experiences of working in home healthcare and their suggestions for the development of this public healthcare sector’ (Vaartio‐Rajalin et al., 2019, p. 260) | A qualitative interview study | Experiences in daily work | Affirmative work shifts for nurses go smoothly and as planned without unexpected tasks, with enough time to document and discuss clients. Non‐affirmative work shifts were comprised of barriers to manage tasks smoothly, burdensome IT programs and an unclear division of responsibility. The more that nurses are engaged in patient‐related nursing activities, patient‐centeredness, collaboration and forward planning, the more perceived influence they have over their work. Suggestions for improvement include collaboration between settings, revised task division, revised IT resources and flexible schedule planning | Descriptive studies of teamwork characteristics |