Patient perspectives on transdisciplinary models of care in allied health: a qualitative study

Abstract

Background

Demand for allied health services continues to grow, driven by rising chronic disease, multimorbidity, and workforce shortages. Although allied health professions each maintain distinct disciplinary expertise, overlap in assessment, treatment, and discharge planning may lead to duplication. Transdisciplinary care, where professionals work across traditional disciplinary boundaries to provide integrated, streamlined care, has emerged as a potential approach to address workforce and duplication challenges. While early studies suggest transdisciplinary models may improve satisfaction and efficiency, patients’ perspectives remain underexplored. This study aimed to explore patient experiences of allied health care across hospital settings and their perspectives on transdisciplinary care to inform future service design.

Methods

A qualitative study guided by interpretive description was conducted at a large metropolitan tertiary hospital. Adults who had received care from at least two allied health disciplines were recruited using purposive sampling to ensure diverse care experiences. Fifteen participants completed semi‑structured interviews in person, via telephone or videoconference. Interviews were audio‑recorded, transcribed verbatim and analysed inductively using thematic analysis. Four researchers independently coded transcripts, met to refine themes, and returned to the data to ensure coherence and representation of participant perspectives.

Results

Three overarching themes reflected how good communication, co‑ordination, and compassionate care fostered trust and confidence in allied health professionals. First, participants valued care that was continuous, well‑co‑ordinated, and centred around their individual goals. They perceived transdisciplinary care to reduce duplication, delays, and the burden of repeating their histories. Second, clear, honest communication between treating staff, and with patients, was essential to feeling informed and heard. Participants noted that transdisciplinary approaches could enhance communication and allow professionals more time to listen. Third, patients deeply valued the empathy and interpersonal qualities of allied health clinicians, while also emphasizing the importance of discipline‑specific expertise. They supported transdisciplinary care provided clinicians practised within their competence and sought specialist input when required.

Conclusion

Patients across hospital settings were accepting of transdisciplinary allied health models provided quality, expertise, and person‑centredness were maintained. Findings highlight that trust, communication and continuity underpin positive patient experience, and that transdisciplinary models may enhance efficiency and timeliness. Successful implementation will require organizational support, workforce development and careful evaluation to ensure new models enhance, rather than dilute, the quality of allied health care.

Introduction

The escalating demand for allied health services within hospitals is a pressing issue exacerbated by an ageing population and the rising prevalence of chronic diseases, comorbidity, and concurrent workforce shortages. In the multifaceted landscape of hospital healthcare, allied health professionals serve as a vital and diverse team alongside doctors and nurses, playing a pivotal role in improving patient outcomes. These professionals, spanning disciplines such as physiotherapy, occupational therapy, social work, speech pathology, dietetics, podiatry, psychology (including neuropsychology), prosthetics and orthotics, and music therapy, collectively contribute to the holistic care of patients. Traditionally, these professionals operate within their distinct clinical scope of practice, yet possess overlapping skills in assessment, treatment, and discharge planning [1]. Although beneficial to patient care, this overlap may contribute to both duplication and underutilization of expertise, leading to inefficiencies in patient care delivery. These overlapping and shared skill sets also present an opportunity to reimagine healthcare delivery.

One model, transdisciplinary care, represents a promising opportunity to address these systemic inefficiencies. Transdisciplinary care teams, distinct from multidisciplinary and interdisciplinary approaches, exemplify the highest level of integration and collaboration among allied health professionals [2]. By embracing and leveraging their overlapping skills, these teams streamline processes and optimize resource allocation, enabling professionals to operate at the pinnacle of their expertise and outside traditional boundaries (but within scope of practice). For example, an occupational therapist working in the emergency department with a transdisciplinary approach may assess and prescribe walking aids and organize services to facilitate discharge home, rather than wait for a physiotherapist and social worker. Suggested benefits of transdisciplinary care in the hospital setting include improved efficiency, reduced costs, and improved quality of care [1]. Benefits may extend beyond the hospital setting. Co-ordinated care teams have the potential to support older adults to maintain independence and remain connected to their homes and communities for longer [3]. As populations age and demand for allied health services grows, understanding patient perspectives on these models becomes increasingly important.

There is little research into patients’ perspectives of transdisciplinary care. For patients receiving care under a transdisciplinary model in acute settings, three studies using surveys have reported either higher or similar levels of patient satisfaction compared to control groups receiving traditional care [4–6]. One qualitative study evaluated the perspectives of 11 patients who received transdisciplinary care in an emergency department and reported that patients appreciated that the transdisciplinary professional spent more time with them [7]. Previous insights into patient perspectives come from acute settings and are mostly from general satisfaction surveys. An in-depth exploration of patient perceptions across various healthcare settings would build on prior research and provide more information on patient experiences, perceptions, preferences, and concerns to inform development of future models of care.

Therefore, this study aimed to explore patient experiences with allied health care across different hospital settings and explore perspectives of allied health transdisciplinary care to help inform future models.

Materials and methods

Design

A qualitative study based on an interpretive description approach was conducted using semi-structured in-depth interviews, as we have little knowledge of patients’ perceptions and interpretations of transdisciplinary care. We followed an interpretive description approach [8] to generate clinically relevant insights to inform practice. Data were viewed through a constructivist lens, which acknowledges that experiences are subjective, and findings are co-created by the participants and researchers [9]. The study is reported following the COREQ checklist [10].

Hospital ethics committee approval was received prior to commencement (HREC/110778/MH-2024), and participants provided written informed consent prior to interviews.

Setting

This study was conducted at the Royal Melbourne Hospital, one of the largest healthcare providers in Australia that provides emergency, acute, subacute, and community services.

Participants

Adults (18+ years) who received care at the hospital in the previous six months were eligible, provided they had received input from at least two different allied health disciplines during their admission. Adults with more than mild cognitive impairment or more than mild expressive or receptive aphasia were excluded as we were not able to provide modifications to support their ability to participate fully in an interview.

Recruitment

To identify eligible participants from various hospital settings, allied health clinicians identified patients in their caseloads who met the inclusion criteria. Clinicians informed patients of the study using a standard script and asked for permission to pass their details on to the researchers. Participants were then approached by a researcher in person at the hospital or via phone if they had returned home.

Purposive sampling techniques were used to ensure we explored the views of patients from various hospital settings. We used intensity sampling to meaningfully and strategically seek rich examples of care across the continuum (e.g. patients who have been in various settings within the hospital as they may offer rich insights). Theoretical sampling followed, to further explore important themes that emerged in certain contexts (e.g. acute, subacute, or community settings) [9].

If patients agreed to participate, a ‘pre-interview’ was conducted by a member of the research team to capture their interest and commitment to the research project and build rapport. The preinterview included key definitions (including an explanation of ‘allied health’ and ‘transdisciplinary care’) and a summary of questions so participants could reflect on their experiences prior to the interview [11] (Supplementary file 1).

Because our intended sample was heterogeneous, it was methodologically inappropriate to try to achieve saturation. Consistent with interpretive description, we aimed for information power, i.e. enough data to capture various views to generate comprehensive clinically useful insights. Guided by Malterud’s concept of information power, we aimed to achieve this by focusing on experiences of allied health (narrow aim), including participants with very recent experiences (specificity), considering established theories, and aiming for quality dialogue [12].

Data collection

Semi-structured in-depth individual interviews were used to gather rich information on patient perspectives in their own words. Using a semi-structured, flexible interview schedule allowed participants to elaborate on questions they had the most to say about and explore emerging themes. The interview schedule was developed by a consumer (K.D.), a neuropsychologist (J.Lewis), an occupational therapist (J.S.), and an experienced qualitative researcher (C.P.), comprised introductory questions (e.g. Tell me a bit about your recent experience with allied health.), and follow-up probing or clarifying questions (e.g. Which allied health clinicians did you see?) (Supplementary file 2). The lived experience consumer also reviewed the final schedule and provided input on the appropriateness of wording, clarity and sequencing of questions. Following the consumer co-creation of questions, formal piloting was not undertaken, but questions were revised and refined throughout data collection to ensure they elicited meaningful responses.

Interviews were conducted by allied health clinician researchers (four women and one man): A.D’S. (physiotherapist, PhD), C.P. (physiotherapist, PhD), C.M. (occupational therapist, PhD), A.d.S. (physiotherapist), and J.Lewis (neuropsychologist). Interviewers were all experienced in qualitative interviews and interested in transdisciplinary care, as the hospital they all worked at was exploring this model. Interviews were conducted in-person at the hospital, via telephone or videoconference (using Microsoft Teams), depending on patient preference. Participants could choose to have their carer or family present during the interview. Field notes were taken by the interviewer, and interviews were audio-recorded and transcribed verbatim using a professional transcription service. There were no repeat interviews.

At the end of the interview, researchers summarized their interpretation of key responses and invited any clarifications or additions to ensure it was an accurate representation of their perceptions [13]. Participants were not sent their transcripts for additional member checking.

Basic patient demographic information was also collected (gender, age, time spent in hospital, reason for admission, settings in hospital, and number of allied health professions seen) to describe the sample.

Data analysis

Inductive thematic analysis [14] using NVivo software to manage data was completed by four researchers: C.P., A.D’S., A.d.S., and L.R. (woman, physiotherapist, PhD). The researchers read and re-read transcripts and/or listened to interviews to familiarize themselves with the data. They then examined the data line by line and independently coded transcripts before exploring connections and comparisons among the codes to develop subthemes and themes. Once independently generated, researchers met to discuss and review themes to ensure consensus. Finally, the researchers developed a coding tree and went back to the data to ensure it supported the themes and to select supporting quotes. Data collection (interviews) and analysis occurred cuncurrently to guide further recruitment, interview questions and to assess for information power. A summary of study findings was sent to participants.

Trustworthiness

Trustworthiness was enhanced through real-time member checking during interviews for credibility, provision of thick description to support transferability, and coding and analysis by multiple researchers to strengthen dependability and confirmability. Given the interpretive nature of the study, researchers engaged in reflexive discussions throughout analysis to consider how their disciplinary backgrounds and assumptions may have influenced data interpretation.

Results

Participants

Between February and October 2025, researchers were notified of 21 eligible patients identified by clinicians. Of these, three declined to participate, all reporting they felt they did not have anything to contribute. An additional three agreed to participate but were unable to complete an interview due to their poor health status or conflicting medical appointments. Therefore, this study includes 15 participants (seven women) who were between 47 and 86 years old (mean 68, SD 11 years) who experienced allied health care from 10 different disciplines across acute, subacute, and community settings (Table 1). One participant (ID6) had a family member with them during their interview. Recruitment was ceased after 15 interviews as we had a range of rich views from a diverse cohort. Interviews lasted an average of 30 (SD 8.2) minutes.

Table 1.

Participant characteristics.

Participant	Sex	Age	Setting	Allied health professions seen across settings (number: professions)	LOS (days)
1	M	53	Acute	4: PT, OT, SW, SP	5
			Subacute	5: PT, OT, PSY, SW, SP	35
			Subacute at home	2: PT, OT	11
			CTS	4: PT, EP, OT, DT	91
2	M	72	Acute	3: PT, OT, SP	6
			Subacute	5: PT, EP, OT, POD, PSY	20
3	M	76	Acute	5: PT, OT, DT, SW, SP	20
4	F	67	Acute	4: PT, OT, DT, SW	1
5	M	73	Acute	3: PT, OT, DT	42
6	F	67	Acute	6: PT, OT, MT, P&O, POD, SP	28
7	F	77	Acute	1: PT	3
			Community	4: PT, EP, OT, SW	129
8	M	54	Community	5: EP, OT, PSY, SW, SP	380
9	F	69	Community	5: PT, EP, OT, DT, SW	138
10	M	76	Acute	4: PT, OT, SW, SP	20
			Subacute	4: PT, OT, SW, SP	14
			Community	4: PT, OT, SW, SP	16
11	M	68	Acute	6: PT, OT, DT, PSY, SW, SP	3
12	M	75	Acute	3: PT, OT, SP	6
13	F	58	Acute	3: PT, OT, SP	13
			Subacute at home	3: PT, OT, SP	10
14	F	47	Acute	3: PT, OT, SP	4
			Subacute at home	5: PT, OT, DT, SW, SP	11
15	F	86	Subacute at home	4: PT, OT, SW, SP	10
			Community	4: PT, OT, DT, SP	49

DT, dietetics; EP, exercise physiology; F, female; LOS, length of stay; M, male; MT, music therapy; OT, occupational therapy; P&O, prosthetics and orthotics; POD, podiatry; PT, physiotherapy; PSY, psychology; SP, speech pathology; SW, social work.

Themes

The overarching theme was that co-ordination, communication and care contributed to trust and confidence in allied health professionals. Because of this trust, participants felt confident in the decisions allied health professionals would make around their care, including the use (or not) of transdisciplinary care. The three main themes and contributing subthemes are described below and in Table 2.

Table 2.

Coding tree.

Themes	Subthemes	Example codes	Example quotes
1. Good care was co-ordinated, continuous and patient-centred	(a) To be seen as a whole and receive intervention individualized to me	I’m more than the parts which each health professional is treating See the whole picture Receive the care I need	I don’t know why anything needs to be separate because we’re all trying to treat the same thing, just in different ways. (P4)
	(b) To receive the right care at the right time with a health professional with the right skills	Good co-ordination Timing of care Discipline doesn’t matter, as long as it’s a good person with the right skills	And I think it gave me confidence to know that this was what they were dealing with every day. (P9)
	(c) To have continuity of care	TDCM could help streamline care Some overlap between professions Overlap to be avoided, but sometimes repetition ok	I think it work equally well because the major benefit [of TDCM] is one of streamlining the process. (P1)
2. Good ­communication was essential between staff and with patients for good care	(a) To know you are communicating between each other and honestly with me	Comfort knowing the team communicate between each other Frustration when team communication broke down Importance of communication Good to know how TDCM would work	I’m not particularly fussed with who supplies the information, as long as I get the information. (P12)
	(b) Want to be heard	Good to be listened to Good to be heard Just want someone to talk to	I think you need to be listened to and have your opinion valued. (P6)
	(c) To acknowledge my goals and values	Important to recognize my goals and values Good to know my goals and values are prioritized	Well, the occupational therapy was initially extremely important to me because I needed to work on my grip and holding cups and things of that kind. And so I underwent those exercises, and they were helpful, I think. (P1)
3. Patients valued the empathetic and expert healthcare they received from the allied health professionals	(a) Empathy and care	Received empathy and care Comfort knowing there was help Great personalities Variety sometimes good	I would say their personalities, their warmth, their friendliness. Obviously, I respected their expertise, but the most important element was a friendly, smiling face that listened to me and reassured me. (P3)
	(b) To know the model of care is not at the detriment of expertise	TDCM good but not at detriment of expertise How to be an expert in everything; too much pressure for one person Potential risk expertise diminished or lost	…understanding as long as the services remain at high standard with [transdisciplinary care], it could be done with multiskilling by the various disciplines. (P15)
	(c) Patients are in a vulnerable position	Putting a lot of trust in the health professionals Moment of stress, being scared A lot going on	Because, basically, we’re all ignorant to this side of the equation and taking for granted what’s being said to us. (P4)

Theme 1: Good care was co-ordinated, continuous, and patient-centred

Participants reported the importance of being seen as a whole and receiving co-ordinated care that was tailored to their needs (subtheme 1a, Table 2). They valued individual expertise of professionals from different disciplines, but felt they (as a whole) needed to be at the centre of care decisions because their individual circumstances influenced care across disciplines.

I was aware of the difference between tongue therapy/ speech therapist and a dietitian. But if I spoke to [dietitian] about the difficulties of swallowing certain foods, it overlaps to a discussion about my tongue, which is not what she’s there for. (P3)

Some participants commented on how transdisciplinary care would further facilitate this.

I thought that [a transdisciplinary model of care] sounds like a good idea, where one person can see the overall improvement or lack of improvement in the patient, rather than an exercise physiologist who is just concerned about exercise physiology and physiotherapist just concerned about physiotherapy. (P1)

Participants wanted to receive the right care at the right time from a health professional with the right skills (subtheme 1b). They mostly reported that they did not mind who delivered the care, provided they had the appropriate knowledge and skills and it was delivered in a timely manner.

Oh, it doesn’t matter who it comes from, as long as it gets there. (P10)

If there was a particular thing that needed to be addressed, whoever’s doing it can do the job. You don’t need to have five different people doing the same thing or approaching it from different angles. If there was a cross-disciplinary skill set that one professional could bring to the table, happy days. I think it would be great. (P8)

In one circumstance, waiting for a certain allied health professional created a detrimental delay.

I was really grateful for the referrals and the occupational therapist was wonderful and very thoughtful. But because of the delay in accessing the service, at that point, I didn’t really need that support. (P9)

Continuity of care between professionals and sites was important (subtheme 1c). Participants described how a transdisciplinary model of care could help to streamline care and make it more efficient. They recognized areas of overlap between professions and thought this duplication could be avoided (although not all participants minded having to repeat themselves).

I didn’t want to have to repeat my medical history again because I was feeling quite traumatised by parts of it. And I’d had to say it a lot. (P9)

That [a transdisciplinary model of care] would reduce the burden and the fatigue. (P14)

Theme 2: Good communication was essential between staff and with patients for good care

Participants were reassured to know that staff were communicating with each other and valued when staff (regardless of profession) communicated openly and honestly with them (subtheme 2a).

Communication between the practitioners was great. And when I would see one, they would make reference to the fact that they’d heard from another one. (P8)

Just like they appreciated honest communication during their care, they reported that they (and future patients) should get honest and clear communication about any transdisciplinary models of care.

I don’t feel like I would be averse to it [a transdisciplinary model of care] if I understood how it worked. (P9)

Participants also wanted to be truly heard and have their goals and values acknowledged (subthemes 2b and 2c, Table 2). They appreciated when staff sat down and took the time to listen to them. In one instance, it was identified that giving staff permission to take the time to listen to patient needs rather than referring on would be sufficient, and that the transdisciplinary model of care may enable this.

They sent the social workers because the day before, I was feeling a bit teary, and [the health professional] observed that. So, they obviously said, send some social workers. And look, that was fine… I wouldn’t say it was 100% necessary… even just maybe a chat with [the health professional] was probably enough. (P14)

Theme 3: Patients valued the empathetic and expert healthcare they received from the allied health professionals

Rather than focusing on discipline expertise, participants highlighted the interpersonal qualities of their allied health professionals as key to their positive experiences (subtheme 3a).

I would say their personalities, their warmth, their friendliness. Obviously, I respected their expertise, but the most important element was a friendly, smiling face that listened to me and reassured me. (P3)

They felt well-supported by their allied health professionals, and although they liked the idea of someone having a more holistic view, opinions varied on seeing fewer allied health professionals.

With variety being the spice of life, I think it can perk you up a bit if you see a different person with slightly different tasks. (P1)

I’m happy with one or two. Maybe other people might want lots of other people. I don’t know. Personally, I don’t like lots of people around. (P5)

Despite the focus on interpersonal skills and the general feeling that a transdisciplinary model of care was a good idea, participants asserted that it should not be to the detriment of each professional’s expertise (subtheme 3b). They also questioned how individuals could be an expert in everything but did trust that their therapists would enlist help from others if anything was outside their expertise. They also stated that transdisciplinary care should only be provided by professionals with the right level of experience.

…it would really depend on the person [the healthcare professional]. How much can one person know? (P13)

Underpinning these responses, participants spoke of being in a vulnerable position while receiving care and putting a lot of trust in their healthcare professionals (subtheme 3c, Table 2).

Discussion

Statement of principal findings

Participants across acute, subacute and community settings described trust in their allied health professionals, built from good communication and patient-centred, co-ordinated and empathetic care. This trust gave them confidence in the care they would receive, regardless of the model. These findings agree with literature reporting that patients judge quality largely on the processes of care (e.g. communication, motivation, and knowledge) [15] and trust allied health professionals to deliver appropriate care [16]. This study adds patient-specific insights to guide transdisciplinary care.

Interpretation within the context of the wider literature

Any new models should consider established frameworks for quality healthcare. The National Academy of Medicine’s six pillars of high-quality healthcare (safe, timely, efficient, effective, equitable, and patient-centred—STEEEP) [17] were reflected in participants’ views. With a focus on patient-centred care, they felt transdisciplinary care could reduce waiting, improve efficiency, and minimize repetition, while professionals should seek discipline-specific support if needed (safety). Moreover, these priorities align with scoping review findings that transdisciplinary care can save clinician time, reduce waiting, reduce clinical risk and improve functional outcomes [1].

Although participants valued patient-centred care, they also emphasized the importance of discipline-specific expertise. Therefore, any new model should not be to the detriment of expertise. Preliminary research suggests that transdisciplinary care does not compromise expertise, with comparable or improved patient health outcomes [1]. Whilst recent investigation suggests clinician acceptability, appropriateness, and feasibility [18], implementation of transdisciplinary care should include resources, processes, and structures that consider clinician competence, leadership support, change management strategies, and interprofessional trust. Previous research suggests transdisciplinary care may increase access to allied health expertise [4, 19], though future research should consider whether they have access to the appropriate expertise within allied health.

Implications for policy, practice, and research

Implementing transdisciplinary care will require careful planning to ensure appropriate organizational structures and workforce supports are in place. Evaluation should extend beyond patient outcomes to consider staff behaviour change and service-level outcomes, as transdisciplinary care is likely to require large shifts in practice [18]. Our findings suggest that patients are accepting of transdisciplinary approaches provided high-quality care is maintained; however, inadequate support for staff to adapt to new ways of working may compromise patient experience. Future research should therefore identify implementation strategies that enable behaviour change, support professional learning, and promote sustainable adoption of transdisciplinary care.

Strengths and limitations

This qualitative study has several strengths including consumer involvement (K.D.) from the conceptual stage, which helped to ensure research relevance and a comprehensive interview schedule. Multidisciplinary research input provided a broad allied health lens when planning and interpreting findings, and purposive sampling ensured broad representation across healthcare settings. An important limitation was that all participants were able to speak English, which may limit generalizability to patients who require an interpreter for healthcare interactions. Future research on transdisciplinary care should consider people who need an interpreter. As participation was voluntary, the findings may over-represent the views of patients who were more engaged or motivated to discuss their healthcare experiences. This study focused on patient perspectives within allied health; findings may not be applicable to nursing and medical models and do not consider allied health professionals’ preferences or preparedness for transdisciplinary practice.

Conclusion

Patients were accepting of transdisciplinary allied health models provided quality, expertise, and person‑centred care were maintained. Trust, communication, and continuity were key to positive patient experiences. Successful implementation of transdisciplinary care models will require organizational support, workforce development and careful evaluation to ensure they enhance, rather than dilute, the quality of allied health care.

Author contributions

Casey Peiris and Aruska D’Souza conceptualized the study. Casey Peiris, Keith Donohoe, James Lewis, and James Seymour developed the interview schedule. Casey Peiris, Celia Marston, Aruska D’Souza, Alisha da Silva, and James Lewis conducted the interviews. Aruska D’Souza, Jacqueline Van Groningen, and James Seymour managed the data. Leanne Rees, Casey Peiris, Aruska D’Souza, and Alisha da Silva completed qualitative data analysis. Casey Peiris and Leanne Rees drafted the original manuscript, and all authors reviewed it. All authors contributed to developing and refining the research question, project administration and methodology.

Supplementary material

Supplementary material is available at IJQHC online.

Conflicts of interest

No known conflicts of interest.

Funding

No funding was received to complete this research.

Data Availability

The data underlying this article cannot be shared publicly for the privacy of individuals who participated in interviews. De-identified transcripts will be shared on reasonable request to the corresponding author.

Ethics

Ethics committee approval was received from the Royal Melbourne Hospital Human Research Ethics Committee prior to commencement (HREC/110778/MH-2024).