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How can interprofessional collaboration be fostered and sustained in team-based care integration for older people in community settings? A realist evidence synthesis

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O’Donnell, Deirdre, Davies, Carmel, Devaney, Catherine, Radomska, Apolonia, O’Shea, Marie, O’Donoghue, Gráinne, De Brún, Aoife, Donnelly, Sarah +6 more·2025·Systematic Reviews
DOI 10.1186/s13643-025-02862-8PMC PMC12107811
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Abstract

BACKGROUND: Community-centred care integration for older adults is a cornerstone of the WHO's Integrated Care for Older People (ICOPE) implementation framework. Realising the potential of care integration for older people requires cohesive coordination of services and interprofessional collaboration (IPC) within and across teams. There is a gap in research evidence to understand how IPC can be fostered and sustained within team-based community care integration for older people. We report on a realist evidence synthesis to identify the contextual influences and mechanisms that support IPC in interprofessional community care teams for older people. METHODS: The three phases of the realist synthesis included an exploratory scoping of research evidence and consultation with four local stakeholder groups to produce initial programme theories. The second phase involved systematic retrieval and synthesis of evidence, including peer-reviewed published empirical studies and grey literature recommended by an expert panel. The third phase involved the development of refined programme theory with stakeholder validation. The stakeholder cohorts included representatives of older people and caregivers, healthcare professionals and operational managers of community specialist older person teams, national policymakers, and programme managers. RESULTS: The resource and reasoning mechanisms that enable contexts for IPC and their associated outcomes are identified within seven programme theory areas: (1) professional identity and growth, (2) information sharing and care coordination across boundaries, (3) effective operational and clinical governance, (4) developing a team learning culture, (5) meaningful inclusion of older people and caregivers, (6) quality improvement and programme development, (7) workforce planning and retention. CONCLUSIONS: The results provide policymakers and clinicians with evidence-based programme theory that will catalyse critical dialogue on IPC implementation. This programme theory informs the prioritisation of resources to enable favourable contexts for successful IPC intervention development and implementation. This research complements and expands the work presented in the WHO ICOPE implementation framework. We encourage local realist application and evaluation of the programme theory within varying health system contexts.

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  • Managers' clear communication of tasks and roles is also identified as crucial in previous studies, as a strong professional identity and a clear understanding of team roles enhance the capacity for effective IPC.

    “Managers' clear communication of tasks and roles is also identified as crucial in previous studies, as a strong professional identity and a clear understanding of team roles enhance the capacity for effective IPC (O'Donnell et al. 2025;Wei et al. 2022).”

    From Leadership of Nurses' Interprofessional Collaboration: A Mixed‐Methods Systematic Review (2026) · cites this paper as O'Donnell et al. 2025

    The Results section, Programme theory A (page not specified), identifies strong professional identity and a clear understanding of team roles as critical to effective interprofessional collaboration. It does not specifically identify managers’ clear communication of tasks and roles as crucial; its discussion of clear communication concerns a shared team purpose. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • Effective operational governance and management are central support mechanisms for interprofessional teams, resulting in team commitment, trust, and capability to deliver effective IPC.

    “A recent review by O'Donnell et al. (2025) identified effective operational governance and management as central support mechanisms for interprofessional teams, resulting in team commitment, trust, and capability to deliver effective IPC.”

    From Leadership of Nurses' Interprofessional Collaboration: A Mixed‐Methods Systematic Review (2026) · cites this paper as O'Donnell et al. 2025

  • The latter study confirms that supportive management enhances teams' trust and capability to deliver effective IPC while autocratic leadership disempowers team collaboration.

    “The latter study confirms that supportive management enhances teams' trust and capability to deliver effective IPC while autocratic leadership disempowers team collaboration (O'Donnell et al. 2025).”

    From Leadership of Nurses' Interprofessional Collaboration: A Mixed‐Methods Systematic Review (2026) · cites this paper as O'Donnell et al. 2025

  • Another synthesis revealed that a bottom-up leadership approach generates supportive and enabling governance, which in turn promotes team commitment to IPC.

    “Another synthesis revealed that a bottom-up leadership approach generates supportive and enabling governance, which in turn promotes team commitment to IPC (O'Donnell et al. 2025).”

    From Leadership of Nurses' Interprofessional Collaboration: A Mixed‐Methods Systematic Review (2026) · cites this paper as O'Donnell et al. 2025

  • O'Donnell et al. also highlighted the importance of working conditions that foster accessible information and knowledge sharing across care sectors to enhance teamwork.

    “O'Donnell et al. (2025) also highlighted the importance of working conditions that foster accessible information and knowledge sharing across care sectors to enhance teamwork.”

    From Leadership of Nurses' Interprofessional Collaboration: A Mixed‐Methods Systematic Review (2026) · cites this paper as O'Donnell et al. (2025)

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Authors
O’Donnell, D., Davies, C., Devaney, C., Radomska, A., O’Shea, M., O’Donoghue, G., De Brún, A., Donnelly, S., Whitty, H., Harnett, P., Lang, D., Ahern, E., Hammoud, S., & Shé, É. N.
Affiliations
  • University College Dublin (IE)
  • Health Service Executive (IE)
  • Royal College of Surgeons in Ireland (IE)
Corresponding author
O’Donnell, Deirdre
ORCID
Venue
Systematic Reviews
Publisher
Springer Science and Business Media LLC
Published
2025-05-27
Volume
14
Issue
1
Pages
117-117
ISSN
2046-4053 (ISSN-L)
DOI
10.1186/s13643-025-02862-8
PMC
PMC12107811
OpenAlex
W4410770593
Cited by
13
References
1
Citations by year
2026: 9 · 2025: 4
FWCI
12.38
Type
journal article
Language
en
Open access
Licence
Locations
  • Systematic Reviews (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Figshare (acceptedVersion, cc-by-nc-nd)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Health Research Board (ILP-HSR-2022-007)
Topics
  • Health Sciences › Health Professions › General Health Professions › Interprofessional Education and Collaboration
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
  • Social Sciences › Decision Sciences › Information Systems and Management › Interdisciplinary Research and Collaboration
Keywords
interprofessional collaboration, integrated care, older adults, community-based care, team-based care, integrated care for older people, care coordination, professional identity, clinical governance, workforce planning, quality improvement, program theory
MeSH terms
Aged, Community Health Services, Cooperative Behavior, Health Services for the Aged, Humans, Interprofessional Relations, Patient Care Team, Delivery of Health Care, Integrated

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