Barriers and Facilitators for the Implementation of an Integrated Care Model: Professionals’ Perspectives

Introduction: Within the framework of the Transformational Project for Care Integration, funded by the Catalan Health System, implemented across five territories (Osona, Alt Maresme, Selva Marítima, Alt Empordà, and Baix Empordà) this study presents findings related to healthcare professionals’ experiences. To address the needs of older adults with multimorbidity and/or frailty, innovative integrated care models supported by technology must be implemented. Evaluating the implementation of such projects is challenging, as it requires consideration of multiple dimensions. Beyond clinical outcomes, health services utilization, patient experience, and organizational processes, the literature highlights the importance of assessing professionals’ experiences.

 

On one hand, professional experience influences the implementation of integrated care; on the other, integrated care impacts professional experience. Recent studies suggest that integration may offer benefits such as professional role recognition, development opportunities, and enhanced collaboration, but also pose risks including increased workload, reduced autonomy, and limited career advancement. In this context, our objective was to describe professionals’ experiences and identify factors that facilitate or hinder the implementation of an integrated care model.

 

Methods: A cross-sectional descriptive study was conducted using an anonymous online survey distributed to professionals across the five participating territories. The survey, answered between July and August 2025, collected data on professional characteristics, clinical practice, interprofessional collaboration, professional development, and recognition across care levels. Qualitative variables were described using frequencies and percentages.

 

Results: A total of 512 healthcare professionals participated. Responses were distributed as follows: 25.8% (n=136) from Osona, 23.9% (n=126) from Alt Maresme, and 19.5% (n=103) from Selva Marítima. By care setting, 48.4% (n=248) worked in hospitals, 35.4% (n=181) in primary care, and 12.3% (n=63) in intermediate care. Most professionals (76%, n=389) had over 10 years of experience in the health sector. A total of 79% (n=405) reported frequently or always caring for patients with complex or advanced chronic conditions. Regarding participation in interinstitutional meetings, 36% (n=185) had never participated, while 17% (n=87) did so frequently (five or more times per year). Shared protocols were accessible to 63% (n=325) of respondents. In terms of communication, 48% (n=246) perceived few or no effective channels between care levels.

 

Additionally, 43.5% (n=223) believed that collaboration with other professionals positively influenced their clinical practice, and 35% (n=179) felt supported in complex clinical decisions through interprofessional collaboration. However, 41.2% (n=211) did not feel sufficiently valued, and only 56% (n=287) reported having access to professional development opportunities.

 

Conclusion: S: The survey reveals a generally positive perception of interprofessional collaboration. Nevertheless, it highlights critical areas such as the lack of stable communication channels, low participation in interinstitutional dynamics, and insufficient professional recognition. These findings provide a solid foundation to guide the actions of the transformational project and support the consolidation of an integrated care model across the territories.