{
  "abstract": "Objectives Our objective was to examine the barriers and facilitators encountered by primary and secondary healthcare professionals when collaborating at the care continuum between primary and secondary care. We aimed to identify specific challenges, observed benefits and proposed changes. By analysing these experiences and identifying opportunities for redesign, we aimed to define specific domains that could improve collaboration, thereby supporting sustainable access to and quality of care in the face of rising demand and constrained resources.Design A qualitative exploratory study using semi-structured interview data guided by two domains of the Consolidated Framework for Implementation Research (CFIR), including Inner Setting—Tension for Change and Individual Characteristics, as well as selected implementation outcomes defined by Proctor et al, all viewed through a service (re)design lens.Setting Consultation and communication between primary and secondary healthcare professionals in a Dutch urbanised area.Participants 37 users of collaboration services (eg, telephone, correspondence) were interviewed between August 2021 and October 2022, including 14 general practitioners (GPs) (10 females, 4 males) and 23 specialists (10 females, 13 males).Results Four key domains with subthemes, subdivided per operation and CFIR domain, were identified as central to optimising the collaboration of professionals within the primary-secondary care continuum: (1) software and record integration; (2) seamless personal interaction; (3) eliminating a sense of ‘us vs them’ and (4) gaps in continuity of care.Conclusions This study reveals that healthcare professionals in both primary and secondary care face similar collaboration challenges due to system-level issues and inadequate collaboration tools, leading to increased workload, miscommunication and reduced quality of care. Improving collaboration between GPs and specialists requires not only adjustments to individual services, but a comprehensive overhaul of the referral and back-referral process. A more integrated approach, addressing key domains, is crucial for enhancing care quality, streamlining workflows and improving health outcomes.",
  "authors": [
    {
      "affiliations": [
        "Department of Public Health & Primary Care/Health Campus The Hague, Leiden University Medical Center, Leiden, Zuid-Holland, Netherlands"
      ],
      "name": "Malou Crasborn"
    },
    {
      "affiliations": [
        "Department of Public Health & Primary Care/Health Campus The Hague, Leiden University Medical Center, Leiden, Zuid-Holland, Netherlands",
        "Department of Internal Medicine, Haga Hospital, Den Haag, Zuid-Holland, Netherlands"
      ],
      "name": "Maarten O van Aken"
    },
    {
      "affiliations": [
        "Department of Cardiology, HMC Westeinde Stichting Haaglanden Medisch Centrum, Den Haag, Zuid-Holland, Netherlands"
      ],
      "name": "Bas L van der Hoeven"
    },
    {
      "affiliations": [
        "Department of Public Health & Primary Care/Health Campus The Hague, Leiden University Medical Center, Leiden, Zuid-Holland, Netherlands"
      ],
      "name": "Mattijs E Numans"
    },
    {
      "affiliations": [
        "Department of Public Health & Primary Care/Health Campus The Hague, Leiden University Medical Center, Leiden, Zuid-Holland, Netherlands"
      ],
      "name": "Sam van Smoorenburg"
    },
    {
      "affiliations": [
        "Department of Public Health & Primary Care/Health Campus The Hague, Leiden University Medical Center, Leiden, Zuid-Holland, Netherlands",
        "Department of Internal Medicine, Haga Hospital, Den Haag, Zuid-Holland, Netherlands"
      ],
      "name": "Rianne M C Pepping"
    },
    {
      "affiliations": [
        "Department of Public Health & Primary Care/Health Campus The Hague, Leiden University Medical Center, Leiden, Zuid-Holland, Netherlands"
      ],
      "name": "Rimke C Vos"
    },
    {
      "affiliations": [],
      "name": "The Hague Consortium Of Network CarE Redesign and Transition"
    }
  ],
  "title": "Perception of primary–secondary care collaboration among general practitioners and specialists and the perceived potential for innovation: an exploratory qualitative study",
  "uid": "b935bc1b-be81-5884-8b23-32be393a73e7"
}