Healthcare professional perspective on barriers and facilitators of multidisciplinary team working in acute care setting: a systematic review and meta-synthesis

Objective A multidisciplinary team is essential to providing high-quality, patient-centred care. However, its effectiveness can be either hindered or facilitated by various factors, such as the need for rapid decision-making, which may compromise patient outcomes despite individual efforts. The aim...

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Main Authors: Giovanna Artioli, Gloria Anderson, Lucia Pradelli, Camilla Risoli, Elena Summer, Giulia Bellini, Fabio Mozzarelli, Massimo Guasconi, Antonio Bonacaro, Leopoldo Sarli
Format: Article
Language:English
Published: BMJ Publishing Group 2025-03-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/3/e087268.full
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author Giovanna Artioli
Gloria Anderson
Lucia Pradelli
Camilla Risoli
Elena Summer
Giulia Bellini
Fabio Mozzarelli
Massimo Guasconi
Antonio Bonacaro
Leopoldo Sarli
author_facet Giovanna Artioli
Gloria Anderson
Lucia Pradelli
Camilla Risoli
Elena Summer
Giulia Bellini
Fabio Mozzarelli
Massimo Guasconi
Antonio Bonacaro
Leopoldo Sarli
author_sort Giovanna Artioli
collection DOAJ
description Objective A multidisciplinary team is essential to providing high-quality, patient-centred care. However, its effectiveness can be either hindered or facilitated by various factors, such as the need for rapid decision-making, which may compromise patient outcomes despite individual efforts. The aim of this study is to synthesise the factors that may act as barriers and facilitators to the work of multidisciplinary teams in managing labour within acute care settings.Design A systematic qualitative review and meta-synthesis was conducted following the five-step methodology proposed by Sandelowski et al.Data source Three databases (Medline, Embase and Scopus) were systematically searched without time restrictions up to 25 May 2024.Eligibility criteria for selecting studies Qualitative studies exploring perspectives, experiences and other similar factors were included. These studies were assessed for methodological quality using the Critical Appraisal Skills Programme.Data extraction and synthesis The reviewers independently searched, screened and coded the results of the included studies. Data were synthesised using the method proposed by Thomas and Harden.Results Seventeen studies were included in the meta-synthesis. Four key dimensions emerged, reflecting both the barriers and the facilitators of multidisciplinary team performances: (1) organisational variables, (2) individual variables, (3) collaborative variables and (4) role variables. A total of 36 variables were identified, which could function as barriers (n=6; eg, high staff turnover), facilitators (n=6; eg, strong listening skills) or both (n=24; eg, team climate), depending on the context.Conclusions This meta-synthesis identifies specific barriers and facilitators and variables that can act as both. Understanding these factors enables targeted interventions to enhance the performance of multidisciplinary teams in clinical practice, particularly in acute care settings.PROSPERO registration number CRD42022297395.
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spelling doaj-art-e199cf3c05f846d4b771712bc098e20f2025-08-20T03:40:25ZengBMJ Publishing GroupBMJ Open2044-60552025-03-0115310.1136/bmjopen-2024-087268Healthcare professional perspective on barriers and facilitators of multidisciplinary team working in acute care setting: a systematic review and meta-synthesisGiovanna Artioli0Gloria Anderson1Lucia Pradelli2Camilla Risoli3Elena Summer4Giulia Bellini5Fabio Mozzarelli6Massimo Guasconi7Antonio Bonacaro8Leopoldo Sarli93 Department of Medicine and Surgery, University of Parma, Parma, Italy4 Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy1 Azienda USL di Piacenza, Piacenza, Italy1 Azienda USL di Piacenza, Piacenza, Italy2 Fondazione Madonna della Bomba Scalabrini ETS, Piacenza, Italy1 Azienda USL di Piacenza, Piacenza, Italy1 Azienda USL di Piacenza, Piacenza, Italy1 Azienda USL di Piacenza, Piacenza, Italy3 Department of Medicine and Surgery, University of Parma, Parma, Italy3 Department of Medicine and Surgery, University of Parma, Parma, ItalyObjective A multidisciplinary team is essential to providing high-quality, patient-centred care. However, its effectiveness can be either hindered or facilitated by various factors, such as the need for rapid decision-making, which may compromise patient outcomes despite individual efforts. The aim of this study is to synthesise the factors that may act as barriers and facilitators to the work of multidisciplinary teams in managing labour within acute care settings.Design A systematic qualitative review and meta-synthesis was conducted following the five-step methodology proposed by Sandelowski et al.Data source Three databases (Medline, Embase and Scopus) were systematically searched without time restrictions up to 25 May 2024.Eligibility criteria for selecting studies Qualitative studies exploring perspectives, experiences and other similar factors were included. These studies were assessed for methodological quality using the Critical Appraisal Skills Programme.Data extraction and synthesis The reviewers independently searched, screened and coded the results of the included studies. Data were synthesised using the method proposed by Thomas and Harden.Results Seventeen studies were included in the meta-synthesis. Four key dimensions emerged, reflecting both the barriers and the facilitators of multidisciplinary team performances: (1) organisational variables, (2) individual variables, (3) collaborative variables and (4) role variables. A total of 36 variables were identified, which could function as barriers (n=6; eg, high staff turnover), facilitators (n=6; eg, strong listening skills) or both (n=24; eg, team climate), depending on the context.Conclusions This meta-synthesis identifies specific barriers and facilitators and variables that can act as both. Understanding these factors enables targeted interventions to enhance the performance of multidisciplinary teams in clinical practice, particularly in acute care settings.PROSPERO registration number CRD42022297395.https://bmjopen.bmj.com/content/15/3/e087268.full
spellingShingle Giovanna Artioli
Gloria Anderson
Lucia Pradelli
Camilla Risoli
Elena Summer
Giulia Bellini
Fabio Mozzarelli
Massimo Guasconi
Antonio Bonacaro
Leopoldo Sarli
Healthcare professional perspective on barriers and facilitators of multidisciplinary team working in acute care setting: a systematic review and meta-synthesis
BMJ Open
title Healthcare professional perspective on barriers and facilitators of multidisciplinary team working in acute care setting: a systematic review and meta-synthesis
title_full Healthcare professional perspective on barriers and facilitators of multidisciplinary team working in acute care setting: a systematic review and meta-synthesis
title_fullStr Healthcare professional perspective on barriers and facilitators of multidisciplinary team working in acute care setting: a systematic review and meta-synthesis
title_full_unstemmed Healthcare professional perspective on barriers and facilitators of multidisciplinary team working in acute care setting: a systematic review and meta-synthesis
title_short Healthcare professional perspective on barriers and facilitators of multidisciplinary team working in acute care setting: a systematic review and meta-synthesis
title_sort healthcare professional perspective on barriers and facilitators of multidisciplinary team working in acute care setting a systematic review and meta synthesis
url https://bmjopen.bmj.com/content/15/3/e087268.full
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