Multi-disciplinary workforce development: How managerial collaboration influences professional roles development in rural regions

Introduction:Integrated care systems in Western countries are expected to meet multi-faceted challenges in contemporary health practice, such as an ageing population against the backdrop of increasing workforce shortage. In the Netherlands, particularly rural regions face great difficulties in attracting healthcare professionals, and healthcare organizations are increasingly confronted with emergency admissions of elderly patients due to staff shortages and related capacity issues, putting pressure on elderly, their relatives as well as healthcare professionals. However, scarce attention in research is paid on how managerial collaboration and professionals influence professional roles development across organisational boundaries.Methods:This study is part of an action-oriented research project (‘RegioZ’) in the Netherlands, in which healthcare organizations experiment with new forms of elderly care, focusing on the combination of professional roles development and organisational structures. In the region Zeeland, which is central to this study, elderly care facilities experiment with new professional roles development and collaboration between healthcare organizations (sharing medical capacity) to maintain regional coverage. However, professionals are employed within organisational boundaries, which makes initiatives on multi-disciplinary workforce development challenging – and particularly cumbersome in light of a geographic island structure and cultural religious differences between these islands. Interviews with professionals (n=23) and elderly care executives (n=7) are conducted as well as observations during project meetings, to deepen managerial collaboration in light of roles development. We use institutional theory to analyse this professional governance.Results:Professionals state that shared infrastructures (access to digital systems, agreements on task reallocation and triage) may strengthen roles development, yet point to historical conflicts and distrust between elderly care executives and professionals that hinder such initiatives. Interestingly, emphasis is placed on the clarification of roles and tasks, while some call for overlap in roles, tasks and responsibilities between professionals. Interestingly, professional roles development serves as a strategy to build regional care networks, in which elderly care executives and professionals create momentum for closer collaboration.Discussion and conclusion:The added value of this research lies