Adopting tailored interprofessional protocols in general practice: barriers, strategies, and lessons learned from a CFIR-guided qualitative study.

BACKGROUND: As the burden of non-communicable diseases continues to rise, general practices in primary care face increasing challenges in delivering high-quality care while managing workload constraints. Interprofessional care models, supported by practice-tailored protocols, offer a promising approach to optimizing task shifting and enhancing care coordination. However, the transition towards protocol-based interprofessional care remains complex and understudied. OBJECTIVE: This study explores the experiences of general practices in developing and implementing practice-tailored protocols to facilitate interprofessional care. Using the Consolidated Framework for Implementation Research (CFIR), we identify key barriers, facilitators and strategies that support this transition. METHOD: We conducted a qualitative study in Flanders, Belgium, using semi-structured interviews with 33 healthcare providers from 18 general practices. Participants represented various disciplines, including general practitioners, nurses, dietitians and reception staff. A hybrid qualitative analysis was applied, beginning with an inductive analysis based on Braun and Clarke's thematic approach, followed by a deductive phase guided by the CFIR-framework. RESULTS: The findings highlight several key factors influencing the development and implementation of practice-tailored protocols in general practices. Participants emphasized that clear task allocation and communication structures within protocols improved care coordination. External factors, such as financial constraints and high workloads, posed challenges, whereas collaborations with external healthcare providers facilitated interprofessional teamwork. Internal practice dynamics, including a shared vision, mutual trust, and structured team meetings, were identified as crucial enablers. At the individual level, motivation to adopt protocols varies, with some physicians expressing reluctance due to concerns about shifting patient relationships and increasing complexity in their caseloads. The implementation process benefited from a stepwise approach guided by a team leader, clear goal setting, continuous evaluation and peer learning. CONCLUSION: The transition towards protocol-based interprofessional care is a complex but mandatory evolution in primary care. While practice-tailored protocols can enhance efficiency and collaboration, their success depends on a structured implementation strategy, effective practice management, and team alignment. Addressing challenges such as gaining trust and provider resistance are critical. Future research should explore scalable support mechanisms and policy adaptations to facilitate widespread adoption of interprofessional care models in primary care settings.