A meta-ethnographic review of interprofessional teamwork in hospitals: what it is and why it doesn't happen more often.

Objectives Although interprofessional teamwork has been shown to improve patient safety, it is not yet routine practice in most hospital settings. There is also a lack of clarity regarding what teamwork actually means, with terms such as collaboration, coordination, networking and knotworking often being used interchangeably. In this study, we analyse 20 years of qualitative research on interprofessional teamwork in hospital settings and examine what it looks like and the factors influencing it. Methods The literature search included articles published between 1996 and 2016, and articles were included if they examined interprofessional teamwork within a hospital using qualitative methodology. We used meta-ethnographic analysis of eligible primary studies applying reciprocal translation and line of argument synthesis. Results Nineteen articles were included. Interprofessional teamwork was largely absent in acute care and found to be influenced by systems perpetuating power imbalances, organizational practices that interfered with interprofessional interactions, representations of teamwork and leadership. Conclusions Future strategies to improve interprofessional practices should include policies and structural changes to develop healthcare systems that facilitate these practices.