Challenges in interprofessional collaboration: experiences of care providers and policymakers in a newly set‐up Dutch assault centre

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Sexual and family violence are highly prevalent problems that cause numerous health problems. Victims often do not seek the help of professional services out of shame, fear of the perpetrator, the assumption that the violence is ‘not serious enough’, unawareness of available services or fear that formal care will not help or even harm them 1. Victims who do seek help often have negative experiences, such as healthcare providers' victim‐blaming attitudes or incomplete medical care 5. They often need to visit various places to receive the care they need 3.
To improve care for victims of acute sexual and family violence, worldwide, sexual assault centres (SACs) have been set up. A SAC is an interprofessional collaboration where medical, forensic, legal and psychosocial services work together at one location. Interprofessional collaboration is defined as an interpersonal process through which members of different disciplines contribute to a common product or goal9. The goal of an SAC is to improve legal outcomes and help‐seeking experiences of victims. SACs indeed seem to have a positive impact on both 4. Effective interprofessional collaboration is a key determinant that is reaching these aims. Interprofessional collaboration consists of five components: interdependence, newly created professional activities, flexibility, collective ownership of goals and reflection on the process 12. Interprofessional collaboration is influenced by several characteristics which are, amongst others, interpersonal characteristics, e.g. trust and respect between members and commitment to the collaboration; structural characteristics, e.g. the strength of well‐defined professional roles and professional autonomy; and organisational characteristics, e.g. allocation of resources and adequate coordination 12. Research from interprofessional collaborations in elderly and psychiatric care and public health shows that interprofessional collaborations are ‘works in progress’: trust, mutual understanding and respect have to grow, and expectations about each others' tasks have to be brought in line 14. Flexibility and reflection are necessary to keep an interprofessional collaboration useful and productive 14. Collaboration in a SAC has an extra dimension, namely that on top of medical and psychosocial services, legal and forensic services are explicitly involved. Furthermore, sexual and family violence are topics that are surrounded by emotions as shame and fear. For victims, it is hard to disclose, and for professionals it is hard to bring it up. Both dimensions are likely to challenge a collaboration even more. Data on interprofessional collaboration in European SACs are largely lacking. From research from the United States, we do indeed know that interprofessional collaboration within SACs faces challenges: role conflict and role confusion are common. Different opinions about professional confidentiality, attitudes towards victims and professionalisation influence the collaboration, as do power disparities 10.
Inadequate interprofessional collaboration can lead to diminished productivity and satisfaction 13. Therefore, we find it important to gain knowledge on the experiences of professionals with interprofessional collaboration within a newly set‐up Dutch assault centre. As an interprofessional approach as conducted in assault centres is advised by the WHO and many researchers in the field, it is likely that, like in the Netherlands, new assault centres will arise. Getting insight in the gains and challenges in the interprofessional collaboration gives grips for improving working processes within assault centres – not only in the Netherlands, but also in other parts of the world as well. As this is the first qualitative study in Europe that focuses on interprofessional collaboration within an assault centre, we want to conduct an exploratory qualitative study with semi‐structured interviews with care providers, legal service providers and policymakers.
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