Understanding Complexities in Collaborative Management of Knowledge on Advance Care Planning for Multi-morbid...

Area of Science:

• Healthcare Management
• Health Informatics
• Systems Thinking

Background:

• Healthcare is transitioning from a paternalistic to a patient-centered model, emphasizing shared decision-making.
• Collaborative knowledge management (CKM) is crucial for integrating diverse professional expertise in healthcare.
• CKM in healthcare faces challenges in managing interdisciplinary collaboration and knowledge sharing.

Purpose of the Study:

• To explore complexities in collaborative knowledge management for advance care planning (ACP) in multi-morbid patients within personalized integrated care.
• To identify key challenges hindering effective CKM in this context using a system modeling approach.

Main Methods:

• A system modeling approach was employed.
• Focus group discussions (FGD) with 11 participants from the Basque Public Health System (Osakidetza) were conducted.
• Causal loop diagrams (CLDs) were developed to visualize systemic dynamics.

Main Results:

• Three primary challenges were identified: cultural reluctance to discuss death, the need for healthcare professionals' attitudinal shifts, and the necessity for the system to adopt a holistic, shared care model.
• CLDs indicated that fragmented and paternalistic care may worsen without recognizing ACP as a social need and clinical practice component.

Conclusions:

• Overcoming cultural, professional, and systemic barriers is critical for successful CKM in advance care planning.
• Implementing a holistic and shared care model is essential to improve care for multi-morbid patients.
• Recognizing advance care plans as a social need is pivotal for clinical practice transformation.