"The patients first and foremost" collaborative practice in the Australian healthcare system: a qualitative study.

Background: Collaborative patient centred practice is an expectation of the Australian healthcare system, yet there is not a clear understanding of what this entails. The aim of this research was to describe collaborative practice, as understood within the context of the Australian health system. Methods: Nineteen focus groups were conducted in 2022 with 84 participants consisting of education providers (n=62), consumers (n=10), representatives from the Health Profession's Education Standing Group (n=8), and health service practitioners (n=4). Framework analysis was undertaken to understand facilitators of, and barriers to, collaborative practice and learning within the Australian education and healthcare systems. Results: Participants were asked to describe examples of effective collaborative practice, what they would expect to experience, and examples of when collaborative practice did not occur and the associated outcomes. Participants from all groups emphasised the importance of elevating the patient voice within a patient centred collaborative healthcare team. Patients, family and carers needed to be positioned as central team members within a collaborative healthcare team. Power and hierarchy within the healthcare team impacted on the ability to deliver collaborative practice. Conclusions: By positioning the patient and their family and carers as members of the team, shared goals for optimal patient outcomes were experienced. By contrast when collaborative practice did not occur, or patients were omitted as central team members, poor communication and disjointed healthcare was described, leaving patients feeling disempowered and disengaged.