Community Case Managers’ (CCMs) perspectives’ collaborating with primary care services when managing complex patients in the community: a qualitative study. (Preprint)

BACKGROUND Strong collaboration between community case managers (CCMs) and medical professionals are vital for the continuity of complex patients’ care in the community. Key challenges can influence or even deter successful collaboration. OBJECTIVE The objective of this qualitative study was to understand the challenges encountered by CCMs when collaborating with primary care services. METHODS This exploratory qualitative descriptive study used individual in-depth interviews. CCMs were selected using maximum variation and snowball sampling. The interviews were semi-structured, guided by a topic guide. Data were analyzed alongside ongoing data collection. Thematic content analysis was used to analyze the transcripts. Initial codes were obtained independently. These codes were then further explored, clarified and iteratively grouped into themes. RESULTS Fourteen individual in-depth interviews were conducted. Six themes emerged from the data i.e. self-identity, patient factor, inter-professional factor, collaborative culture, confidentiality and organizational structure. Challenges that resonated with previous studies were self-identity, inter-professional factors and confidentiality, whereas other challenges such as patient factors, collaborative culture, and organizational structure, were unique to Singapore’s health care landscape. CONCLUSIONS Significant challenges were encountered by CCMs when collaborating with primary care services. Understanding these challenges is key to refining intervention in current models of comprehensive community care between medical and non-medical professionals.