Publications

BACKGROUND

There is limited collaboration between hospitals and primary care despite parallel efforts to improve postdischarge care transitions.

OBJECTIVE

To understand what primary care leaders perceived as barriers and facilitators to collaboration with hospitals.

METHODS

Qualitative study with in-depth, semistructured interviews of 22 primary care leaders in 2012 from California safety-net clinics.

RESULTS

Major barriers to collaboration included lack of institutional financial incentives for collaboration, competing priorities (e.g., regulatory requirements, strained clinic capacity, financial strain) and mismatched expectations about role and capacity of primary care to improve care transitions. Facilitators included relationship building through interpersonal networking and improving communication and information transfer via electronic health record (EHR) implementation.

CONCLUSIONS

Efforts to improve care transitions should focus on aligning financial incentives, standardizing regulations around EHR interoperability and data sharing, and enhancing opportunities for interpersonal networking.