Developing Collaborative Practices in Co-Located Health and Social Services: An Observational Study of a Multidisciplinary Development Group.

Despite ongoing efforts to integrate health and social services, achieving integration in front-line practice remains challenging. This study explored collaboration in a multidisciplinary development group aimed at improving collaboration in one co-located health and social services centre in Helsinki, Finland. Drawing on the notion of knowledge practices as means for solving complex issues, the study analysed how collaboration and co-development are enacted within the group. Observational data collected from 11 development workshops were analysed using an abductive approach. The analysis identified three modes of collaboration: 1) one-sided knowledge sharing, 2) collaborative knowledge sharing, and 3) collaborative knowledge creation. Shared concepts and a new multidisciplinary service process supported collaborative modes for working, while some facilitation practices seemed to hinder them. The findings revealed a gap between the ideal of bottom-up development and the organisational conditions influencing it. A clear mandate and purposeful facilitation are critical to achieving the intended goals of such development initiatives. Stronger theoretical foundations and explicit theories of change could enhance development efforts. This study identified theoretical concepts that illuminate collaboration as a contextually shaped set of social practices. These insights can contribute to the design and facilitation of practice-based development efforts.