Communities of Practice in Long-Term Care-Exploring Frameworks, Barriers and Enablers: A Systematic Review.

内容摘要

Communities of Practice (CoPs) offer staff an opportunity to learn with and from one another, and to explore and advance practice. This study aimed to identify the frameworks that underpin the development, operation and evaluation of CoPs, and barriers and enablers to implementing this social learning approach in long term care (LTC). This systematic review comprehensively searched four databases (MEDLINE, CINAHL, PsycInfo and Embase) from inception to August 2025, identifying studies focused on supporting LTC staff implementing evidence-based practice, best practice or quality improvement. Inclusion screening, data extraction and quality assessment using the Quality Assessment with Diverse Studies tool (QuADS) were completed independently. Findings were mapped to the Values Creation Framework. Fifteen papers represented eight CoP programs ranging from small, standalone groups to large national collaboratives. Frameworks or specific CoP definitions underpinned planning for seven programs. Two programs drew on stakeholder input in development; however, none described formal co-design. Seven programs were multidisciplinary. Evaluation was qualitative (n = 8), mixed methods (n = 4) or quantitative (n = 3), with limited application of evaluation frameworks. A wide range of enablers and barriers was identified, with structural and cultural challenges affecting sustained CoP engagement and implementation of CoP learning outcomes. Despite 20 years of CoP implementation in LTC, there are few comprehensive evaluations to guide practice. Community of Practice participation delivers individual learning and peer support; however, system and organisational barriers affect sustained staff participation and translation. Consistent application of existing frameworks and enhanced CoP reporting will better support future CoP development and implementation in LTC.