The role of relational routines in hindering transdisciplinary collaboration: the case of the setting up of a team in an Italian Breast Unit

Interprofessional teamwork is one of the main characteristics of centers specialized in the treatment of breast cancer, known as Breast Units, which since 2016 European legislation has made mandatory for Member States. However, interprofessional collaborative practice (ICP) has often been applied in traditional healthcare contexts on the basis of mono-disciplinary approaches. This paper reports the results of a case study of an Italian Breast Unit carried out through a qualitative research strategy. To understand the case being studied in its complexity the data were drawn from multiple sources of evidence: documents, in-depth interviews with Breast Unit members and field notes from the participant observation of team meetings. The case study shows that, despite the healthcare organization promoting interprofessional collaboration through the creation of protocols, organizational environments and structures aimed at encouraging communication and collaboration between the professionals of the team, a series of older routine relational practices remain. These are based on traditional communication models, cultural and professional barriers between members of the team, which hinder the development of innovative ICPs, thus preventing professionals from seeing the need for change in their relational practices towards a trans-disciplinary approach.