Examining how Primary Care Team Structures are Used and Their Effect on Cross-disciplinary Relationships PDF Download

Author: Matthew John DePuccio
Publisher:
ISBN:
Category : Health care teams
Languages : en
Pages : 109

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Book Description
Team-based primary care is an innovative care delivery model that has the potential to improve access to comprehensive, coordinated, and high-quality patient care. It is understood that in order for primary care teams to work effectively, health care providers must work across disciplinary boundaries and develop strong relationships that enable them to coordinate their roles and expertise. This research investigated how health care providers make use of different team structures (i.e., tools) to manage their interdependent work, enabling them to deliver team-based primary care. This research also examined how team structures influence the intra-team relationships important for coordinating care. By exploring the different ways primary care teams enact team structures, this research identifies ways primary care teams use team structures differently to address the needs of patients and coordinate team-based care. In-person interviews were conducted at 7 primary care clinics participating in a population health management program in a southeastern city in the United States. Research participants from various health care disciplines (e.g., medicine, nursing, social work) were asked to describe their experiences delivering team-based primary care. Interviews were recorded, transcribed, and analyzed. Data were analyzed using a constant comparative approach in order to investigate how different team structures were used to address the needs of patients and the challenges of delivering team-based primary care. The data suggested that primary care teams enact structures in different ways. In some teams, huddles were used to anticipate the specific needs of patients and coordinating care, referrals occurred via warm handoffs with co-located providers, and protocols were used to facilitate collaborative problem-solving. In other clinics, huddles were focused on clinic operations, referrals were performed using traditional methods (e.g., phone calls), and protocols were used to guide task delegation. Participants in some clinics described how team huddles were used to leverage high-quality relationships by fostering respectful interactions between team members. More research is needed to determine whether the use of patient-focused huddles, warm handoffs, and protocols that initiate problem-solving is associated with better patient outcomes, particularly for patient populations with complex medical and non-medical needs.

Author: Scott Reeves
Publisher: John Wiley & Sons
ISBN: 1444347799
Category : Medical
Languages : en
Pages : 275

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Book Description
PROMOTING PARTNERSHIP FOR HEALTH This book forms part of a series entitled Promoting Partnership for Health publishedin association with the UK Centre for the Advancement of Interprofessional Education (CAIPE). The series explores partnership for health from policy, practice and educational perspectives. Whilst strongly advocating the imperative driving collaboration in healthcare, it adopts a pragmatic approach. Far from accepting established ideas and approaches, the series alerts readers to the pitfalls and ways to avoid them. DESCRIPTION Interprofessional Teamwork for Health and Social Care is an invaluable guide for clinicians, academics, managers and policymakers who need to understand, implement and evaluate interprofessional teamwork. It will give them a fuller understanding of how teams function, of the issues relating to the evaluation of teamwork, and of approaches to creating and implementing interventions (e.g. team training, quality improvement initiatives) within health and social care settings. It will also raise awareness of the wide range of theories that can inform interprofessional teamwork. The book is divided into nine chapters. The first 'sets the scene' by outlining some common issues which underpin interprofessional teamwork, while the second discusses current teamwork developments around the globe. Chapter 3 explores a range of team concepts, and Chapter 4 offers a new framework for understanding interprofessional teamwork. The next three chapters discuss how a range of range of social science theories, interventions and evaluation approaches can be employed to advance this field. Chapter 8 presents a synthesis of research into teams the authors have undertaken in Canada, South Africa and the UK, while the final chapter draws together key threads and offers ideas for future of teamwork. The book also provides a range of resources for designing, implementing and evaluating interprofessional teamwork activities.

Author: Dr. Brenda Freshman
Publisher: Jones & Bartlett Publishers
ISBN: 1449617794
Category : Law
Languages : en
Pages : 440

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Book Description
Invited esteemed professionals from public health, medicine, nursing, health services and administration, and other areas, present their diverse perspectives on collaboration across the spectrum of the health care fields in this interesting and timely text. With a ‘student centered’ approach (also known as ‘learning-centered’), Collaboration Across the Disciplines in Health Care is accompanied by companion exercises, games and simulations, creating a thought-provoking learning experience.Important Notice: The digital edition of this book is missing some of the images or content found in the physical edition.

Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309187362
Category : Medical
Languages : en
Pages : 485

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Book Description
Building on the revolutionary Institute of Medicine reports To Err is Human and Crossing the Quality Chasm, Keeping Patients Safe lays out guidelines for improving patient safety by changing nurses' working conditions and demands. Licensed nurses and unlicensed nursing assistants are critical participants in our national effort to protect patients from health care errors. The nature of the activities nurses typically perform â€" monitoring patients, educating home caretakers, performing treatments, and rescuing patients who are in crisis â€" provides an indispensable resource in detecting and remedying error-producing defects in the U.S. health care system. During the past two decades, substantial changes have been made in the organization and delivery of health care â€" and consequently in the job description and work environment of nurses. As patients are increasingly cared for as outpatients, nurses in hospitals and nursing homes deal with greater severity of illness. Problems in management practices, employee deployment, work and workspace design, and the basic safety culture of health care organizations place patients at further risk. This newest edition in the groundbreaking Institute of Medicine Quality Chasm series discusses the key aspects of the work environment for nurses and reviews the potential improvements in working conditions that are likely to have an impact on patient safety.

Author: Karleen Frances Giannitrapani
Publisher:
ISBN:
Category :
Languages : en
Pages : 83

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Book Description
Team functioning is a prerequisite to interdisciplinary healthcare teams achieving the goal of improving quality of care and patient outcomes. This three-paper dissertation examines barriers, facilitators and correlates of team functioning within patient aligned care teams (PACT), the Veterans Health Administration's implementation of interdisciplinary primary care teams and a patient centered medical home. Interprofessional team-based models that expand the role of support staff are increasingly adopted in primary care practices. In the first study we query team members of a newly implemented medical home to identify factors that may inhibit nursing staff self-efficacy, a belief of possessing the capacity to execute a role effectively. We analyzed data from 79 key informants' interviews with primary care team members at six Veterans Health Administration (VA) clinics in Southern California. All sites had implemented Patient Aligned Care Teams (PACT), the VA's version of a patient centered medical home (PCMH). We identified three themes that produce the self-efficacy necessary for successful role expansion: 1) role training 2) time and resources for roles and 3) cross-disciplinary role agreement. Clarifying the factors that impact self-efficacy for the role expansion of PACT staff can inform strategies for role transformation under other PCMH models. The second paper aims to characterize PACT team members' perceptions of the role their direct supervisors play in day-to-day primary care team functioning. In this qualitative analysis we review teamlet members' perceptions of how their supervising middle managers are essential to the day-to-day functioning of PACT teamlets. Supervisors fulfill necessary leadership functions both within and across teams. They are involved in defining the specific roles and responsibilities of teamlet members, facilitating conflict resolution between teamlet members, setting expectations and mechanisms of accountability, facilitating within teamlet and cross teamlet coverage, and facilitating teamlet member initiated innovation. Within a multilevel system, frontline interdisciplinary teams continue to perceive the need for leadership by middle management supervisors from their own professional disciplines. The primary objective of the third study is to employ a mixed-methods study design to identify modifiable practice climate factors associated with team function under PACT. We fielded a cross-sectional online survey of 818 providers and staff working in 23 VA primary care clinics in early stages of PCMH implementation. We simultaneously conducted semi-structure interviews with teamlet members. A cluster adjusted regression revealed perceived support from leadership, and satisfaction with the team were associated with team functioning. Attending local trainings, attending regional trainings, and attending trainings with team members were not. Qualitative interviews reveal substantial implementation variation in training. Identifying modifiable practice climate factors that are associated with team function at early stages of PCHM implementation can provide insight into where to invest resources during times of transition.

Author: Kara L. Hall
Publisher: Springer Nature
ISBN: 303020992X
Category : Psychology
Languages : en
Pages : 633

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Book Description
Collaborations that integrate diverse perspectives are critical to addressing many of our complex scientific and societal problems. Yet those engaged in cross-disciplinary team science often face institutional barriers and collaborative challenges. Strategies for Team Science Success offers readers a comprehensive set of actionable strategies for reducing barriers and overcoming challenges and includes practical guidance for how to implement effective team science practices. More than 100 experts--including scientists, administrators, and funders from a wide range of disciplines and professions-- explain evidence-based principles, highlight state-of the-art strategies, tools, and resources, and share first-person accounts of how they’ve applied them in their own successful team science initiatives. While many examples draw from cross-disciplinary team science initiatives in the health domain, the handbook is designed to be useful across all areas of science. Strategies for Team Science Success will inspire and enable readers to embrace cross-disciplinary team science, by articulating its value for accelerating scientific progress, and by providing practical strategies for success. Scientists, administrators, funders, and others engaged in team science will also leave equipped to develop new policies and practices needed to keep pace in our rapidly changing scientific landscape. Scholars across the Science of Team Science (SciTS), management, organizational, behavioral and social sciences, public health, philosophy, and information technology, among other areas of scholarship, will find inspiration for new research directions to continue advancing cross-disciplinary team science.

Author: Helen Elizabeth Ovsepyan
Publisher:
ISBN:
Category :
Languages : en
Pages : 0

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Book Description
Team-based care can be associated with improved care quality, but simply being on a team is not sufficient for achieving the "quadruple aim" of enhancing patient care experiences, improving population health, reducing healthcare costs and improving provider experience. Rather, implementation of healthcare teams varies greatly across and within organizations, and there is a growing body of contradictory evidence on how implementing team models can impact the well-being of team members. This dissertation examines how healthcare organizations may take steps to improve team functioning and team member well-being in primary care settings.Our first study addresses this question by contributing empirical evidence to guide practices on how to optimize team functioning. We examined how the implementation strategy, evidence-based quality improvement (EBQI), was used to change PC team processes at two VA medical centers (Sites A and B) over a two year period. We used a comparative case study, analyzing multiple qualitative data sources collected from those sites: baseline and follow-up interviews with key stakeholders and provider team ("teamlet") members (n=64), and EBQI meeting notes, reports, and supporting materials. Our analysis showed that the sites developed unique innovations upon participating in EBQI, with each project tailored to their site's respective needs, context and capacity: Site A's QI project entailed engaging in structured daily huddles using a huddle checklist and developing a protocol clarifying team member roles and responsibilities; and Site B initiated weekly virtual team meetings that spanned two practice locations. Respondents from both sites perceived these projects as improving team structure and staffing, team communications, role clarity, staff voice and personhood, accountability, and ultimately, overall team functioning over time. Our second study examines the association between team processes and team members' well-being, as well as the practices that optimize their team experiences in those areas. We used a sequential explanatory mixed methods approach and examined: cross-sectional survey data (n=244) to explore the relationship between team processes such as communication and participation in decision-making with job satisfaction, as well as the more distal outcome of turnover intent; and interview data (n=73) to conduct a thematic analysis of how various practices and mechanisms impacted team members' experiences with those team processes. Additionally, we explored whether team members varied in their reported well-being and team experiences by role. We found a strong and significant association between team member processes (e.g., communication and participation in decision-making) with team members' reported rate of job satisfaction and, to a lesser degree, their intent to remain in their positions. Job satisfaction and intent to continue were generally high among care teams, but clinical associates were less likely to be satisfied with their jobs, and clerical associates were less likely to report an intent to stay in their current positions. Qualitative analysis found some clerical and clinical staff still experiencing an imbalance in voice and participation within their teams. The qualitative analysis affirmed the importance of the proximity, availability and attributes of providers and staff in how their team members experienced team processes.

Author: Audrey Leathard
Publisher: Routledge
ISBN: 1135480087
Category : Medical
Languages : en
Pages : 393

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Book Description
In Interprofessional Collaboration the benefits of collaboration for patients and carers are confirmed through theoretical models illustrated with case studies of existing examples.

Author: National Research Council
Publisher: National Academies Press
ISBN: 0309316855
Category : Business & Economics
Languages : en
Pages : 255

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Book Description
The past half-century has witnessed a dramatic increase in the scale and complexity of scientific research. The growing scale of science has been accompanied by a shift toward collaborative research, referred to as "team science." Scientific research is increasingly conducted by small teams and larger groups rather than individual investigators, but the challenges of collaboration can slow these teams' progress in achieving their scientific goals. How does a team-based approach work, and how can universities and research institutions support teams? Enhancing the Effectiveness of Team Science synthesizes and integrates the available research to provide guidance on assembling the science team; leadership, education and professional development for science teams and groups. It also examines institutional and organizational structures and policies to support science teams and identifies areas where further research is needed to help science teams and groups achieve their scientific and translational goals. This report offers major public policy recommendations for science research agencies and policymakers, as well as recommendations for individual scientists, disciplinary associations, and research universities. Enhancing the Effectiveness of Team Science will be of interest to university research administrators, team science leaders, science faculty, and graduate and postdoctoral students.

Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309255201
Category : Medical
Languages : en
Pages : 212

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Book Description
Ensuring that members of society are healthy and reaching their full potential requires the prevention of disease and injury; the promotion of health and well-being; the assurance of conditions in which people can be healthy; and the provision of timely, effective, and coordinated health care. Achieving substantial and lasting improvements in population health will require a concerted effort from all these entities, aligned with a common goal. The Health Resources and Services Administration (HRSA) and the Centers for Disease Control and Prevention (CDC) requested that the Institute of Medicine (IOM) examine the integration of primary care and public health. Primary Care and Public Health identifies the best examples of effective public health and primary care integration and the factors that promote and sustain these efforts, examines ways by which HRSA and CDC can use provisions of the Patient Protection and Affordable Care Act to promote the integration of primary care and public health, and discusses how HRSA-supported primary care systems and state and local public health departments can effectively integrate and coordinate to improve efforts directed at disease prevention. This report is essential for all health care centers and providers, state and local policy makers, educators, government agencies, and the public for learning how to integrate and improve population health.