Primary care professionals perspective on working as a team Kirti - - PowerPoint PPT Presentation

Kirti Doekhie, LLM MSc,

• Dr. M. Buljac, Dr. M. Strating, Prof. Dr. J. Paauwe

Institute of Health Policy and Management Erasmus University Rotterdam, The Netherlands EFPC conference 30 August – 1 September 2015

Primary care professionals’ perspective

• n working as a team

Background

• Growing prevalence of people with

multimorbidity

• Need for more collaboration instead of fragmentation

between multiple primary care professionals

• What is a primary care team?
• romanticizing of the effectiveness of teams
• real teams versus pseudo teams

Input – Process – Outcome (IPO) Framework

Input

Team composition

• Team size
• Diversity

Process

Communication dimensions

• Frequency, Timeliness. Accuracy,

Problem solving Relationship dimensions

• Shared goals, Shared knowledge,

Mutual Respect

Outcome

Perceived team effectiveness by team members (subjective outcome)

Methods

• Cross-sectional study in Dutch primary care setting
• Survey analysis following the IPO model (n=159)
• 13 different disciplines, e.g. general practitioners, remedial

therapists, dieticians, practice nurses

• 38 different primary care teams:

community care teams (n=16) physiotherapy centers (n=9) general practitioners centers (n=6) monodisciplinary centers (n=6) primary health care centers (n=1))

Results – Input

• Professionals have different indications of their

team size and diversity

• Average team size ranges between 8 to 10 members
• Average diversity is .45

Results - Process

• Rankings of the degree of relational coordination with another

PC professional vary between disciplines

Relational coordination in eyes

• f:

1 2 3 4 1Physiotherapist 3.85 2.82 2.75 2.15 2(registered or licensed) Nurse 2.99 4.58 2.49 1.84 3Occupational Therapist 4.64 4.79 2.93 4.07 4Speech Therapist 4.29 4.00 4.19 3.00

Results – IPO Framework

Input

Team composition

• Team size
• Diversity

Process

Communication dimensions

• Frequency, Timeliness. Accuracy,

Problem solving Relationship dimensions

• Shared goals, Shared knowledge,

Mutual Respect

Outcome

Perceived team effectiveness by team members (subjective outcome)

β = .32* β = .38* β = .23*

* Significant at the .05 level

Conclusions & Practice Implications

• Dutch primary care setting is very complex
• Inner and outer circles
• Conceptualization of “primary care teams” differs between

perspectives

• Patient and primary care professionals’ perspectives
• Practice implications:
• Investing in communication and relationships
• Organizing meetings to reflect on the underlying collaborations

between disciplines

Thank you for your attention!

+31 10 408 9554 doekhie@bmg.eur.nl Kirti Doekhie, LLM MSc