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Primary care multidisciplinary teams in practice: a qualitative study

BACKGROUND: Current recommendations for strengthening the US healthcare system consider restructuring primary care into multidisciplinary teams as vital to improving quality and efficiency. Yet, approaches to the selection of team designs remain unclear. This project describes current primary care t...

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Autores principales: Leach, Brandi, Morgan, Perri, Strand de Oliveira, Justine, Hull, Sharon, Østbye, Truls, Everett, Christine
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5747144/
https://www.ncbi.nlm.nih.gov/pubmed/29284409
http://dx.doi.org/10.1186/s12875-017-0701-6
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author Leach, Brandi
Morgan, Perri
Strand de Oliveira, Justine
Hull, Sharon
Østbye, Truls
Everett, Christine
author_facet Leach, Brandi
Morgan, Perri
Strand de Oliveira, Justine
Hull, Sharon
Østbye, Truls
Everett, Christine
author_sort Leach, Brandi
collection PubMed
description BACKGROUND: Current recommendations for strengthening the US healthcare system consider restructuring primary care into multidisciplinary teams as vital to improving quality and efficiency. Yet, approaches to the selection of team designs remain unclear. This project describes current primary care team designs, primary care professionals’ perceptions of ideal team designs, and perceived facilitating factors and barriers to implementing ideal team-based care. METHODS: Qualitative study of 44 health care professionals at 6 primary care practices in North Carolina using focus group discussions and surveys. Data was analyzed using framework content analysis. RESULTS: Practices used a variety of multidisciplinary team designs with the specific design being influenced by the social and policy context in which practices were embedded. Practices overwhelmingly located barriers to adopting ideal multidisciplinary teams as being outside of their individual practices and outside of their control. Participants viewed internal organizational contexts as the major facilitators of multidisciplinary primary care teams. The majority of practices described their ideal team design as including a social worker to meet the needs of socially complex patients. CONCLUSIONS: Primary care multidisciplinary team designs vary across practices, shaped in part by contextual factors perceived as barriers outside of the practices’ control. Facilitating factors within practices provide a culture of support to team members, but they are insufficient to overcome the perceived barriers. The common desire to add social workers to care teams reflects practices’ struggles to meet the complex demands of patients and external agencies. Government or organizational policies should avoid one-size-fits-all approaches to multidisciplinary care teams, and instead allow primary care practices to adapt to their specific contextual circumstances.
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spelling pubmed-57471442018-01-03 Primary care multidisciplinary teams in practice: a qualitative study Leach, Brandi Morgan, Perri Strand de Oliveira, Justine Hull, Sharon Østbye, Truls Everett, Christine BMC Fam Pract Research Article BACKGROUND: Current recommendations for strengthening the US healthcare system consider restructuring primary care into multidisciplinary teams as vital to improving quality and efficiency. Yet, approaches to the selection of team designs remain unclear. This project describes current primary care team designs, primary care professionals’ perceptions of ideal team designs, and perceived facilitating factors and barriers to implementing ideal team-based care. METHODS: Qualitative study of 44 health care professionals at 6 primary care practices in North Carolina using focus group discussions and surveys. Data was analyzed using framework content analysis. RESULTS: Practices used a variety of multidisciplinary team designs with the specific design being influenced by the social and policy context in which practices were embedded. Practices overwhelmingly located barriers to adopting ideal multidisciplinary teams as being outside of their individual practices and outside of their control. Participants viewed internal organizational contexts as the major facilitators of multidisciplinary primary care teams. The majority of practices described their ideal team design as including a social worker to meet the needs of socially complex patients. CONCLUSIONS: Primary care multidisciplinary team designs vary across practices, shaped in part by contextual factors perceived as barriers outside of the practices’ control. Facilitating factors within practices provide a culture of support to team members, but they are insufficient to overcome the perceived barriers. The common desire to add social workers to care teams reflects practices’ struggles to meet the complex demands of patients and external agencies. Government or organizational policies should avoid one-size-fits-all approaches to multidisciplinary care teams, and instead allow primary care practices to adapt to their specific contextual circumstances. BioMed Central 2017-12-29 /pmc/articles/PMC5747144/ /pubmed/29284409 http://dx.doi.org/10.1186/s12875-017-0701-6 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Leach, Brandi
Morgan, Perri
Strand de Oliveira, Justine
Hull, Sharon
Østbye, Truls
Everett, Christine
Primary care multidisciplinary teams in practice: a qualitative study
title Primary care multidisciplinary teams in practice: a qualitative study
title_full Primary care multidisciplinary teams in practice: a qualitative study
title_fullStr Primary care multidisciplinary teams in practice: a qualitative study
title_full_unstemmed Primary care multidisciplinary teams in practice: a qualitative study
title_short Primary care multidisciplinary teams in practice: a qualitative study
title_sort primary care multidisciplinary teams in practice: a qualitative study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5747144/
https://www.ncbi.nlm.nih.gov/pubmed/29284409
http://dx.doi.org/10.1186/s12875-017-0701-6
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