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Suitability of a Programme for Improving Interprofessional Primary Care Team Meetings.

ABSTRACT: Introduction:Primary care is increasingly being confronted with complex health care demands stemming from both biomedical and psychosocial problems of people with chronic diseases. Interprofessional collaboration is needed to enhance person-centredness and coordinate care provision in an efficient manner, which should eventually result in high-quality and integrated care. In primary care, collaboration often occurs through periodic interprofessional team (IPT) meetings. We have developed a multifaceted programme (including a reflection framework, training activities and a toolbox) to enhance team functioning in terms of improved person-centredness and efficiency of meetings. The aim of this study was to evaluate the perceived suitability and potential impact of this programme. Eventually, findings of this evaluation should contribute to understanding the suitability of the programme and optimizing its design. Methods:A prospective process evaluation was conducted, using a mixed-methods approach. Six primary care IPTs participated. Data collection included observations of team meetings, semi-structured interviews with team chairpersons, a focus group meeting, and a questionnaire for all team members. Qualitative data were analysed using directed content analysis and quantitative data using descriptive statistics. Results:The results show that, on the whole, the programme was appreciated. Most progress was perceived regarding structure and organization. Chairs perceived increased awareness of person-centredness and team processes. They perceived the training activities as useful and instructive, and valued peer feedback and on-the-job coaching as the most effective strategies. Findings from the questionnaire showed a tendency in the desired direction for all variables. Conclusion:To conclude, the programme can be considered as a suitable approach for improving team functioning. However, enhancing person-centredness requires additional training/practice and on-the-job coaching. Lastly, the programme should be context-specific, flexible in use, and preferably delivered and mediated by an external facilitator at the workplace.

SUBMITTER: van Dongen JJJ

PROVIDER: S-EPMC6293205 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

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Project description:BackgroundThe number of people with multiple chronic conditions receiving primary care services is growing. To deal with their increasingly complex health care demands, professionals from different disciplines need to collaborate. Interprofessional team (IPT) meetings are becoming more popular. Several studies describe important factors related to conducting IPT meetings, mostly from a professional perspective. However, in the light of patient-centeredness, it is valuable to also explore the patients' perspective.ObjectiveThe aim was to explore the patients' perspectives regarding IPT meetings in primary care.MethodsA qualitative study with a focus group design was conducted in the Netherlands. Two focus group meetings took place, for which the same patients were invited. The participants, chronically ill patients with experience on interprofessional collaboration, were recruited through the regional patient association. Participants discussed viewpoints, expectations, and concerns regarding IPT meetings in two rounds, using a focus group protocol and selected video-taped vignettes of team meetings. The first meeting focused on conceptualization and identification of themes related to IPT meetings that are important to patients. The second meeting aimed to gain more in-depth knowledge and understanding of the priorities. Discussions were audio-taped and transcribed verbatim, and analyzed by means of content analysis.ResultsThe focus group meetings included seven patients. Findings were divided into six key categories, capturing the factors that patients found important regarding IPT meetings: (1) putting the patient at the center, (2) opportunities for patients to participate, (3) appropriate team composition, (4) structured approach, (5) respectful communication, and (6) informing the patient about meeting outcomes.ConclusionsPatients identified different elements regarding IPT meetings that are important from their perspective. They emphasized the right of patients or their representatives to take part in IPT meetings. Results of this study can be used to develop tools and programs to improve interprofessional collaboration.

Project description:Effective delivery of healthcare is highly interdependent within and between interprofessional (IP) care teams and the patients they serve. This is particularly true for complex health conditions such as advanced heart failure (AHF). Our Academic Practice Partnership received funding to carry out IP workforce development with inpatient AHF care teams. Our objectives were to (a) identify challenges in team functioning that affected communication and relationships among the AHF care teams, (b) collaboratively identify a focal work process in need of improvement, and (c) test whether facilitated the implementation of team training and work process changes would lead to improvements in team communication, relationships, and process outcomes. The health-care team identified implementation of structured IP bedside rounds (SIBR) as the preferred approach to improving collaborative care. Utilizing a cross-sectional pre/post design, changes in team communication and relationships before and after a team intervention that included TeamSTEPPS training and SIBR implementation, were assessed using a validated Relational Coordination (RC) survey. The study population included AHF care team members (n ~ 100) representing seven workgroups (e.g., nurses, pharmacists) from two inpatient cardiology units at a 450-bed academic medical center in the Pacific Northwest during 2015-2016. Improvements in RC scores were demonstrated across all seven RC dimensions from baseline (Year 1) to follow-up (Year 2). Percent change on each of the seven dimensions ranged from 3.57% to 9.85%. Changes were statistically significant for improvements between baseline and follow-up on all but one of the seven RC dimensions (shared knowledge). The IP team intervention was associated with improvements in RC from baseline to follow-up. Additional research is needed to assess patient perspectives and outcomes of the IP team intervention. Findings of this study are consistent with the growing body of RC and SIBR research and provide a useful model of an IP team-based intervention in clinical practice.

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Suitability of a Programme for Improving Interprofessional Primary Care Team Meetings.

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