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Dimensions and intensity of inter-professional teamwork in primary care: evidence from five international jurisdictions

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journal contribution
posted on 2018-06-01, 00:00 authored by Jean-Frederic Levesque, Mark F Harris, Cathie Scott, Benjamin Crabtree, William Miller, Lisa M Halma, William E Hogg, Jan-Willem Weenink, Jenny R Advocat, Jane Gunn, Grant Russell
Background: Inter-professional teamwork in primary care settings offers potential benefits for responding to the increasing complexity of patients' needs. While it is a central element in many reforms to primary care delivery, implementing inter-professional teamwork has proven to be more challenging than anticipated. Objective: The objective of this study was to better understand the dimensions and intensity of teamwork and the developmental process involved in creating fully integrated teams. Methods: Secondary analyses of qualitative and quantitative data from completed studies conducted in Australia, Canada and USA. Case studies and matrices were used, along with face-to-face group retreats, using a Collaborative Reflexive Deliberative Approach. Results: Four dimensions of teamwork were identified. The structural dimension relates to human resources and mechanisms implemented to create the foundations for teamwork. The operational dimension relates to the activities and programs conducted as part of the team's production of services. The relational dimension relates to the relationships and interactions occurring in the team. Finally, the functional dimension relates to definitions of roles and responsibilities aimed at coordinating the team's activities as well as to the shared vision, objectives and developmental activities aimed at ensuring the long-term cohesion of the team. There was a high degree of variation in the way the dimensions were addressed by reforms across the national contexts. Conclusion: The framework enables a clearer understanding of the incremental and iterative aspects that relate to higher achievement of teamwork. Future reforms of primary care need to address higher-level dimensions of teamwork to achieve its expected outcomes.

History

Journal

Family practice

Volume

35

Pagination

285-294

Location

Oxford, Eng.

Open access

  • Yes

ISSN

0263-2136

eISSN

1460-2229

Language

eng

Publication classification

C1.1 Refereed article in a scholarly journal

Copyright notice

2017, The Authors

Issue

3

Publisher

Oxford University Press