Effective teamwork in primary healthcare through a structured patient-sorting system - a qualitative study on staff members’ conceptions

Abstract

BackgroundPrimary healthcare meets increased demands from an aging population concerning quality and availability while concurrently dealing with a growing shortage of general practitioners and imperfect efficiency in healthcare processes. Reorganization and team development can improve quality and performance but projects in primary care frequently do not attain the targeted results. By developing and introducing a structured patient-sorting system a primary healthcare centre in Western Sweden increased its access rate significantly and employed its medical professionals more efficiently. The aim of this study was to explore staff members’ conceptions of the structured patient-sorting system in order to gain an inside perspective on this project.MethodsIn this qualitative study 16 interviews were conducted over a period of two years and data was analysed using a phenomenographic approach to identify the various conceptions of the eleven participants.ResultsThree categories of description were identified: The system was conceptualized as 1) a framework for the development of patient-centred processes that were clear and consistent, 2) a promotor of professional development and a shared ideal of cooperative practice and 3) a common denominator and catalyst in conflict management.In an overall perspective the system was conceived as being an appropriate platform for promoting transformation into an effective patient-centred primary healthcare team in which organizational development was perceived as a continuous participative process demanding the commitment of all team members.ConclusionsThis study demonstrates that the introduction of a structured patient-sorting system makes it possible for several important change processes to take place concurrently: improvement of healthcare processes, empowerment of professionals and team development. It therefore indicates the importance of an appropriate, contextualized framework to support multiple concomitant quality improvement processes. Knowledge from this study can be used to assist and improve future implementations in primary healthcare centres.

Patient Safety Culture in Tunisia: Defining Challenges and Opportunities

“…In a recently published study, only 28% of the staff members dared to speak with their superior regarding their concerns about the risk of a planned measure while the other staff members remained silent. In nearly 90% of the cases, the silence led to a near miss [17][18][19].…”

Culture de sécurité des soins dans les centres de soins primaires tunisiens : une étude multicentrique

“…Cela pourrait êtred ûau fait que les soins de santé primaires sont des structures non sophistiquées contenant un nombre limité de professionnelsqui s'entraidentmutuellement [21]. En effet,letravail en équipe est connu comme un processus dynamique contribuant à l'amélioration de la qualité dessoins et ainsi à la diminution des EI [22]. Concernant la dimension « liberté d'expression et réponsenon punitive à l'erreur »,notre étudeamontré que les professionnels n'étaient pas encouragés à exprimer leurs points de vue.…”

Access systems in general practice: a systematic scoping review

“…Redirection was a common approach in which patients were signposted to self-help advice, NHS111 (UK), pharmacies or to make solely administrative requests e.g., repeat prescriptions Non-GP Healthcare Professional Appointments Some systems introduced more appointments non-GPs healthcare professionals. Instead of seeing a GP in the first instance, patients were triaged to an appointment with another professional instead, e.g., a practice nurse, psychotherapist, counsellor (59,68,70,72,96).…”