Evaluation of PCMH Model Adoption on Teamwork and Impact on Patient Access and Safety

Abstract

Purpose: Each of the participating patient-centered medical home (PCMH) received coaching and participated in learning collaborative for improving teamwork. The objective of the study was to assess the impact of trainings on patient-centered teamwork. Methods: The Teamwork Perception Questionnaire (TPQ) was administered once in spring 2014 and then in fall 2015. The TPQ consists of 35 questions across 5 domains: mutual support, situation monitoring, communication, team structure, and leadership. Based on our objective we compared the frequencies of strongly agree/agree by domain. The difference was tested using chi-square test. We compared the scores on each domain (strongly agree/agree = 1; maximum score = 7) via Wilcoxon rank sum test. Results: The response rate for this survey was n = 29 (80.6%) in spring 2014, and n = 31 (86.1%) in fall 2015. We found that the practice members significantly (P < .05) strongly agreed/agreed more in fall 2015 than spring 2014 for characteristics—“staff relay relevant information in a timely manner” (64.5% vs 83.9%) and “staff follow a standardized method of sharing information when handing off patients” (67.7% vs 90.3%) under communication domain and for characteristic—“staff within my practice share information that enables timely decision making” (74.2% vs 90.3%). However, there was no statistical significant difference observed in the scores for the overall TPQ at the 2 time points. Conclusion: Despite the statistical insignificance, the observations in PCMHs across the spectrum of practices participating in the Maryland Multi-Payer Program demonstrated enhanced teamwork specifically in communication and in leadership. This we believe will continue to result in enhanced patient access to care and safety.

Psychometric properties of the Chinese version of the TeamSTEPPS teamwork perceptions questionnaire to measure teamwork perceptions of Chinese residents: a cross-sectional study

“…Therefore, a good measuring tool is especially important to evaluate teamwork perceptions of the health professionals. [25][26][27] The TeamSTEPPS Teamwork Perception Questionnaire (T-TPQ) is one of the most frequently applied tools used for such evaluation. It is a self-report questionnaire, which evaluates perceptions of a healthcare professional on group-level teamwork situation in a medical team.…”

An Inquiry Into the Patient Safety Management Patterns: A Review Study

“…11,[13][14][15]17,[21][22][23][24][25][26] Similarly, health care providers, encouraging patients to criticize and express their views, creating a friendly environment for patient safety in the hospital, identifying the patient's proper identity, sharing patient-related practices, establishing personal and professional communication, as well as leaders and staff communication, having effective communication at patient handover, establishing communication before and after safety incidents, encouraging the desire to help the leader, focusing on the manager's communication with the patient, the physician's communication with the nurse, and the coordination and communication between team members. 4,[11][12][13]16,18,20,[23][24][25][27][28][29][30][31] Coordination dimension was highlighted in nine articles including topics such as positive and constructive interaction, mutual support, coordination and cooperation among health care providers at high levels of workload, coordination in critical situations, patient transfer and dispatch, and ensuring the accuracy of medication, inter-department coordination and implementation of patient safety priorities, sharing experiences, coordination in continuity of care, coordination and preparation, coordination in providing clinical services to patients, and finally, interpersonal coordination and collaboration. 13,14,19,21,23,27,28,30 Eventually, 11 articles highlighted the control dimension when introducing their pattern and in this area, controlling safety condition of the patient, evaluating and measuring the results, assessing the quality of health services continuously, contro...…”

“…4,[11][12][13]16,18,20,[23][24][25][27][28][29][30][31] Coordination dimension was highlighted in nine articles including topics such as positive and constructive interaction, mutual support, coordination and cooperation among health care providers at high levels of workload, coordination in critical situations, patient transfer and dispatch, and ensuring the accuracy of medication, inter-department coordination and implementation of patient safety priorities, sharing experiences, coordination in continuity of care, coordination and preparation, coordination in providing clinical services to patients, and finally, interpersonal coordination and collaboration. 13,14,19,21,23,27,28,30 Eventually, 11 articles highlighted the control dimension when introducing their pattern and in this area, controlling safety condition of the patient, evaluating and measuring the results, assessing the quality of health services continuously, controlling functions and processes, controlling the equipment and ensuring its faultlessness, controlling treatment protocols, following up corrective actions, showing agreement with corrective actions by senior hospital management, providing real-time supervision, ensuring the non-occurrence of the errors, safe systems, the manner of evaluating and disseminating the evaluation results, providing governance management and supervision, and monitoring the beds. 11,15,19,22,23,26,29,30…”

Visit Entropy Associated with Diabetic Control Outcomes

“…13 Patientcentered, team-based care is rapidly being adopted by many primary care practices due, in part, to financial incentives. 14,15 Such team-based care should be more organized than usual care because patients are actively directed by their primary care physician to needed resources and consults. The very nature of care teams, with inherent patient interactions involving multiple care team members, decrease longitudinal continuity as currently measured by conventional metrics.…”