Family physicians’ perspectives on interprofessional teamwork: Findings from a qualitative study

Abstract

The aim of this study was to describe family physicians' perspectives of their role in the primary care team and factors that facilitate and hinder teamwork. A qualitative study was conducted employing individual interviews with 19 academic/community-based family physicians who were part of interprofessional primary care teams in Edmonton, Alberta, Canada. Professional responsibilities and roles of physicians within the team and the facilitators and barriers to teamwork were investigated. Interviews were audiotaped, transcribed and analysed for emerging themes. The study findings revealed that family physicians consistently perceived themselves as having the leadership role on in the primary care team. Facilitators of teamwork included: communication; trust and respect; defined roles/responsibilities of team members; co-location; task shifting to other health professionals; and appropriate payment mechanisms. Barriers to teamwork included: undefined roles/responsibilities; lack of space; frequent staff turnover; network boundaries; and a culture of power and control. The findings suggest that moving family physicians toward more integrative and interdependent functioning within the primary care team will require overcoming the culture of traditional professional roles, addressing facilitators and barriers to teamwork, and providing training in teamwork.

Are interprofessional healthcare teams meeting patient expectations? An exploration of the perceptions of patients and informal caregivers

“…Characteristics and attributes that facilitate effective teams and the function of those teams have been well documented in the literature (Grace et al, 2017;Szafran et al, 2018) (Nancarrow et al, 2013). A number of team attributes including communication, leadership and understanding the roles of others were considered key.…”

“…In addition, practical factors, such as the geography of the workplace and work schedule, can impact the accessibility of team members, which can hinder the teamworking process (Delva, Jamieson, & Lemieux, 2008;S Reeves, Lewin, Espin, & Zwarenstein, 2010;Sargeant et al, 2008). As face-to-face communication is not always possible, there is then a greater need for effective communication using a range of processes to support information sharing and exchange within a team; central coordinators such as secretaries are seen as central to facilitating communication because they interacted with all team members (Aungst & Belliveau, 2015;Azar et al, 2017;Bardach, Real, & Bardach, 2017;Delva et al, 2008;Kuziemsky & Reeves, 2012;Szafran, Torti, Kennett, & Bell, 2018).…”

“…Whilst Soklaridis et al ((Soklaridis et al, 2017) found that there is a growing appreciation of the patient perspective in delivering Are healthcare teams meeting patient expectations8 patient-centred care, it was suggested that there is a risk of "tokenising"(p124) the patient perspective since healthcare professional control healthcare provision. More recently, there is evidence that doctors do not conceptualise patients as members of the primary care team (Szafran et al, 2018) and it has been suggested that proactive discussion with patients regarding their health could have a negative psychological impact on patients (Howe, 2006).…”

A Scoping Review of Facilitators of Multi-Professional Collaboration in Primary Care

“…In particular, we have evaluated the relational, processual, organisational and contextual dimensions of professional collaboration, inspired by Reeves et al’s framework for inter-professional collaboration [14]. Previous application of this framework has been used, for example, in studies describing the perspectives of GPs of their role in the primary care team, the factors that facilitate and hinder teamwork [15] and in examining the perspectives and experiences of family health team members regarding inter-professional collaboration and perceived benefits [16]. …”

Patients’ perceptions of team-based care in family practice: access, benefits and team roles

“…a study of physicians' perspectives on interprofessional teamwork found that family physicians also see themselves as the team leaders. 29 The College of Family Physicians of Canada advocates for family physicians being the 'most responsible provider' within the Patient-Centered Medical Home, 2 hence in the leadership role. Other health professionals have different perspectives on team leadership, which can result in tensions in professional relationships.…”