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

Abstract

INTRODUCTION:The increasing complexity of health care and escalating prevalence of multiple chronic conditions have driven interprofessional team-based care in family practice. Most published studies examine team-based care from the perspective of health professionals. The purpose of this study was to examine patients' perceptions of team-based care in family practice. METHODS:This was a waiting room survey conducted in five family medicine academic teaching clinics in Edmonton, Alberta, Canada. Patients aged ≥18 years were invited to participate in a survey addressing patient access to team-based care, perceived benefits, preferred health professional and team member roles. RESULTS:Of the 44.3% (565/1274) of respondents, 41.8% (231/552) reported receiving care from a team of health professionals, primarily for chronic disease management or pharmacy consultations. While there was a consistent pattern of patient perception that many aspects of care did not worsen with team-based care, improvements in knowledge of their medical condition (67.4%); the care received (65.0%); access to care (51.1%); ability to self-care (48.9%) and maintain their independence (43.7%); and overall health (51.1%) were reported. Some patients felt that team-based care reduced emergency visits (34.6%) and hospitalisations (29.9%), and 44.1% of patients felt that they had an active role on the team and made decisions about their care together with health professionals. CONCLUSION:Patients perceive that team-based care in family practice has improved their knowledge and access to care, overall health and avoided some emergency department visits and hospital admissions. The findings support the continued development of team-based care in family practice.

A Review and Synthesis of TBPCC Evaluation in Canada: Looking beyond the Quadruple Aim

“…From our review, there is considerable evidence that TBPCC can enhance patient experience of care through strategies related to accessibility, respectful supportive relationships, enhanced opportunities for knowledge sharing, self-management, and community advocacy (24,33,34,40). The availability of enhanced case management or specialized support roles also positively influences patient experience (44,45,72).…”

“…Four of the seven studies from the Prairie Provinces (Alberta=6, Manitoba=1) mapped to the Quadruple Aim. Two studies reported on patient experience (33,34), one on population health (35), and one on provider experience (36). Three of seven studies reported on team collaboration and function as important components of transitioning to TBC (36)(37)(38).…”

“…Emerging themes from the studies were patient needs regarding respect, support, and advocacy, and improved knowledge, independence, care received, ability to make decisions, and overall health. Other related themes included: provider and patient experience with overall delivery and quality of care (33)(34)(35)39), provider remuneration, and support for information technology, leadership, and education (38).…”

“…One study emphasized that while the respect, support, and community advocacy provided to patients as a result of a TBC model was appreciated, accessibility continued to be a barrier for patients (33). Another study reported a perceived benefit improvement in access to care (34). One study noted increased job satisfaction for providers (36).…”

From the Editor: Reading, writing and research impact

“…Szafran's team from Canada show how patients value the team-based care that has been implemented in Canadian primary care clinics for more than a decade 17 and McKinlay's team extend our knowledge about the importance of social networks by testing the knowledge in general practice about patients' social networks by the statements of patients themselves of their own networks. 18 Strobel et al use routinely collected data to examine process of care indicators for indigenous children in Australia.…”