Team Effectiveness in General Practice: Insights from the Norwegian Primary Healthcare Team Pilot

Abstract

This chapter provides insights into team effectiveness in general practice. It is based on a qualitative case study from five purposively recruited Norwegian general practices participating in a pilot for implementing primary healthcare teams. To assess team effectiveness, 41 individual and group interviews were performed in the practices. The data production and the analysis were guided by Hackman’s team effectiveness model. Five overarching themes were identified: teamwork nature, buy-in, macro-team leadership, individual satisfaction, and performance outcome. Despite variation in the organizational context, the informants at four of five of the practices agreed that functional teamwork produced good and relevant results—primarily for the patients, as well as largely for themselves as it increased job satisfaction. The study shows that becoming real and effective micro- or macro-teams involves extensive, targeted, and time-consuming change work. Actual change requires leadership, buy-in, and a significant effort linked to structuring the teamwork. The results raise the question of whether it is a sensible use of resources to scale up and spread primary healthcare teams to all general practices in Norway. Management training as part of specialist training for all general practitioners to acquire the competence to lead effective micro-teams could be beneficial for teamwork development.