Primary care multidisciplinary teams in practice: a qualitative study.
Repository Usage Stats
BACKGROUND: Current recommendations for strengthening the US healthcare system consider restructuring primary care into multidisciplinary teams as vital to improving quality and efficiency. Yet, approaches to the selection of team designs remain unclear. This project describes current primary care team designs, primary care professionals' perceptions of ideal team designs, and perceived facilitating factors and barriers to implementing ideal team-based care. METHODS: Qualitative study of 44 health care professionals at 6 primary care practices in North Carolina using focus group discussions and surveys. Data was analyzed using framework content analysis. RESULTS: Practices used a variety of multidisciplinary team designs with the specific design being influenced by the social and policy context in which practices were embedded. Practices overwhelmingly located barriers to adopting ideal multidisciplinary teams as being outside of their individual practices and outside of their control. Participants viewed internal organizational contexts as the major facilitators of multidisciplinary primary care teams. The majority of practices described their ideal team design as including a social worker to meet the needs of socially complex patients. CONCLUSIONS: Primary care multidisciplinary team designs vary across practices, shaped in part by contextual factors perceived as barriers outside of the practices' control. Facilitating factors within practices provide a culture of support to team members, but they are insufficient to overcome the perceived barriers. The common desire to add social workers to care teams reflects practices' struggles to meet the complex demands of patients and external agencies. Government or organizational policies should avoid one-size-fits-all approaches to multidisciplinary care teams, and instead allow primary care practices to adapt to their specific contextual circumstances.
Published Version (Please cite this version)10.1186/s12875-017-0701-6
Publication InfoLeach, Brandi; Morgan, Perri; Strand de Oliveira, Justine; Hull, Sharon; Østbye, Truls; & Everett, Christine (2017). Primary care multidisciplinary teams in practice: a qualitative study. BMC Fam Pract, 18(1). pp. 115. 10.1186/s12875-017-0701-6. Retrieved from https://hdl.handle.net/10161/16033.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
More InfoShow full item record
Associate Professor in Family Medicine and Community Health
Dr. Everett joined the faculty of the Department of Community and Family Medicine at Duke University in August 2013 and gained a secondary appointment in the Department of Population Health in 2018. Prior to joining the faculty, she worked clinically in emergency departments in rural Wisconsin. Prior to becoming a physician assistant (PA), Dr. Everett worked in research at the National Institutes of Health and public health policy at the Food and Drug Administration. Dr. Everett&rsqu
Professor of Family Medicine and Community Health
Professor in Family Medicine and Community Health
Dr. Morgan is a health services researcher focusing on PAs and NPs in the health workforce and on outcomes associated with their use in different roles and settings. As Director of Research in the Duke PA Division, she led the development of the PA Research section, which is one of only a few such groups nationally. As a practicing PA for 25 years, Dr. Morgan has extensive knowledge of the PA profession from the perspective of a clinician. As one of a very few national exper
Professor Emeritus in Family Medicine and Community Health
Public health, health workforce, physician assistants, advanced practice nursing, primary care, health policy, organizational behavior, provider-patient interactions, medical sociology, sociology of professions, health equity, social mission in health professions education.
Alphabetical list of authors with Scholars@Duke profiles.