Overcoming Challenges to Teamwork in Patient-Centered Medical Homes: A Qualitative Study

Publisher: Journal of General Internal Medicine (published online ahead of print)
Nov 11, 2014
Authors
Ann S. O'Malley, Rebecca Gourevitch, Kevin Draper, Amelia Bond, and Manasi A. Tirodkar
  • Practices emphasizing teamwork overcame common challenges through the incremental delegation of non-clinical tasks away from physicians.
  • The roles of medical assistants and nurses are expanding to include template-guided information collection from patients prior to the physician office visit as well as many other tasks.
  • The inclusion of staff input in care workflow redesign and the use of data to demonstrate how team care process changes improved patient care were helpful in gaining staff buy-in.

 

There is emerging consensus that enhanced inter-professional teamwork is necessary for the effective and efficient delivery of primary care, but there is less practical information specific to primary care available to guide practices on how to better work as teams.The purpose of this study was to describe how primary care practices have overcome challenges to providing team-based primary care and the implications for care delivery and policy. Practices for this qualitative study were selected from those recognized as patient-centered medical homes (PCMHs) via the most recent National Committee for Quality Assurance PCMH tool, which included a domain on practice teamwork. Sixty-three respondents, ranging from physicians to front-desk staff, were interviewed from May through December of 2013. Practice respondents came from 27 primary care practices ranging in size, type, geography, and population served.