Institute of Health Policy, Management and Evaluation, Toronto, Canada.
Brown School, Washington University, St. Louis, USA.
J Interprof Care. 2022 Jan-Feb;36(1):52-63. doi: 10.1080/13561820.2021.1874896. Epub 2021 Apr 17.
Despite growing emphasis on adopting team-based models of primary care to facilitate patient access to a diverse range of care providers, our understanding of team functioning within primary care teams remains limited. This study examined interprofessional teamwork within primary care practices (Family Health Teams [FHT] and Community Health Centers - [CHC]) in Ontario and explored team-level and organizational factors associated with interprofessional teamwork. Interprofessional teamwork was measured using the Collaborative Practice Assessment Tool (CPAT), which was completed by providers in each participating team. The CPAT responses of 988 providers representing on average 12 professions (sd = 2.1) across 66 teams (44 FHTs and 22 CHCs) were included in the analysis. The average CPAT score was 46.6 (sd = 2.5). CHCs had significantly higher CPAT scores than FHTs (m = 1.7, = .02). Using diverse communication mechanisms to share information, increasing quality improvement capacities, and age of practice, had a statistically significant positive association with CPAT scores. Increasing team size, using centralized administrative processes, a high level of information exchange, and having a mixed governance board were significantly negatively associated with CPAT score. Findings illustrate factors associated with interprofessional teamwork and offer insight into the comparative performance of two team-based primary care models in Ontario.
尽管越来越强调采用基于团队的初级保健模式，以方便患者获得各种不同的医疗服务提供者，但我们对初级保健团队内部团队运作的理解仍然有限。本研究考察了安大略省的家庭健康团队（FHT）和社区健康中心（CHC）内的专业间团队合作，并探讨了与专业间团队合作相关的团队层面和组织因素。使用协作实践评估工具（CPAT）衡量专业间团队合作，每个参与团队的提供者都要完成 CPAT。分析中包括了 66 个团队（44 个 FHT 和 22 个 CHC）中 988 名代表平均 12 种职业（标准差= 2.1）的提供者的 CPAT 反应。CPAT 的平均得分为 46.6（标准差= 2.5）。CHC 的 CPAT 得分明显高于 FHT（m = 1.7，=.02）。使用多种沟通机制共享信息、提高质量改进能力和实践年限与 CPAT 得分呈正相关。增加团队规模、使用集中的行政流程、高水平的信息交换以及拥有混合治理委员会与 CPAT 得分呈显著负相关。研究结果说明了与专业间团队合作相关的因素，并深入了解了安大略省两种基于团队的初级保健模式的比较绩效。
