Establishing Continuity of Care Through a Team-Based Care Approach: Implementation Challenges.

BACKGROUND

Continuity of care (CoC) has been proven to improve patient-doctor relationship and patient health outcomes. However, challenges in providing CoC by a team, instead of a single care provider, is seldom explored. This study aimed to identify the implementation challenges in delivering CoC through a newly implemented team-based care model.

METHODS

A qualitative study involving interviews of 39 healthcare providers and 7 patients was conducted across 2 polyclinics between January and April 2023. Two researchers conducted the interviews using semi-structured interview guides. The interviews were audio-recorded, transcribed verbatim, and analysed in NVivo using a thematic approach.

RESULTS

While patients and providers recognised the importance of CoC, incorporating the concept into the existing clinical care pathway was challenging. The key barriers that hindered establishing CoC were: lack of manpower and prioritisation of the team-based care model, uncertainty of 'who' is in the team, lack of access to relevant and timely information to address patients' care needs, and patients' difficulty in understanding the '1-patient, 1-team' concept.

CONCLUSION

While the team-based care model was well received, systemic barriers hindered its implementation. Addressing issues like IT system redesign and manpower allocation is essential for successfully embedding CoC within team-based care in Singapore's primary care setting.