Coordination of Patient Care in General Practice: Primary Care Professionals’ Perceptions on Team Effectiveness

Abstract

The effectiveness of primary care teams is increasingly becoming an important research focus in the healthcare management and organisation literature. Teamwork is necessary for any team setting, but is highly important within primary health care because professionals are continually working with each other to address common, everyday health issues. Understanding primary care team structures and processes is necessary to implement and maintain collaborative practices, but also to improve the delivery of care services to the community. This study aimed to explore the perceptions of primary care professionals on team effectiveness and, in turn, understand if teamwork, as a measure of effectiveness, has an influence on the coordination of patient care in New Zealand general practices. Two qualitative research methodologies were used in this study. Qualitative Content Analysis was used to categorise and analyse the factors of effective teamwork, and qualitative description provided a detailed account of professionals’ perceptions. Twelve semi-structured interviews were conducted with practice managers, doctors and nurses from four general practices in Auckland. The interview transcripts were closely analysed to identify emerging themes and patterns from the data. The findings revealed that communication, clear objectives, participation, commitment to teams through trust and respect, and support for innovation were amongst the factors that led to effective primary care team performance. Professionals also advocated for more leadership in general practice and acknowledged the continuity of staff members and their wellbeing as important factors in influencing the coordination of patient care. Effective teamwork underpins the above factors but, more importantly, this research recognises that teamwork is influenced by organisational culture. This is discussed in light of incorporating Kaupapa Māori principles as a cultural theory to guide the provision of primary health care services in New Zealand. Professionals’ insights into collaborative team practices paint a vivid picture of the challenges and benefits of working in teams. It is also a step forward in addressing and improving the care coordination for patients in primary health care settings.