Online Program

Environmental scan of measures of team-based primary care: The current state and preliminary gaps

Tuesday, November 5, 2013

Kathleen Fuda, Ph.D., Health Policy, Abt Associates Inc., Cambridge, MA
Sarah J. Shoemaker, PhD, PharmD, Health Policy, Abt Associates, Cambridge, MA
Michael Parchman, M.D., M.P.H., MacColl Center for Heatlh Care Innovation, Group Health Research Institute, Seattle, WA
Judith Schaefer, MPH, MacColl Center for Health Care Innovation, Group Health Research Institute, Seattle, WA
Richard Ricciardi, Ph.D., N.P., Center for Primary Care, Prevention and Clinical Partnerships, Agency for Health Care Research and Quality, Rockville, MD
Background: A growing body of literature acknowledges that primary care settings that use team-based approaches are likely to have higher patient satisfaction as well as improved health outcomes. Comprehensive and coordinated team-based care is a facet of many models of primary care transformation, including the patient-centered medical home. Thus, robust measures of team-based care appropriate for the primary care setting and suitable for research, quality improvement, and/or evaluation are of utmost importance in order to improve patient outcomes through better team functioning. Existing measurement tools often focus on settings other than primary care, rarely evaluate patient experience, and often are atheoretical or lack adequate psychometric testing. The aims of this study are to identify existing measures of team-based care and related measures that can be adapted for that setting, understand the domains of team-based care the measures address within a newly-developed conceptual model, and identify preliminary gaps for future development. Methodology: To identify measures of team-based care we explored several sources, including: measure databases (e.g., NQF, Nat'l Quality Measures Clearinghouse, HHS Measure Inventory, NIH GEM database), Measures Application Partnership, and CAHPS. We also sought input from experts in team care, examined reviews of team care measures, and completed a review of the peer-reviewed and grey literature on both teamwork and team-based primary care. Results: The following are preliminary results based on the measures that have been identified to date. Over one hundred different measures of teamwork and team-based care have been identified. The majority of measures identified are surveys or observational checklists and related tools. The measures or tools have measured attributes of teamwork from individuals, teams or even patients' perspectives. Among the most common domains or attributes of teamwork and team-based primary care identified include: communication, coordination, collaboration, respect, use of all team member's expertise, conflict management, group cohesion or shared identity, shared workload, and role responsibility and understanding. The environmental scan will be completed in July 2013; the full results will be presented at the meeting. Conclusions/Discussion: As health care delivery continues to evolve toward patient-centered medical homes and other models of team-based care, having measures to understand, evaluate and improve upon team-based care will be instrumental to future progress. Many existing measures of team functioning may require adaptation, and/or demonstration of adequate psychometric properties, for use in the primary care setting.

Learning Areas:

Administration, management, leadership
Provision of health care to the public

Learning Objectives:
Identify existing measures of team-based care in the literature, and related measures from non-medical fields Describe the domains of team-based primary care (e.g., communication, coordination), type of measure or tool (e.g., survey), and reliability and validity of the identified measures Identify preliminary gaps in measurement of team-based primary care for research, evaluation, and quality improvement efforts

Keyword(s): Primary Care, Health Care Delivery

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am leading the Environmental Scan task on this project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.