Implementing new teamwork models in primary care – perceptions of professionals

Abstract

Introduction: Finland is facing a large-scale health and social services reform in 2023. The aims of the reform are among others to improve access to care, equity of services and care continuity. In our study, we had one region, with three different organizations, that had implemented new teamwork models. These models aimed to improve multiprofessional co-operation and patients’ care continuity within the primary care services. In this study, we aimed to investigate how the new teamwork models are perceived by the professionals in health and social services (HSS) centers.
 Methods: In total, we are aiming to conduct approximately 20 semi-structured interviews with professionals working in primary care HSS centers (the interviews are still ongoing). There were 8 semi-structured, pair or individual, interviews that were included in this study. The participants were from four different HSS centers, and they represented professionals from different occupational groups (nurses, specialized nurses, physicians, social workers). The interviews will be analyzed using Grounded Theory. 
 Results: Preliminary analyses showed that employees felt that their co-operation with other professionals had improved and working in the same building or hallway enhanced co-operation. However, a lot of the co-operation level was dependent on the familiarity with other professionals. Regarding the teamwork model, the professionals thought for instance, that the model was ‘a half-way’ model, the wheel was re-invented with the model and that it was just crammed into the HSS center. On the other hand, the professionals described that they were fairly satisfied with their co-operation with other professionals in their own health and social services center. Nurses and physicians were closely co-operating on a daily basis, whereas other professionals, such as social workers were not that integrated into the teams. Strain and time pressure emerged from the interviews since new tasks had been given to the participants, especially for nurses. Turnover of employees and lack of physicians was further perceived burdening.
 Conclusions: There were positive and negative sides of the new teamwork models. The models had been implemented fairly recently and therefore they were seen as not reached their full potential yet. In addition, professionals perceived that patient’s care continuity was smooth across actors. However, in some organizations the professionals feared that the reform will worsen the situation.