Linking clinician interaction and coordination to clinical performance in Patient-Aligned Care Teams.

Sylvia J Hysong,Amber B Amspoker,Candice L Thomas,Christiane Spitzmüller,Lechauncy Woodard,Varsha Modi,Aanand D Naik

doi:10.1186/s13012-015-0368-0

Abstract

BackgroundTeam coordination within clinical care settings is a critical component of effective patient care. Less is known about the extent, effectiveness, and impact of coordination activities among professionals within VA Patient-Aligned Care Teams (PACTs). This study will address these gaps by describing the specific, fundamental tasks and practices involved in PACT coordination, their impact on performance measures, and the role of coordination task complexity.Methods/designFirst, we will use a web-based survey of coordination practices among 1600 PACTs in the national VHA. Survey findings will characterize PACT coordination practices and assess their association with clinical performance measures. Functional job analysis, using 6–8 subject matter experts who are 3rd and 4th year residents in VA Primary Care rotations, will be utilized to identify the tasks involved in completing clinical performance measures to standard. From this, expert ratings of coordination complexity will be used to determine the level of coordinative complexity required for each of the clinical performance measures drawn from the VA External Peer Review Program (EPRP). For objective 3, data collected from the first two methods will evaluate the effect of clinical complexity on the relationships between measures of PACT coordination and their ratings on the clinical performance measures.DiscussionResults from this study will support successful implementation of coordinated team-based work in clinical settings by providing knowledge regarding which aspects of care require the most complex levels of coordination and how specific coordination practices impact clinical performance.Electronic supplementary materialThe online version of this article (doi:10.1186/s13012-015-0368-0) contains supplementary material, which is available to authorized users.

Highlights

Team coordination within clinical care settings is a critical component of effective patient care
1: Characterize coordination practices, and elements of coordination utilized by PatientAligned Care Teams (PACTs) and assess the association between coordination practices utilized by PACTs and clinical performance
Contributions to practice Addressing the current gaps in our understanding of coordination within clinical care settings, this study will provide an in-depth look at the specific fundamental practices involved in coordination, their impact on clinical outcomes, and the role of coordinative complexity in these relationships

Summary

Introduction

Team coordination within clinical care settings is a critical component of effective patient care. Less is known about the extent, effectiveness, and impact of coordination activities among professionals within VA PatientAligned Care Teams (PACTs). Organizing patient care and enhancing coordination are essential components to improving quality healthcare delivery [1,2,3]. Many healthcare facilities are transitioning to team-based healthcare where coordination among interdisciplinary team members must occur for successful patient care [4,5,6]. Coordination is a critical feature of effective teamwork [6, 8] and is a major challenge in the implementation of care teams [9]. Coordination consists of team members working collectively on interdependent tasks and coordination-intensive procedures that require effective.

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