Abstract
The aim of the study was to describe practices that support collaboration in interprofessional primary health care teams, and identify performance indicators perceived to measure the impact of this collaboration from the perspective of interprofessional health providers. Despite the surge of interprofessional primary health care models implemented across Canada, there is little evidence as to whether or not the intended outcomes of primary health care teams have been achieved. Part of the challenge is determining the most appropriate measures that can demonstrate the value of collaborative care. To date, little remains known about performance measurement from the providers contributing to the collaborative care process in interprofessional primary care teams. Having providers from a range of disciplinary backgrounds assist in the development of performance measures can help identify measures most relevant to demonstrate the value of collaborative care on the intended outcomes of interprofessional primary care models. A qualitative study; part of a larger mixed methods developmental evaluation to examine performance measurement in interprofessional primary health care teams. A stakeholder workshop was conducted at an annual association meeting of interprofessional primary health care teams in the province of Ontario, Canada. Six questions guided the workshop groups and participant responses were documented on worksheets and flip charts. All responses were collected and entered verbatim into a word document. Qualitative analytic strategies were applied to each question. A total of 283 primary health care providers from 14 health professions working in interprofessional primary health care teams participated. Top three elements of interprofessional collaboration (total n = 628) were communication (n = 146), co-treatment (n = 112) and patient-based conferences (n = 81). Top three performance indicators currently used to demonstrate the value of interprofessional collaboration (total n = 241) were patient experience (n = 71), patient health status (n = 35) and within team referrals (n = 30).
Highlights
Primary health care is the pillar of the health care system, with interprofessional collaborative teams being increasingly considered a key tenet and an important means for providing quality primary health care services
The top three outcomes, assessments, and/or indicators that were identified as being used to demonstrate the value of interprofessional collaboration were patient experience (n = 71), patient health status (n = 35), and intra-agency team referrals (n = 30)
This study provides a unique contribution to the literature on performance measurement of interprofessional primary health care teams by providing the provider perspective on both the existing indicators being used, as well as recommendations for alternative indicators that might better capture collaborative contributions and impact on patient outcomes
Summary
Primary health care is the pillar of the health care system, with interprofessional collaborative teams being increasingly considered a key tenet and an important means for providing quality primary health care services While interprofessional collaboration is recognized as an essential aspect of care for patients with complex and chronic conditions (Reeves et al, 2011; Pullon et al, 2016), the evidence remains in its infancy. For these reasons, policy makers in Canada and elsewhere have continued to call for greater integration of interprofessional team-based primary health care and the development of indicators that recognize the value of this added lens (Hutchison et al, 2011; Ministry of Health and Long-Term Care, 2015). There is a strong move to team-based primary health care, often referred to as medical homes, to enhance integration of services and emphasize health promotion and chronic disease management
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