Skip to main content
×
Home
    • Aa
    • Aa

The impact of space and time on interprofessional teamwork in Canadian primary health care settings: implications for health care reform

  • Ivy F. Oandasan (a1), Lesley Gotlib Conn (a2), Lorelei Lingard (a3), Allia Karim (a2), Difat Jakubovicz (a4), Cynthia Whitehead (a5), Karen-Lee Miller (a6), Natalie Kennie (a7) and Scott Reeves (a8)...
Abstract
Aim

This paper explores the impact of space and time on interprofessional teamwork in three primary health care centres and the implications for Canadian and other primary health care reform.

Background

Primary health care reform in Canada has emphasized the creation of interprofessional teams for the delivery of collaborative patient-centred care. This involves the expansion and transformation of existing primary health care centres into interprofessional family health teams (FHT) promising to provide patients better access, more comprehensive care, and improved utilization of individual health professionals. Benefits for providers include improved workplace satisfaction and organizational efficiencies. Currently, there is little evidence for how effective interprofessional teamwork happens and little is known about how to create high-functioning teams in the primary health care setting.

Methods

We used ethnographic observations and interviews to gain a deep understanding of the nature of interprofessional teamwork. Three academic family health centres participated in a total of 139 h of observation and 37 interviews. Team members in all three centres from the disciplines of medicine, nursing, physiotherapy, occupational therapy, social work, dietetics, pharmacy, and office administration participated in this study.

Findings

We found that both the quantity and quality of interprofessional communication and collaboration in primary health care is significantly impacted by space and time. Across our research sites, the physical layout of clinical space and the temporal organization of clinical practice led to different approaches to, and degrees of success with, interprofessional teamwork. Varied models of interprofessional collaboration resulted when these factors came together in different ways. These findings have important implications for the transition to interprofessional family health teams in Canada and beyond.

Copyright
Corresponding author
Correspondence to: Ivy F. Oandasan (MD CCFP MHSc FCFP), Office of Interprofessional Education at the University Health Network, Toronto Western Hospital, 750 Dundas Street West, Suite. 302 Toronto, Ontario M6J 3S3. Email: ivy.oandasan@uhn.on.ca
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

S. Baxter S. Brumfitt 2008: Once a week is not enough: evaluating current measures of teamworking in stroke. Journal of Evaluation in Clinical Practice 14, 241247.

S.L. Dieleman , K.B. Farris , D. Feeny , J.A. Johnson , R.T. Tsuyuki S. Brilliant 2004: Primary health care teams: team members’ perceptions of the collaborative process. Journal of Interprofessional Care 18, 7578.

D. Grinspun 2007: Healthy workplaces: the case for shared clinical decision making and increased full-time employment. Healthcare Papers 7, (Suppl), 8591.

A. Hansson , F. Friberg , K. Segesten , B. Gedda B. Mattsson 2008: Two sides of the coin: general practitioners’ experience of working in multidisciplinary teams. Journal of Interprofessional Care 22, 516.

E. Hummers-Pradier , C. Scheidt-Nave , H. Martin , S. Heinemann , M.M. Kochen W. Himmel 2008: Simply no time? Barriers to GPs’ participation in primary health care research. Family Practice 25, 105112.

J. Liaschenko 1994: The moral geography of home care. Advances in Nursing Science 17, 1625.

J. Molyneux 2001: Interprofessional teamworking: what makes teams work well? Journal of Interprofessional Care 15, 2935.

J. Meuser , T. Bean , J. Goldman S. Reeves 2006: Family health teams: a new Canadian interprofessional initiative. Journal of Interprofessional Care 20, 436438.

T. Ostbye , K.S.H. Yarnall , K.M. Krause , K.I. Pollak , M. Gradison J.L. Michener 2005: Is there time for management of patients with chronic diseases in primary care? Annals of Family Medicine 3, 209214.

S. Reeves S. Lewin 2004: Hospital-based interprofessional collaboration: strategies and meanings. Journal of Health Services Research and Policy 9, 218225.

S. Reeves , A. Russell , M. Zwarenstein , C. Kenaszchuk , L. Gotlib Conn , D. Doran , L. Sinclair , L. Lingard , I. Oandasan , K. Thorpe , Z. Austin , J. Beales , W. Hindmarsh , C. Whiteside , B. Hodges , L. Nasmith , I. Silver , K.-L. Miller , V. Vogwill S. Straus 2007: Structuring communication relationships for interprofessional teamwork (SCRIPT): a Canadian initiative aimed at improving patient-centred care. Journal of Interprofessional Care 21, 111114.

A. Shaw , S. de Lusignan G. Rowlands 2005: Do primary care professionals work as a team: a qualitative study. Journal of Interprofessional Care 19, 396405.

M. Tai-Seale , T.G. McGuire W. Zhang 2007: Physician and patient behaviour: time allocation in primary care office visits. Health Services Research 42, 18711894.

C. Thompson , L. Dalgleish , T. Bucknall , C. Estabrooks , A.M. Hutchinson , K. Fraser , R. Rien de Vos , J. Binnekade , G. Barrett J. Saunders 2008: Nurses’ risk assessment decisions: a signal detection analysis. Nursing Research 57, 302311.

D.S. Thompson , K. O’Leary , E. Jensen , S. Scott-Findlay , L. O-Brien-Pallas C.A. Estabrooks 2008: The relationship between busyness and research utilization: it is about time. Journal of Clinical Nursing 17, 539548.

A. Xyrichis K. Lowton 2007: What fosters or prevents interprofessional teamworking in primary and community care? A literature review. International Journal of Nursing Studies 45, 140153.

K.S.H. Yarnall , K.I. Pollak , T. Ostbye , K.M. Krause J.L. Michener 2003: Primary care: is there enough time for prevention? American Journal of Public Health 93, 635641.

G.J. Andrews 2006: Geographies of health in nursing. Health & Place 12, 110118.

S. Halford P. Leonard 2003: Space and place in the construction and performance of gendered nursing identities. Journal of Advanced Nursing 42, 201208.

F. Rapport , M.A. Doel G. Elwyn 2007: Snapshots and snippets: general practitioners’ reflections on professional space. Health & Place 13, 532544.

F. Rapport , M.A. Doel , D. Greaves G. Elwyn 2006: From manila to monitor: biographies of general practitioner workspaces. Health (London) 10, 233251.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Primary Health Care Research & Development
  • ISSN: 1463-4236
  • EISSN: 1477-1128
  • URL: /core/journals/primary-health-care-research-and-development
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords: