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Effective leadership and team behaviors are key to fostering strong teamwork in patient-centered medical homes (PCMH). Practices in intermediate PCMH transformation stages also show enhanced team perceptions, highlighting factors for successful healthcare redesign.

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Area of Science:

  • Healthcare Management
  • Teamwork in Healthcare
  • Primary Care Practice Transformation

Background:

  • Team-based care is fundamental to healthcare redesign models, including the patient-centered medical home (PCMH).
  • Rigorous examination of factors influencing teamwork perceptions during PCMH implementation is limited.
  • Understanding these factors is crucial for optimizing team function in primary care.

Purpose of the Study:

  • To identify factors associated with the perception of a practice operating as a cohesive team.
  • To explore the relationship between PCMH transformation stage and teamwork perceptions.
  • To investigate the role of leadership, team behaviors, and job satisfaction in fostering teamwork.

Main Methods:

  • An online workforce survey was administered to all staff across 12 primary care sites undergoing PCMH transformation.
  • Bivariate and multivariate statistical analyses were employed to examine factors associated with teamwork perceptions.
  • Data were collected from practices at various stages of PCMH implementation.

Main Results:

  • Effective leadership was strongly associated with enhanced practice teamwork perceptions (OR, 10.49).
  • Practices in intermediate PCMH transformation stages reported higher teamwork perceptions (OR, 2.44).
  • Higher care team behaviors, team perceptions, and job satisfaction were also linked to improved teamwork perceptions when leadership was excluded from the model.

Conclusions:

  • Effective leadership is a primary driver of perceived teamwork in primary care settings.
  • Intermediate stages of PCMH transformation and specific team behaviors positively influence teamwork perceptions.
  • Attention to leadership, team dynamics, and job satisfaction may be vital for enhancing practice teamwork during healthcare redesign.