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Processes that influence the evolution of family health teams
Judith Belle Brown1, Bridget L Ryan2
1Professor and Chair of the MClSc and PhD programs in the Centre for Studies in Family Medicine in the Department of Family Medicine at the Schulich School of Medicine and Dentistry at Western University in London, Ont, and Professor at the School of Social Work at King's University College in London. jbbrown@uwo.ca.
Objective:
To identify the processes that influence the evolution of family health teams (FHTs).
Design:
Qualitative study using grounded theory methodology.
Setting:
Family health teams in Ontario.
Participants:
A total of 110 team members from 20 FHT sites in Ontario.
Methods:
Individual semistructured interviews were conducted and data were analyzed using initial coding, focused coding, and a constant comparison analysis.
Main Findings:
The analysis illuminated the complex and diverse nature of the FHTs' evolutionary trajectories, which were influenced by 7 discrete but interrelated processes: sharing a common philosophy about teamwork; having effective leadership; respecting each other's scopes of practice; sharing the physical environment; including team activities; supporting conflict resolution; and managing change. The status of each site's evolution was categorized as evolving, progressing, or stalled.
Conclusion:
The concept of evolution by its very definition does not imply stasis, and as the data revealed, change is always on the horizon. This study revealed 7 processes that influenced team evolution, and these processes were observed to be either optimally applied or noticeably limited in their execution, irrespective of team composition or configuration. These processes can be extrapolated to other primary health care teams to facilitate team evolution.
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