Improving team coordination in primary-care settings via multifaceted team-based feedback: a non-randomised...

Area of Science:

• Healthcare Management
• Teamwork and Collaboration
• Quality Improvement in Healthcare

Background:

• Effective coordination is vital for team-based healthcare, yet clinicians often lack formal training in teamwork.
• Audit and feedback (A&F) presents a potential strategy to enhance team coordination.
• Designing A&F interventions specifically for healthcare teams is crucial for success.

Purpose of the Study:

• To evaluate the effectiveness of a multifaceted A&F intervention combined with debriefing on primary care team coordination.
• To compare the coordination improvements in intervention teams versus control teams.

Main Methods:

• A case-control trial was conducted within the US Veterans Health Administration.
• Thirty-four primary care teams received monthly A&F reports and structured debriefings for 7 months.
• Coordination was measured using a composite score and indicators like on-time appointments and ED utilization.

Main Results:

• Overall, intervention teams did not show significant improvement compared to controls.
• Variability in intervention fidelity was observed, particularly in debriefing attendance.
• Teams with high debriefing exposure demonstrated significant improvements in coordination and patient portal enrollment.

Conclusions:

• Team-based A&F, incorporating sufficient reflection time, can enhance healthcare coordination.
• The study highlights a dose-dependent relationship between intervention exposure and improved coordination.
• Consistent debriefing engagement is more critical for implementation fidelity and effectiveness than the proportion of team members attending.