Improving primary care team functioning through evidence based quality improvement: A comparative case study.

Area of Science:

• Healthcare Management
• Quality Improvement Science
• Team Dynamics in Clinical Settings

Background:

• Team-based primary care (PC) is linked to better quality, but optimizing team function requires evidence.
• Limited empirical data exists on effective strategies for enhancing PC team processes.
• Evidence-based quality improvement (EBQI) offers a framework to address these gaps.

Purpose of the Study:

• To examine how EBQI was utilized to modify primary care team processes.
• To understand the impact of EBQI on team functioning and member perceptions.
• To identify effective implementation strategies for improving PC team performance.

Main Methods:

• A comparative case study design was employed at two VA medical centers (2014-2016).
• Qualitative data were collected through 64 interviews with stakeholders and team members.
• Analysis included EBQI meeting notes, reports, and supporting documentation.

Main Results:

• Site A implemented daily huddles and role clarification protocols.
• Site B initiated weekly virtual team meetings across practice locations.
• Both sites reported improvements in team structure, communication, role clarity, accountability, and overall functioning.

Conclusions:

• EBQI facilitated the development and implementation of innovations to enhance PC team processes.
• The multi-level EBQI approach empowered staff and fostered innovation within teams.
• EBQI is an effective strategy for addressing practice-based challenges and improving team functioning in diverse clinical settings.