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Perceptions of Responsibilities by Primary Care Staff in a Patient-Centered Medical Home
Bonnie J Wakefield1, Amany Farag, Monica B Paez
1Author Affiliations: Investigator (Dr Wakefield), Veterans Integrated Service Network 23, Primary Care Analytic Team (PCAT), Iowa City VA Healthcare System, Associate Professor (Dr Wakefield), Sinclair School of Nursing, University of Missouri, Columbia; Investigator (Dr Farag), Veterans Integrated Service Network 23, Primary Care Analytic Team (PCAT), Iowa City VA Healthcare System, and Associate Professor (Dr Farag), University of Iowa College of Nursing; Ethnographic Methods and Implementation Core (EMIC) Program Manager (Paez), Veterans Integrated Service Network 23, Primary Care Analytic Team (PCAT), Iowa City VA Healthcare System, and VA Office of Patient Care Services (EMIC), Program Manager (Paez), The Comprehensive Access and Delivery Research and Evaluation (CADRE), Center at the Iowa City VA Healthcare System; Director (Dr Stewart), Veterans Integrated Service Network 23, Primary Care Analytic Team (PCAT), Iowa City VA Healthcare System, and VA Office of Patient Care Services; Professor (Dr Stewart), Tippie College of Business, University of Iowa.
Objective:
To examine the extent to which Veterans Health Administration (VHA) Patient-Aligned Care Team (PACT) members have a shared understanding/ agreement upon and enact responsibilities within the team.
Background:
The PACT model focuses on team-based care management. However, lack of a shared understanding of team-based care management roles and responsibilities makes system-wide implementation a challenge.
Methods:
Quantitative and qualitative analysis of national survey data collected in 2022 from primary care personnel working in a VHA-affiliated primary care facility.
Results:
Significant discrepancies exist in responses about what core team members say they do and what others perceive they should be doing, indicating either a lack of agreement, knowledge, or training about what core team members should do.
Conclusions:
Successful implementation of a team-based model requires adequate support and training for teamwork including shared mental models to work according to their clinical competency. Clear guidance and communication of expectations are critical for role clarity.
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