Establishing Continuity of Care Through a Team-Based Care Approach: Implementation Challenges

Continuity of care (CoC) has been proven to improve patient-doctor relationship and patient health outcomes. However, challenges in providing CoC by a team, instead of a single care provider, is seldom explored. This study aimed to identify the implementation challenges in delivering CoC through a newly implemented team-based care model.

A qualitative study involving interviews of 39 healthcare providers and 7 patients was conducted across 2 polyclinics between January and April 2023. Two researchers conducted the interviews using semi-structured interview guides. The interviews were audio-recorded, transcribed verbatim, and analysed in NVivo using a thematic approach.

While patients and providers recognised the importance of CoC, incorporating the concept into the existing clinical care pathway was challenging. The key barriers that hindered establishing CoC were: lack of manpower and prioritisation of the team-based care model, uncertainty of 'who' is in the team, lack of access to relevant and timely information to address patients' care needs, and patients' difficulty in understanding the '1-patient, 1-team' concept.

While the team-based care model was well received, systemic barriers hindered its implementation. Addressing issues like IT system redesign and manpower allocation is essential for successfully embedding CoC within team-based care in Singapore's primary care setting.