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Table 1 Results of Systematic Review

From: ‘Gearing Up’ to improve interprofessional collaboration in primary care: a systematic review and conceptual framework

(1)
Authors
(2)
Study Aim
And Principal Outcome(s)
(3)
Outcome(s)
(4)
Method
(5)
Setting/Model
(6)
Team Composition
(7)
Sample
(8)
Study Findings:
Factor and its Relationship to IPC Collaboration Processes*
(9)
Significant Factors
(10)
Quality Score
1. Sicotte et al. (2002) To understand Interdisciplinary collaboration among groups of professionals. Interdisciplinary co-ordination
Interdisciplinary care sharing activities
Survey, Questionnaire of health professionals within teams. Regression analysis to model factors associated with two separate outcome measures: (i) interdisciplinary coordination and (ii) interdisciplinary care sharing activities. Community Health Care Centers (CLSCs) in Quebec, Canada Varies. May include physicians, nurses, social workers, physical therapists, occupational therapists and psychologists N = 157 Formal assessment of care quality (S)
Beliefs in the benefits associated with interdisciplinary collaboration (S)
Social integration within work groups” (S)
“Level of conflicts associated with interdisciplinary collaboration” (S)
Unique clinical data form (S)
R 2 = .59 for interdisciplinary collaboration
R 2 = .72 for interdisciplinary care-sharing activities
program manager (NS)
structure (NS)
Quality Audit/process
Belief in IPC teamwork
Feeling Part of the Team
Levels of Conflict
Information Systems
12
2. Gene-Badia et al. (2007) Assess components of primary health care output using Confirmatory Factor Analysis Scientific-Technical quality
Team coordination
Survey of IPC teams. A confirmatory factor analysis was carried out to determine factors associated with team coordination. Primary Care Teams in Catalunya, Spain. Varies. Includes physicians, nurses, clerical staff. N = 213 Support from supervisors (β =0.676) (NS)
Support from colleagues
(β = 0.859) (S)
Work feedback (β =0.616) (NS)
Proposal listened to and applied (β = 0.325) (NS)
Supportive Colleagues 14
3. McLean et al. (2005) Impact of Quality Practice Award (QPA) on teamwork in IPC teams. Teamwork in the practice Survey of IPC team members who had completed QPA process to determine to what extent their perception of teamwork had increased by completing the QPA. Primary Health Care Teams, Scotland. Varies. GPs, practice nurses, community nursing staff, administrative staff. N = 158 Completing the quality accreditation process led to perceived improvement in IPC collaboration across all professional groups. (p = 0.000). Quality audit/process 12
4. Poulton, & West (1999) Examine the relationship between team structure and processes and team effectiveness. Team Work
Organizational efficiency
Health care practice
Patient-centred care
Survey of health professionals in IPC teams. Correlations and regression analysis between team processes and structure measures and team effectiveness measures (emphasis here on team work measure). Primary care practices, UK. Varies. GPs, health visitors, district nurses, practice nurses, receptionists, midwives, counselors, community psychiatric nurses. N = 528 Shared objectives (r = 0.51, p < 0.001).
Support for innovation (r = 0.41, p < 0.01)
Quality emphasis (p < 0.05)
Participation (NS)
Team Size (NS)
Team Tenure (NS)
Fundholding Status (NS)
Team Vision/Goals
Support for innovation
Quality audit/process
12
5. Hern, et al; (2009) Assess whether the introduction of patient care management teams improves continuity of care, office efficiency and communication. Continuity of care
Office Efficiency
Team Communication
Survey of IPC team members to evaluate perceived effectiveness of changes over time (9 and 20 months) following introduction of patient care management team. IPC residency clinic, Chicago, Illinois, U.S.A. Faculty, residents, RNs, Medical Assistants, Clerical Assistants, Medical Records Staff N = 62 Intervention:
changes to team structure and size
formalization of monthly team meetings, introduction of electronic message management system and common electronic system for lab results
Scores on team communication increased after 9 months and were maintained at 20 months. (p < .05). (S)
Team size
Team Meetings
Information Systems
12
6. Bower et al. (2003) Assess whether practice structure
influences team processes and whether both structure and process predict team outcomes.
Self-Rated Team Effectiveness
Innovation
Various Chronic Disease Management Measures
Self-report measures and questionnaires among staff within and attached to 42 general practices. Regression analyses. Focus here is on impact on team climate measure. General practices in England. Doctors, nurses, non-medical clinical staff, administrative staff N = 802 Singlehanded practices (vs. partnerships) were associated with better team climate (as measure of team process). (β = 2.38) (S) Governance 13
7. Shortell (2004) Assess if interprofessional collaboration is related to quality improvement, and to assess differences in perceived team effectiveness. Perceived
Team Effectiveness
Surveyed team members as part of the U.S. National evaluation of the Improving Chronic Illness Care program. Regression analysis of relationship between a number of factors on perceived team effectiveness (includes IPC collaboration). Chronic care teams (from 21 US states and Puerto Rico Varies. Not specified. N = 40 teams organizational team culture balance (β = 3.10, p < 0.10),
patient satisfaction as focus (β = 0.49, p < 0.05),
presence of a team champion (β = 0.69, p < 0.01)
Team size (β = -0.06,) p < 0.10)
R 2 adj = 0.40
Organizational Culture
Team Vision/Goals
Champion/Facilitator
Team Size
13
8. Goni (1999) Assess the relationship between team design, individual characteristics and team performance. Team Performance
Team Reliability
Surveys of IPC members and administrative data. Two groups of teams were identified based on a cluster analysis: reliable and worse teams. Differences between groups attributable to each factor was estimated using one-way ANOVA. Primary health care teams (PHCTs) Navarre, Spain Doctor, pediatrician, nurse, social work, administrative staff. N = 256 common goals (p < 0.01)
empowerment (feeling part of team, team has ability to overcome problems (p < 0.01)
communication (p < 0.01)
flexibility (p < 0.01)
recognition (p < 0.01)
Team Vision/Goals
Feeling Part of Team
Group problem-solving
Open communication
Flexibility
Recognition
9
9. Dieleman
(2004)
Evaluate the impact of team care on providers’ attitudes. Provider attitudes toward team activities (job satisfaction, role recognition, experience in team, quality of care) Questionnaire used in pre and post-test design. General primary care setting, Alberta, Canada. Pharmacists, physicians, nurses. N = 22 Better functioning teams were more satisfied with decision-making process and decisions (p = 0.03). Decision-making processes 13
  1. *‘S’ = Statistically significant and ‘NS’ = not statistically significant as reported by study authors