Perceived Effectiveness of Home-Based Primary Care Teams in Veterans Health Administration.
Adult
Female
Health Personnel
/ psychology
Home Care Services
/ organization & administration
Humans
Interdisciplinary Communication
Leadership
Male
Middle Aged
Patient Care Team
/ organization & administration
Primary Health Care
/ organization & administration
Surveys and Questionnaires
United States
United States Department of Veterans Affairs
Veterans
Veterans Health
Interdisciplinary teamwork
Performance
Primary care model
Journal
The Gerontologist
ISSN: 1758-5341
Titre abrégé: Gerontologist
Pays: United States
ID NLM: 0375327
Informations de publication
Date de publication:
02 04 2020
02 04 2020
Historique:
received:
27
04
2018
pubmed:
19
1
2019
medline:
2
10
2020
entrez:
19
1
2019
Statut:
ppublish
Résumé
Previous studies have shown that staff perception of team effectiveness is related to better health outcomes in various care settings. This study focused on the Veterans Health Administration's Home-Based Primary Care (HBPC) program. We examined variations in HBPC interdisciplinary teamwork (IDT) and identified modifiable team and program characteristics that may influence staff perceptions of team effectiveness. We used a broadly validated survey instrument to measure perceived team effectiveness, workplace conditions/resources, group culture, and respondents' characteristics. Surveys were initiated in January and completed in July, 2016. Team membership rosters (n = 249) included 2,852 IDT members. The final analytical data set included 1,403 surveys (49%) from 221 (89%) teams. A generalized estimating equation model with logit link function, weighted by survey response rates, was used to examine factors associated with perceived team effectiveness. Respondents who served as primary care providers (PCPs) were 8% more likely (p = .0044) to view team's performance as highly effective compared to other team members. Teams with nurse practitioners serving as team leader reported 6% higher likelihood of high-perceived team effectiveness (p = .0234). High team effectiveness was 13% more likely in sites where the predominant culture was characterized as group/developmental, and 7%-8% more likely in sites with lower environmental stress and better resources and staffing, respectively. Team effectiveness is an important indirect measure of HBPC teams' function. HBPC teams should examine their predominant culture, workplace stress, resources and staffing, and PCP leadership model as part of their quality improvement efforts.
Sections du résumé
BACKGROUND AND OBJECTIVES
Previous studies have shown that staff perception of team effectiveness is related to better health outcomes in various care settings. This study focused on the Veterans Health Administration's Home-Based Primary Care (HBPC) program. We examined variations in HBPC interdisciplinary teamwork (IDT) and identified modifiable team and program characteristics that may influence staff perceptions of team effectiveness.
RESEARCH DESIGN
We used a broadly validated survey instrument to measure perceived team effectiveness, workplace conditions/resources, group culture, and respondents' characteristics. Surveys were initiated in January and completed in July, 2016.
METHODS
Team membership rosters (n = 249) included 2,852 IDT members. The final analytical data set included 1,403 surveys (49%) from 221 (89%) teams. A generalized estimating equation model with logit link function, weighted by survey response rates, was used to examine factors associated with perceived team effectiveness.
RESULTS
Respondents who served as primary care providers (PCPs) were 8% more likely (p = .0044) to view team's performance as highly effective compared to other team members. Teams with nurse practitioners serving as team leader reported 6% higher likelihood of high-perceived team effectiveness (p = .0234). High team effectiveness was 13% more likely in sites where the predominant culture was characterized as group/developmental, and 7%-8% more likely in sites with lower environmental stress and better resources and staffing, respectively.
CONCLUSIONS AND IMPLICATIONS
Team effectiveness is an important indirect measure of HBPC teams' function. HBPC teams should examine their predominant culture, workplace stress, resources and staffing, and PCP leadership model as part of their quality improvement efforts.
Identifiants
pubmed: 30657887
pii: 5292363
doi: 10.1093/geront/gny174
doi:
Types de publication
Journal Article
Research Support, U.S. Gov't, Non-P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
494-502Informations de copyright
© The Author(s) 2019. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.