Are Patients Ready for Team Based Care?
Background: Interprofessional teamwork within healthcare delivery has been shown to improve patient satisfaction, decrease provider burnout, and lead to improved healthcare outcomes. The patient is a critical part of this team, and their perspective has become an increased focus in health care decision making. At our institution, we found that there was no correlation between staff perception of team functioning and patient perception of team functioning or overall patient experience. Therefore, the purpose of this study was to evaluate patients' awareness of team-based care, interprofessional communication, shared decision making, and their care outcomes.
Methodology: To explore the current state of patients’ understanding and expectations of teamwork within their “care team” a qualitative case study design was utilized. The perspective of four primary care patients with complex care coordination needs were evaluated utilizing a semi-structured interview guide. Interviews were transcribed verbatim and coded by the primary researcher utilizing an inductive approach over two rounds. Emerging themes were identified and informed care team map creation.
Results: Four themes emerged including Communication/Teamwork, Emotions/Reactions, Challenges/Barriers, and Patient Advocacy. Care team map creation yielded only physician members as described by patients. Patients described patient-clinician, clinician-clinician, and interdepartmental communication as critical to facilitating teamwork and shared plans of care. Emotions surrounding healthcare experiences varied from grateful for care ingenuity to fearful of adverse outcomes. Several challenges and barriers to communication were identified including technological and healthcare literacy, system complexity, and physician accessibility. Many patients acknowledged the importance of advocacy through clinician encouragement of shared decision making and optimization of external support sources.
Conclusions: Further consideration of patients’ understanding of interprofessional collaboration and shared decision making is warranted. As we are training new providers on the importance of teamwork, it is critical that patients understand the value of this work as it contributes to their care outcomes and satisfaction. A culture change surrounding collaborative efforts is needed and may be aided by educational resources targeted towards patients. A limitation of this study is that these patients were primarily of the “baby boomer” generation which raises the question of whether there are differences in generational attitudes towards non-physician providers and team-based care. Assurance of a shared understanding of interprofessional collaboration between patients and providers may lead to improved communication and outcomes.