Beyond Co-location: Visual Connections of Staff Workstations and Staff Communication in Primary Care Clinics

2020 ◽  
pp. 001391652095027
Author(s):  
Lisa Lim ◽  
Ruth Kanfer ◽  
Robert J. Stroebel ◽  
Craig M. Zimring
Keyword(s):  
Primary Care ◽  
Empirical Studies ◽  
Healthcare Providers ◽  
Healthcare Organizations ◽  
Spatial Metrics ◽  
Team Members ◽  
Primary Care Clinics ◽  
Staff Members ◽  
Work Spaces ◽  
Team Based Care

The importance of communication among healthcare providers has been long recognized, and many healthcare organizations are implementing team-based care, with emphasis on staff communication. While previous empirical studies in various settings illustrate the role of built environments in user communication, there is a lack of quantified interpersonal spatial metrics to predict interactions. This study investigates how interpersonal spatial metrics at different scales predict staff communication patterns by empirically studying four primary care clinics that provide team-based care. We found that staff members in clinics with higher visual connections among staff members reported more timely and frequent communication. We also found that staff members talked to each other more frequently when their workstations were visually connected. The findings of this study are expected to help designers and facility managers provide well-designed team-based clinic layouts, beyond just shared work spaces for team members, for improved staff communication.

The Representational Function of Clinic Design: Staff and Patient Perceptions of Teamwork

2020 ◽  
pp. 193758672095707
Author(s):  
Lisa Lim ◽  
Ruth Kanfer ◽  
Robert J. Stroebel ◽  
Craig M. Zimring
Keyword(s):  
Primary Care ◽  
Patient Perceptions ◽  
Patient Centered ◽  
Primary Care Clinics ◽  
Staff Members ◽  
Visual Access ◽  
Quality Of Patient Care ◽  
Care Approach ◽  
User Groups ◽  
Team Based Care

Objective: This study empirically investigates the relationships between visibility attributes and both patients’ and staff members’ teamwork experiences. Background: Teamwork among healthcare professionals is critical for the safety and quality of patient care. While a patient-centered, team-based care approach is promoted in primary care clinics, little is known about how clinic layouts can support the teamwork experiences of staff and patients in team-based primary clinics. Methods: This article measured teamwork perceptions of staff members and patients at four primary care clinics providing team-based care. Visual access to staff workstations from both staff and patient perspectives was analyzed using VisualPower tool(version 21). The relationships between teamwork perception and visibility attributes were analyzed for each entity: staff members and patients. Results: The results showed that the visual relationships among staff members and those between staff members and patients have significant associations with overall perceptions of teamwork. While clinics providing more visual connections between staff workstations reported higher teamwork perception of staff members, patient perceptions of staff teamwork were inversely related to the number of visual connections between patients and staff workstations. Conclusions: The findings of the study provide implications for designing team-based primary care clinics to enhance the teamwork experience of both staff members and patients, which is also applicable to teamwork perceptions in other settings where both inhabitants and visitors are main user groups of the spaces. This study illustrates the representational function of space: Organizations can emphasize their values via layout design by regulating what they show to inhabitants or visitors.

scholarly journals Family Physician’s and Primary Care Team’s Perspectives on Supporting Family Caregivers in Primary Care Networks

2021 ◽  
Vol 18 (6) ◽  
pp. 3293
Author(s):  
Jasneet Parmar ◽  
Sharon Anderson ◽  
Marjan Abbasi ◽  
Saeed Ahmadinejad ◽  
Karenn Chan ◽  
...  
Keyword(s):  
Primary Care ◽  
Family Caregivers ◽  
Healthcare Providers ◽  
Family Physicians ◽  
Care Team ◽  
Primary Care Team ◽  
Caregiver Support ◽  
Team Members ◽  
Primary Care Teams ◽  
Support Family

Background. Research, practice, and policy have focused on educating family caregivers to sustain care but failed to equip healthcare providers to effectively support family caregivers. Family physicians are well-positioned to care for family caregivers. Methods. We adopted an interpretive description design to explore family physicians and primary care team members’ perceptions of their current and recommended practices for supporting family caregivers. We conducted focus groups with family physicians and their primary care team members. Results. Ten physicians and 42 team members participated. We identified three major themes. “Family physicians and primary care teams can be a valuable source of support for family caregivers” highlighted these primary care team members’ broad recognition of the need to support family caregiver’s health. “What stands in the way” spoke to the barriers in current practices that precluded supporting family caregivers. Primary care teams recommended, “A structured approach may be a way forward.” Conclusion. A plethora of research and policy documents recommend proactive, consistent support for family caregivers, yet comprehensive caregiver support policy remains elusive. The continuity of care makes primary care an ideal setting to support family caregivers. Now policy-makers must develop consistent protocols to assess, and care for family caregivers in primary care.

scholarly journals Team-based primary health care for non-communicable diseases: complexities in South India

2020 ◽  
Vol 35 (Supplement_2) ◽  
pp. ii22-ii34 ◽  
Author(s):  
Dorothy Lall ◽  
Nora Engel ◽  
Narayanan Devadasan ◽  
Klasien Horstman ◽  
Bart Criel
Keyword(s):  
Primary Care ◽  
Quality Improvement ◽  
Chronic Care ◽  
South India ◽  
Health Workers ◽  
Communicable Diseases ◽  
Non Communicable Diseases ◽  
Primary Care Clinics ◽  
Primary Health ◽  
Team Based Care

Abstract Chronic non-communicable diseases (NCDs), such as diabetes and cardiovascular diseases, have reached epidemic proportions worldwide. Health systems, especially those in low- and middle-income countries, such as India, struggle to deliver quality chronic care. A reorganization of healthcare service delivery is needed to strengthen care for chronic conditions. In this study, we evaluated the implementation of a package of tailored interventions to reorganize care, which were identified following a detailed analysis of gaps in delivering quality NCD care at the primary care level in India. Interventions included a redesign of the workflow at primary care clinics, a redistribution of tasks, the introduction of patient information records and the involvement of community health workers in the follow-up of patients with NCDs. An experimental case study design was chosen to study the implementation of the quality improvement measures. Three public primary care facilities in rural South India were selected. Qualitative methods were used to gain an in-depth understanding of the implementation process and outcomes of implementation. Observations, field notes and semi-structured interviews with staff at these facilities (n = 15) were thematically analysed to identify contextual factors that influenced implementation. Only one of the primary health centres implemented all components of the intervention by the end of 9 months. The main barriers to implementation were hierarchical arrangements that inhibited team-based care, the amount of time required for counselling and staff transfers. Team cohesion, additional staff and staff motivation seem to have facilitated implementation. This quality improvement research highlights the importance of building relational leadership to enable team-based care at primary care clinics in India. Redesigned organization of care and task redistribution is important solutions to deliver quality chronic care. However, implementing these will require capacity building of local primary care teams.

scholarly journals Protocol for a cross-sectional study measuring person-centredness among healthcare providers in Malaysian primary care clinics: the adaptation and validation of the Person-Centred Practice Inventory-Staff (PCPI-S) Questionnaire

BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e034128 ◽  
Author(s):  
Nur Zahirah Balqis-Ali ◽  
Pui San Saw ◽  
Anis Syakira Jailani ◽  
Tze Wei Yeoh ◽  
Weng Hong Fun ◽  
...  
Keyword(s):  
Primary Care ◽  
Cultural Context ◽  
Healthcare Providers ◽  
Internal Validity ◽  
Cross Sectional Study ◽  
Ethics Committee ◽  
Expert Committee ◽  
Cross Sectional ◽  
Primary Care Clinics ◽  
Human Research Ethics

IntroductionPerson-centred care (PCC) has become a global movement in healthcare. Despite this, the level of PCC is not routinely assessed in clinical practice. This protocol describes the adaptation and validation of the Person-Centred Practice Inventory-Staff (PCPI-S) tool that will be used to assess person-centred practices of primary healthcare providers in Malaysia.Methods and analysisTo ensure conceptual and item equivalence, the original version of the PCPI-S will be reviewed and adapted for cultural context by an expert committee. The instrument will subsequently be translated into Malay language using the forward-backward translation method by two independent bilingual speaking individuals. This will be pretested in four primary care clinics and refined accordingly. The instrument will be assessed for its psychometric properties, such as test-retest reliability, construct and internal validity, using exploratory and confirmatory factor analysis.Ethics and disseminationStudy findings will be disseminated to healthcare professionals and academicians in the field through publication in peer-reviewed journals and conference presentations, as well as at managerial clinic sites for practice improvement. The study was approved by the Medical Research and Ethics Committee (MREC), Ministry of Health Malaysia (KKM/NIHSEC/ P18-766 (14) and Monash University Human Research Ethics Committee (2018-14363-19627).

scholarly journals Challenges to the implementation of a nationwide electronic prescribing network in primary care: a qualitative study of users’ perceptions

2015 ◽  
Vol 22 (4) ◽  
pp. 838-848 ◽  
Author(s):  
Aude Motulsky ◽  
Claude Sicotte ◽  
Marie-Pierre Gagnon ◽  
Julie Payne-Gagnon ◽  
Julie-Alexandra Langué-Dubé ◽  
...  
Keyword(s):  
Primary Care ◽  
Community Pharmacists ◽  
Electronic Prescribing ◽  
Community Pharmacies ◽  
Pharmacy Staff ◽  
Standard Drug ◽  
Primary Care Clinics ◽  
Staff Members ◽  
Potential Benefits ◽  
Dispensing Data

Abstract Background and objective The objective of this study was to identify physicians’ and pharmacists’ perceptions of the challenges and benefits to implementing a nationwide electronic prescribing network linking medical clinics and community pharmacies in Quebec, Canada. Methods Forty-nine people (12 general practitioners, 2 managers, 33 community pharmacists, and 2 pharmacy staff members) from 40 points of care (10 primary care clinics (42% of all the connected sites) and 30 community pharmacies (44%)) were interviewed in 2013. Verbatim transcripts were analyzed using thematic analysis. Results A low level of network use was observed. Most pharmacists processed e-prescriptions by manual entry instead of importing electronically. They reported concerns about potential errors generated by importing e-prescriptions, mainly due to the instruction field. Paper prescriptions were still perceived as the best means for safe and effective processing of prescriptions in pharmacies. Speed issues when validating e-prescription messages were seen as an irritant by physicians, and resulted in several of them abandoning transmission. Displaying the medications based on the dispensing data was identified as the main obstacle to meaningful use of medication histories. Conclusions Numerous challenges impeded realization of the benefits of this network. Standards for e-prescription messages, as well as rules for message validation, need to be improved to increase the potential benefits of e-prescriptions. Standard drug terminology including the concept of clinical medication should be developed, and the implementation of rules in local applications to allow for the classification and reconciliation of medication lists from dispensing data should be made a priority.

scholarly journals Practical Opportunities for Biopsychosocial Education Through Strategic Interprofessional Experiences in Integrated Primary Care

2021 ◽  
Vol 12 ◽  
Author(s):  
Jennifer S. Funderburk ◽  
Julie Gass ◽  
Robyn L. Shepardson ◽  
Luke D. Mitzel ◽  
Katherine A. Buckheit
Keyword(s):  
Primary Care ◽  
Integrated Primary Care ◽  
Direct Patient Care ◽  
Team Members ◽  
Shared Medical Appointments ◽  
Case Examples ◽  
Interprofessional Teamwork ◽  
Primary Care Settings ◽  
Team Based Care ◽  
Biopsychosocial Care

Even with the expansion of primary care teams to include behavioral health and other providers from a range of disciplines, providers are regularly challenged to deliver care that adequately addresses the complex array of biopsychosocial factors underlying the patient's presenting concern. The limits of expertise, the ever-changing shifts in evidence-based practices, and the difficulties of interprofessional teamwork contribute to the challenge. In this article, we discuss the opportunity to leverage the interprofessional team-based care activities within integrated primary care settings as interactive educational opportunities to build competencies in biopsychosocial care among primary care team members. We argue that this approach to learning while providing direct patient care not only facilitates new provider knowledge and skills, but also provides a venue to enhance team processes that are key to delivering integrated biopsychosocial care to patients. We provide three case examples of how to utilize strategic planning within specific team-based care activities common in integrated primary care settings—shared medical appointments, conjoint appointments, and team huddles—to facilitate educational objectives.

scholarly journals Designing for Effective and Safe Multidisciplinary Primary Care Teamwork: Using the Time of COVID-19 as a Case Study

2021 ◽  
Vol 18 (16) ◽  
pp. 8758
Author(s):  
Lisa Lim ◽  
Craig M. Zimring ◽  
Jennifer R. DuBose ◽  
Jaehoon Lee ◽  
Robert J. Stroebel ◽  
...  
Keyword(s):  
Primary Care ◽  
Situational Awareness ◽  
Healthcare Organizations ◽  
Physical Separation ◽  
Medical Assistants ◽  
Face To Face ◽  
Primary Care Clinics ◽  
Experience Of Care ◽  
Part Time

Effective medical teamwork can improve the effectiveness and experience of care for staff and patients, including safety. Healthcare organizations, and especially primary care clinics, have sought to improve medical teamwork through improved layout and design, moving staff into shared multidisciplinary team rooms. While co-locating staff has been shown to increase communication, successful designs balance four teamwork needs: face-to-face communications; situational awareness; heads-down work; perception of teamness. However, precautions for COVID-19 make it more difficult to conduct face-to-face communications. In this paper we describe a model for understanding how layout affects these four teamwork needs and describe how the perception of teamwork by staff changed after COVID-19 precautions were put in place. Observations, interviews and two standard surveys were conducted in two primary care clinics before COVID-19 and again in 2021 after a year of precautions. In general, staff felt more isolated and found it more difficult to conduct brief consults, though these perceptions varied by role. RNs, who spent more time on the phone, found it convenient to work part time-from home, while medical assistants found it more difficult to find providers in the distanced clinics. These cases suggest some important considerations for future clinic designs, including greater physical transparency that also allow for physical separation and more spaces for informal communication that are distanced from workstations.

Converging resources and co-producing for innovation: evidence from healthcare services

2019 ◽  
Vol 23 (3) ◽  
pp. 429-453 ◽  
Author(s):  
Sanjeewani Sehgal ◽  
Garima Gupta
Keyword(s):  
Health Services ◽  
Empirical Studies ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Incremental Innovation ◽  
Future Research ◽  
Healthcare Organizations ◽  
Content Type ◽  
Internal Resources ◽  
And Performance

Purpose The purpose of this paper is to examine healthcare organizations for the improvements in their existing services (incremental innovation) as well as for the new service developments (radical innovation) initiated through the utilization of resources and co-producing behavior. Design/methodology/approach The paper uses an SEM approach to analyze the responses obtained from 257 medical administrators of 50 hospitals registered with National Accreditation Board for Hospitals and Healthcare Providers. Findings The results reflect a positive and significant impact that is more driven by internal resources and is found to be stronger for incremental innovation in healthcare. The study also posits that resource utilization in conjunction with co-production activities has greater potential to bring innovation that is likely to succeed and stay inimitable. Research limitations/implications The paper outlines scope for future research and suggests inclusion of other service sectors, geographical locations and performance indicators to attain a better understanding of the constructs examined. Practical implications The paper outlines implications for policy makers concerned with healthcare. Providers of health services ought to develop a proactive customer-oriented approach so as to deliver value through service innovations. Integrating customer co-production processes may further augment the overall quality of care. Originality/value Empirical studies integrating the resource-oriented view of innovation along with firms’ co-production and collaborative mechanisms are majorly lacking. The study bridges this gap and suggests ways to bring innovation in health services, a pivotal need for health institutions of an emerging economy like India.

Association of medical home team-based care functions and perceived improvements in patient-centered care at VHA primary care clinics

Healthcare ◽  
2014 ◽  
Vol 2 (4) ◽  
pp. 238-244 ◽  
Author(s):  
Christian D. Helfrich ◽  
Emily D. Dolan ◽  
Stephan D. Fihn ◽  
Hector P. Rodriguez ◽  
Lisa S. Meredith ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Home ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Home Team ◽  
Primary Care Clinics ◽  
Centered Care ◽  
Team Based Care

scholarly journals A Qualitative Evaluation of Knowledge of and Attitudes toward VA Smoking Cessation Services

2011 ◽  
Vol 6 (2) ◽  
pp. 152-158 ◽  
Author(s):  
Cassie L. Cunningham ◽  
Peter J. Kaboli ◽  
Sarah Ono ◽  
Mark W. Vander Weg
Keyword(s):  
Primary Care ◽  
Smoking Cessation ◽  
Tobacco Cessation ◽  
Primary Care Clinic ◽  
Qualitative Evaluation ◽  
Care Clinic ◽  
Primary Care Clinics ◽  
Staff Members ◽  
Smoking Cessation Services ◽  
Lack Of Knowledge

AbstractIntroduction:The aim of this study was to assess Veterans' and primary care clinic staff's knowledge about, and experiences with, tobacco cessation services available through their Department of Veterans Affairs (VA) medical facility.Methods:Qualitative, semi-structured, in-depth interviews and surveys were conducted with 7 patients and 12 providers/clinic staff members at three VA primary care clinics serving large numbers of rural Veterans. Interviews were transcribed and coded for the- matic content.Results:Five primary themes emerged: (1) lack of knowledge about available cessation services, (2) smoking cessation services provided to patients, (3) perceived barriers to cessation and the provision of treatment, (4) patient receptiveness to treatment and primary care provider involvement, (5) recommended strategies for improving smoking cessation services.Discussion:Our findings suggest there is a considerable lack of knowledge regarding available tobacco cessation services in VA primary care clinics serving rural Veterans. While many patients expressed the opinion that VA was providing adequate care for nicotine dependence, they also identified important barriers to cessation and offered opinions regarding what more could be done to help them to quit smoking. Clinicians/staff also provided insight into barriers they encounter in the delivery of cessation services. Future work should focus on attempting to address these barriers.

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