Collaborative Care in Primary Care: The Influence of Practice Interior Architecture on Informal Face-to-Face Communication—An Observational Study

Abstract

Background: Quality patient care in primary care settings, especially for patients with complex long-term health needs, is improved by interprofessional collaborative practice. Effective collaboration is achieved in large part by frequent informal face-to-face “on-the-fly” communication between team members. Research undertaken in hospitals shows that interior architecture influences informal communication and collaboration between staff. However, little is known about how the interior architecture of primary care practices might facilitate or hinder informal communication and collaboration among primary care staff. Objectives: This research explores the influence of primary care practice interior architecture on face-to-face on-the-fly communication for collaborative care. Methods: An observational study was undertaken to compare face-to-face informal interactions between staff in three primary care practices of differing interior architecture. Data collected from practices included: direct observations floor plans, photographs, interviews, and surveys. Results: Most primary care staff engaged in frequent, brief face-to-face interactions, which appeared to be key to the delivery of effective collaboration. Features of primary care practice designs that were associated with increased frequency of staff interaction included shared spaces, staff proximity/visibility, and the presence of convenient circulatory and transitional spaces where staff were able to easily engage in timely on-the-fly communication with colleagues. Conclusions: The interior architecture of primary care practices has an important impact on staff collaboration. Although more research is needed to investigate further details in more practices, close attention should nevertheless be paid to maximizing opportunities for brief face-to-face communication in well-designed shared spaces in primary care practices.

Scoping review to identify strategies and interventions improving interprofessional collaboration and integration in primary care

“…By collaborating with different disciplines and professions, many caregivers were experiencing problems regarding information sharing43 49 54 57 59 61 65 68 71 73 and referring44 45 49 51 55 59 61 65 66 68 between primary healthcare workers. Twenty articles, therefore, provided strategies to improve coordination in order to ameliorate information sharing between caregivers, to facilitate referrals for the patient and to guarantee the continuity of care 43–45 49 51 53–55 59 61 65 66 68–73 75 76. Accordingly, reciprocity and reciprocal interdependence were shown to play a crucial role in the coordination of primary care 55 61…”

“…Colocation and the importance of architecture and building characteristics were, in some cases, mentioned as influential factors for collaboration 70 75 76. By optimising the architecture and working under one roof, brief face-to-face interactions may increase.…”

The Delivery of Patient Care in Ontario’s Family Health Teams during the First Wave of the COVID-19 Pandemic

“…One of the challenges for primary care teams is to find new ways to collaborate with one another in the context of physical distancing during the pandemic ( Donnelly et al 2021 ). Team collaboration in primary care often relies on frequent and informal in-person encounters in an appropriate physical space ( Goldman et al 2010 ; Levesque et al 2017 ; Morgan et al 2020 ). Our study demonstrates that primary care teams were using a range of alternate modalities to stay engaged with one another early in the pandemic.…”

“…Our study demonstrates that primary care teams were using a range of alternate modalities to stay engaged with one another early in the pandemic. A risk of virtual collaboration is that the frequency of team interactions may decrease while the formality of interactions may increase ( Morgan et al 2020 ). It is crucial to ensure that primary care teams maintain their ability to interact with one another despite the challenges presented in virtual care, especially given the significant investments made in the recent past to establish primary care teams in Ontario and elsewhere ( Hutchison et al 2011 ).…”

“…Team-based primary care brings family physicians together to work in tandem with a range of interprofessional healthcare providers (IHPs) -such as nurses, nurse practitioners, social workers, dietitians and pharmacists among others -in the same practice setting (Donnelly et al 2021). Primary care teams are associated with improved clinical outcomes, positive patient experiences and decreased healthcare utilization (Gocan et al 2014;Khan et al 2021;Manns et al 2012;Morgan et al 2020;Mulvale et al 2009;Strumpf et al 2017).…”