Development and early experience from an intervention to facilitate teamwork between general practices and allied health providers: the Team-link study

Abstract

BackgroundThis paper describes the development and implementation of an intervention to facilitate teamwork between general practice and outside allied and community health services and providers.MethodsA review of organizational theory and a qualitative study of 9 practices was used to design an intervention which was applied in four Divisions of General Practice and 26 urban practices. Clinical record review and qualitative interviews with participants were used to determine the key lessons from its implementation.ResultsFacilitating teamwork across organizational boundaries was very challenging. The quality of the relationship between professionals was of key importance. This was enabled by joint education and direct communication between providers. Practice nurses were key links between general practices and allied and community health services.ConclusionsCurrent arrangements for Team Care planning provide increased opportunities for access to allied health. However the current paper based system is insufficient to build relationships or effectively share roles as part of a patient care team. Facilitation is feasible but constrained by barriers to communication and trust.

Patient and practice characteristics predict the frequency of general practice multidisciplinary referrals of patients with chronic diseases: A multilevel study

“…The study focused on the process of inter-professional collaboration between GPs, practice nurses, other practice staff, and AHPs and engaging patients in self-management. The early intervention group received an intervention which involved a six-month low intensity facilitation by a facilitator from the local DGP to enhance multidisciplinary care in chronic disease management [11]. The delayed intervention group provided 'usual care' for the first 6 months which served as comparison group with the early intervention group.…”

“…The patient characteristics included age (collapsed into four categories: 19-45, 46-59, 60-70 and 70+ years), gender, employment status, education levels, disease conditions, years with the conditions, self-reported health, admission to hospital in the last 12 months, holders of pension cards, language spoken at home, smoking habits, home and car ownership. Patient socioeconomic status was classified according to the 2006 index of relative socioeconomic advantage/disadvantage for the area in which the patient lived [12]. In this index, the lower the score, the more disadvantaged the area [12].…”

“…Patient socioeconomic status was classified according to the 2006 index of relative socioeconomic advantage/disadvantage for the area in which the patient lived [12]. In this index, the lower the score, the more disadvantaged the area [12]. The measure of 'Patient Assessment of Chronic Illness Care' [13] and the two sub-scores for the validated measure for Quality of Life (SF-12) [14]: Physical Component Summary of the SF12 (PCS SF12) and Mental Component Summary (MCS SF12) of SF12 at baseline were also included as patient variables.…”

“…The Team Link study was designed to evaluate the impact of an intervention to enhance multi-disciplinary teamwork in Australian general practice on the process of care and outcomes for patients with diabetes, IHD or hypertension [7,11]. The aim of this article is to explore the influence of patient and practice characteristics on referrals to allied health professionals (AHPs) outside the practice for multidisciplinary care.…”

Secondary analysis and literature review of community rehabilitation and intermediate care: an information resource

“…Young 107 and Wilson and Parker 108 ), has been described as a problem with communication and trust. 109 However, this perhaps highlights a broader issue in the NHS regarding the primacy of issues of responsibility and ownership rather than collaboration, co-operation and integration. 110 This view is supported by Weinberg et al 111 who concluded that collaborative capacity is somewhat constrained by a rigid hierarchy of health-care occupations and division of labour.…”