Facilitating teamwork in general practice: moving from theory to practice

Abstract

The aims of this paper are to describe the development of an intervention to improve teamwork and systems in general practice that support the care of patients with diabetes, ischaemic heart disease and hypertension and to identify the challenges to implementing the intervention. Effective teamwork in general practice encompasses general practitioners (GP), clinical and non-clinical staff, each with clearly defined roles and opportunities to provide feedback and input into how the practice is run and chronic disease managed. The intervention implemented in this study provided an opportunity for key members of general practice teams to work with a facilitator on changes to improve teamwork over three practice visits over 6–12 months. Facilitators had experience in practice support and goal setting, an understanding of the Medicare Items and knowledge about teamwork and systems. The visits focussed on the specific needs and capacities of each practice, assisting the team to set manageable goals and building systems that best utilise the systemic and human resources available. Successful implementation of sustained change depended on strong leadership in the practice and cooperation between team members as well as clear and achievable goals being set. Structured facilitation of teamwork in general practice should focus on goal setting and the development of leadership and communication rather than delivery of information or resources.

Readiness for organisational change among general practice staff

“…This paper analyses the baseline data from a randomised controlled trial evaluating a practice-based intervention to enhance the role of non-general practitioner staff in chronic disease management 13. It examines readiness for organisational change of practice staff and its association with staff and practice characteristics.…”

An integrative review of facilitators and barriers influencing collaboration and teamwork between general practitioners and nurses working in general practice

“…, Taggart et al . ). Similar to collaboration and teamwork, shared care is also used to describe an approach where different health professionals work together and share skills, knowledge, decision‐making and responsibilities (Condon et al .…”

“…A frequent misconception associated with collaboration and teamwork, is the assumption that one is inextricably linked to the other (Xyrichis & Ream 2008). Whilst collaboration and teamwork share common characteristics around shared goals, decision-making, trust and respect, the two comprise subtle differences in relation to leadership, power and autonomy (D'Amour et al 2005, Meads et al 2005, Taggart et al 2009). Similar to collaboration and teamwork, shared care is also used to describe an approach where different health professionals work together and share skills, knowledge, decision-making and responsibilities (Condon et al 2000, McCann & Baker 2003.…”

Formal and informal governance networks: Diabetes care in Australia and India

“…This leads to issues over power and authority, mistrust, and lack of respect among each other. Although the roles of GPs are important in diabetes care, particularly in implementation of the components of the diabetes cycle of care (Saunders, Schattner, & Mathews, 2008); numerous studies (e.g., Aylen, Watson, & Audehm, 2006;Harris, 2008;Infante et al, 2004;Proudfoot et al, 2007;Taggart et al, 2009) show that GPs are only able to provide sub-optimal care to people with diabetes. The main barriers in the provision of effective care in the general practice are because of the limited organizational capacity to provide structured care (Harris, 2008;Proudfoot et al, 2007), lack of time and work pressure (Aylen et al, 2006;Harris, 2008), and a lack of knowledge of what is available in terms of diabetes education services (Aylen et al, 2006).…”