“It goes beyond good camaraderie”: A qualitative study of the process of becoming an interprofessional healthcare “teamlet”

Abstract

Within the US, the patient-centred medical home has become a predominant model in the delivery of primary care. This model requires a shift from the physician-centric model to an interprofessional team-based approach. Thus, healthcare staff are being reorganized into teams, resulting in having to work and relate to one another in new ways. In 2010, the Veterans Health Administration implemented the patient aligned care team (PACT) model, its version of the patient-centred medical home. The transition to the PACT model involved restructuring primary care staff into "teamlets", consisting of a registered nurse, licensed practical nurse, and administrative clerk for each full-time-equivalent primary care provider. This qualitative study used observation and semi-structured interviews to understand the factors that affect teamlet functioning as they implement this new model of care and how teams are interacting to address those factors. Findings suggest that role understanding includes understanding how each teamlet member's tasks are performed in the daily operations of the clinic. In addition, willingness to perform tasks that benefit the teamlet and acceptance of delegation from all teamlet members were found to be important for teamlet functioning and cohesion. In order for healthcare teams to provide patient-centred care, it is important to provide guidance and support about what these new relationships and roles will entail. The building of team relationships is not a static process; ways of working together build over time and, therefore, should be seen as a continuous cycle of quality improvement.

Are interprofessional healthcare teams meeting patient expectations? An exploration of the perceptions of patients and informal caregivers

“…However, it is key that individuals' understanding their own roles and the role of others help team members understand scopes of practice, enhance respect for each other's roles, and importantly allowed them to understand how the roles of others are complementary to their own (Bainbridge et al, 2010;Harrod et al, 2016;Nancarrow et al, 2013).…”

“…Relationships between team members including mutual trust, support and recognition, were found to improve effective team working and team relationships over time (Harrod et al, 2016;Jackson & Bluteau, 2011;Youngwerth & Twaddle, 2011). Team members should have knowledge of and respect for the competences, roles and contributions of other professionals within a team and the ability to complete the team goal (Vyt, 2008;West & Lyubovnikova, 2013).…”

Reconceptualizing the U.S. Military’s Transition Assistance Program: The Success in Transition Model

“…Aspects of camaraderie, especially when it is formed during military deployment, have been shown to decrease the development and severity of PTSD along with aiding in recovery from trauma responses (Nevarez et al, 2017;Wright, Kelsall, Sim, Clarke, & Creamer, 2013). Infusing features of camaraderie into education and social service programs is also linked with improved retention/use of material and higher levels of participation (Brake & Kelly, 2019;Harrod et al, 2016).…”

The role of the psychologist in the veterans administration’s patient aligned care team and huddle: A review, practical recommendations, and a call to action

“…This may be particularly true with an interdisciplinary staff. Without proper role expectations, the huddle can quickly sink (Harrod et al , 2016 ). Providers need be aware of their responsibilities, expectations, and what they need to bring to the huddle.…”