Collaboration in Primary Care: It’s not all Teamwork

Background: Interprofessional collaborative practice principles, models and competency frameworks align well with the activities of co-located health teams, particularly in acute or tertiary care. However, collaboration among primary care practitioners in community settings is influenced by factors such as team composition, setting (co-located vs. distributed), asynchronous and/or episodic communication, sense of team identity etc.

 

These factors lead to variability in collaborative practice across health care professionals and settings and has prompted renewed consideration of ways of working and challenging the usual conceptualization of ‘team.’ The greater integration of community members and patients as active decision-makers in primary care also may further challenge conventional understanding and the dynamics of teamwork.

 

Audience: Individuals who have been working or researching primary care collaboration in practice and questioning the concept and operationalization of collaboration when providers are not co-located.

 

Approach: The workshop will be grounded in theoretical models of collaborative practice and the complexities that influence collaborative practice and ways of working in primary care and given the diverse needs of persons in care. The presentation will include a typology from Xyrichis and colleagues,¹ which categorizes four types of collaborative practice, ranging from interprofessional (IP) teamwork/collaboration (characterized by interdependency and shared accountability, typically found in hospital settings) to IP coordination/networks (which involve greater independence and less shared accountability, often seen in distributed community or primary care teams).

We will engage attendees in an active learning workshop to examine collaboration in primary care and strategies that will enhance ways of working with multiple professionals and persons in the circle of care, particularly where primary care providers may be more distributed. Participants will first engage in an appreciative inquiry process to identify existing strengths in current practices (assets) and envision high-performing teams (values and aspirations). This will include mapping their ‘sphere of collaboration’, identifying proximal, distal and non-collaborators and the common systemic, interpersonal and individual barriers influencing collaboration. Participants will engage in solution-focused discussions to define actionable steps that support stronger communication and interactions within their sphere of collaboration. Through facilitated discussions and group sharing, the session aims to characterize collaboration and dynamics that are responsive to the unique nature of distributed primary care providers, the needs of persons in care, and engage in solution-focused discussions to define actionable steps that support high-performing teams.

 

Outcomes: This workshop builds on the challenges identified from a Delphi process and cognitive interviews used to develop a survey to assess interprofessional collaboration in various practice settings. It was also inspired by a growing literature exploring the concept of collaboration as not all practitioners who come together to collaborate comprise teams. At the conclusion of this workshop, participants will be able to…

1)Characterize collaboration, teams and teamwork in co-located vs distributed primary care

2)Identify common barriers to healthcare collaboration.

3)Develop strategies to communicate and collaborate effectively across healthcare contexts.

¹ Xyrichis, A.et al (2017). Examining the nature of interprofessional practice: An initial framework validation and creation of the InterProfessional Activity Classification Tool (InterPACT). Journal of Interprofessional Care, 32(4).