Table 1
Items focus groups.
| Domain Integrated Team Effectiveness Model | Question |
|---|---|
| Team effectiveness | What will effective teamwork in COPD care bring in and how can we measure that? |
| Organisational context | How do you define an organisational context with incentives for effective teamwork in COPD care? |
| Task design | How do you define your role in the COPD team? |
| Team processes | How do you define basic criteria for an effective team process considering the following key words: communication, collaboration, coordination, conflict, leadership, decision-making and participation? |
| Team psychosocial traits | What characteristics are required in a COPD team to be involved in the team and how important is that? |
Table 2
Integrated Team Effectiveness Model applied to integrated care for people with COPD.
| Domain Integrated Team Effectiveness Model | Focus groups |
|---|---|
| Organisational context | |
| Goals/standard | The collaborative practice aims to improve patients’ quality of life |
| Structure/characteristics | Clarity about structure and agreements of collaborative practice No competition among team members |
| Rewards/supervision | Team members are accessible for consultation |
| Training Environment | There are adequate training opportunities |
| Resources | The availability of time and work places |
| Information System | The information system is functioning and add relevant data |
| Task design | |
| Interdependence | Team members are interdependent to deliver quality of care |
| Autonomy | The input of every team member is valued |
| Clarity of rules and procedures | In general, the team will follow the care protocols. |
| Team process | |
| Communication | Relevant patient data are exchanged Team meetings are effective |
| Coordination | Communication contributes to continuity of care |
| Decision-making | A decision to be off track will be discussed within the team |
| Participation | Team members give priority to team meetings |
| Conflict | Open communication is valued |
| Team psychosocial traits | |
| Cohesion | Personal involvement in a COPD team |
| Norms | Mutual respect and trust between team members |
| Team effectiveness | |
| Objective outcomes | |
| Patient | Several indicators (e.g. exacerbation and quality of life) which are not only a determinant of teamwork |
| Patient drop-out | |
| Subjective outcomes | Patients know their primary contact person |
| Perceived team effectiveness | Satisfaction about the joint contribution to patients’ quality of life The care is patient-centred, not only disease specific The team has an overview about their patients |
Table 3
Number of invited healthcare providers, response rate and number of returned questionnaires.
| Discipline | Number of respondents | Response rate (%) | Number of questionnaires |
|---|---|---|---|
| General practitioner | 53 | 65 | 53 |
| Practice nurse | 32 | 71 | 40 |
| Pulmonologist | 1 | 100 | 27 |
| Respiratory nurse | 3 | 60 | 29 |
| Dietician | 3 | NA | 3 |
| Physiotherapist | 1 | NA | 1 |
| Total | 93 | NA | 153 |
Table 4
Communalities, component loadings of the PCA and Cronbach’s alpha.
| Item | Cs* | Component | |||
|---|---|---|---|---|---|
| 1 | 2 | 3 | |||
| Component 1 | |||||
| In our COPD …. | |||||
| 4 | 0.51 | … the electronic system for sharing data contributes to our teamwork | 0.75 | −0.01 | −0.20 |
| 24 | 0.45 | … The drop out of COPD patients is low | 0.67 | 0.01 | −0.02 |
| 25 | 0.44 | … we not only focus on the disease but keep an overall picture of the patient | 0.63 | −0.21 | 0.17 |
| 23 | 0.39 | … we have a better overview of our COPD patients due to our teamwork | 0.55 | 0.00 | 0.17 |
| 22 | 0.42 | … patients know their personal contact point | 0.51 | 0.25 | 0.07 |
| 13 | 0.52 | … we are providing patient data which are relevant for team members | 0.47 | 0.27 | −0.05 |
| 21 | 0.62 | … I feel that we jointly are doing a good job in meeting patients’ care needs | 0.45 | 0.21 | 0.41 |
| 9 | 0.25 | … there are adequate opportunities to increase our knowledge about COPD | 0.34 | 0.20 | 0.13 |
| Cronbach’s alpha = 0.80 (7 or 8 items) | |||||
| Component 2 | |||||
| In our COPD-team …. | |||||
| 5 | 0.59 | … there is not enough available time for each other | −0.11 | 0.81 | −0.21 |
| 2 | 0.54 | … the different roles and responsibilities needs to be more clearly defined | −0.02 | 0.72 | 0.06 |
| 7 | 0.54 | … the consultation function of team members needs to be more accessible | 0.14 | 0.68 | 0.01 |
| 16 | 0.29 | … we need more communication to provide continuity of care | 0.31 | 0.56 | −0.17 |
| 14 | 0.42 | … team meetings are easily cancelled | −0.17 | 0.55 | 0.30 |
| 10 | 0.40 | … we accomplish each other (vision, knowledge and skills) | 0.21 | 0.41 | 0.23 |
| 12 | 0.48 | … reasons to deviate from protocol are discussed | 0.33 | 0.38 | 0.25 |
| Cronbach’s alpha = 0.76 (7 items) | |||||
| Component 3 | |||||
| In our COPD team …. | |||||
| 18 | 0.64 | … team members feel that they are valued and respected | 0.14 | −0.20 | 0.78 |
| 17 | 0.51 | … I know I can rely on the expertise of my team members | 0.03 | 0.07 | 0.68 |
| 8 | 0.30 | … competition interfered with my collaborative work | 0.01 | −0.10 | 0.56 |
| 19 | 0.52 | … our communication is characterised by openness | 0.37 | −0.08 | 0.54 |
| 6 | 0.29 | … a need for proper work rooms is impeding our team functioning | −0.27 | 0.12 | 0.52 |
| 1 | 0.45 | … we are working towards a common purpose | 0.29 | 0.03 | 0.51 |
| 20 | 0.36 | … I consider myself as a member of this team | −0.01 | 0.30 | 0.45 |
| 11 | 0.54 | … members of the team feel that their expertise is fully utilised | 0.32 | 0.33 | 0.38 |
| 3 | 0.52 | … we have well understood work agreements | 0.30 | 0.34 | 0.37 |
| Cronbach’s alpha = 0.81 (9 items) | |||||
[i] The numbers in bold reflect a loading of items on either component 1, 2 or 3, where the factor loading is =>0.35.
Cs*: communalities.