Developing High-Functioning Teams: Factors Associated With Operating as a “Real Team” and Implications for Patient-Centered Medical Home Development
Open accessAbstract
Team-based care is a foundation of health care redesign models like the patient-centered medical home (PCMH). Yet few practices rigorously examine how the implementation of PCMH relates to teamwork. We identified factors associated with the perception of a practice operating as a real team. An online workforce survey was conducted with all staff of 12 primary care sites of Cambridge Health Alliance at different stages of PCMH transformation. Bivariate and multivariate analyses of factors associated with teamwork perceptions were conducted. In multivariate models, having effective leadership was the main factor associated with practice teamwork perceptions (odds ratio [OR], 10.49; 95% confidence interval [CI], 5.39-20.43); in addition, practicing at a site in an intermediate stage of PCMH transformation was also associated with enhanced team perceptions (OR, 2.44; 95% CI, 1.28-4.64). In a model excluding effective leadership, respondents at sites in an intermediate stage of PCMH transformation (OR, 1.95; 95% CI, 1.1-3.4) and who had higher care team behaviors (such as huddles and weekly meetings; OR, 3.41; 95% CI, 1.30-8.92), higher care team perceptions (OR, 2.65; 95% CI, 1.15-6.11), and higher job satisfaction (OR, 2.00; 95% CI, 1.02-3.92) had higher practice teamwork perceptions. This study highlights the strong association between effective leadership, care team behaviors and perceptions, and job satisfaction with perceptions that practices operate as real teams. Although we cannot infer causality with these cross-sectional data, this study raises the possibility that providing attention to these factors may be important in augmenting practice teamwork perceptions.
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Primary care practices reporting better teamwork were more likely to be in later stages of transformation to PCMHs than practices with poorer teamwork.
“In the other, primary care practices reporting better teamwork were more likely to be in later stages of transformation to PCMHs than practices with poorer teamwork [88].”
From Teamwork and implementation of innovations in healthcare and human service settings: a systematic review (2024) · cites this paper as [88]
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- Authors
- Stout, S., Zallman, L., Arsenault, L., Sayah, A., & Hacker, K.
- Affiliations
- Cambridge Health Alliance (US)
- Health Resources in Action (US)
- University of Pittsburgh (US)
- Corresponding author
- Zallman, Leah
- Venue
- INQUIRY: The Journal of Health Care Organization, Provision, and Financing
- Publisher
- SAGE Publications
- Published
- 2017-01-01
- Volume
- 54
- Pages
- 46958017707296-46958017707296
- ISSN
- 0046-9580 (ISSN-L)
- 1945-7243
- PMC
- PMC5798723
- OpenAlex
- W2624855658
- Cited by
- 22
- References
- 24
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2023: 3 · 2022: 4 · 2021: 3 · 2020: 3 · 2019: 3 · 2018: 1
- FWCI
- 3.10
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- INQUIRY The Journal of Health Care Organization Provision and Financing (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Health Professions › General Health Professions › Interprofessional Education and Collaboration
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Social Sciences › Psychology › Social Psychology › Team Dynamics and Performance
- Keywords
- patient-centered medical home, team-based care, teamwork, primary care practice transformation, leadership, job satisfaction, team perceptions, health care redesign
- MeSH terms
- Boston, Cross-Sectional Studies, Humans, Job Satisfaction, Leadership, Patient Care Team, Primary Health Care, Surveys and Questionnaires, Patient-Centered Care, Internet
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