Abstract:
:In this paper we present results of a mixed methods study conducted to identify barriers to team function among staff implementing patient aligned care teams - the Department of Veterans Affairs' patient centered medical home (PCMH) model. Using a convergent mixed methods design, we administered a standardized survey measure (Team and Individual Role Perception Survey) to assess work role challenge and engagement; and conducted discussion groups to gather context pertaining to role change. We found that the role of primary care providers is highly challenging and did not become less difficult over the initial year of implementation. Unexpectedly over the course of the first year nurse care managers reported a decrease in their perceptions of empowerment and clerical associates reported less skill variety. Qualitative data suggest that more skilled team members fail to delegate and share tasks within their teams. We characterize this interprofessional knowledge factor as an empowerment paradox where team members find it difficult to share tasks in ways that are counter to traditionally structured hierarchical roles. Health care systems seeking to implement PCMH should dedicate resources to facilitating within-team role knowledge and negotiation.
journal_name
J Interprof Carejournal_title
Journal of interprofessional careauthors
Solimeo SL,Ono SS,Lampman MA,Paez MB,Stewart GLdoi
10.3109/13561820.2014.937480subject
Has Abstractpub_date
2015-01-01 00:00:00pages
26-33issue
1eissn
1356-1820issn
1469-9567journal_volume
29pub_type
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