Interprofessional primary care protocols: A strategy to promote an evidence-based approach to teamwork and the delivery of care

Abstract

Primary care reform involving interprofessional team-based care is a global phenomenon. In Ontario, Canada, 150 Family Health Teams (FHTs) have been approved in the past few years. The transition to a FHT is complex involving many changes and the processes for collaborative teamwork are not clearly delineated. To support the transition to team-based care in FHTs, a project was undertaken to develop and implement a series of interprofessional protocols in four clinical areas. These interprofessional protocols would contain relevant and evidence-based resources to support both a team and evidence-based approach to care. This paper reports on a qualitative study to examine the process of interprofessional protocol development and pilot implementation. Adopting an exploratory case study approach (Robson, ), 36 interviews were conducted with health professionals and community group members who participated in the creation and piloting of the protocols, and with project managers. In addition, observational and documentary data were gathered on the protocol development and implementation processes. The findings from the protocol development stage demonstrate the value of the focus on evidence and team, the process of assessing and targeting FHT needs, inter-organizational and interprofessional sharing, the importance of facilitation and support, and expectations for implementation. The findings from the pilot implementation stage report on the importance of champions and leaders, the implementation strategies used, FHT and organizational factors affecting implementation, and outcomes achieved. Findings are discussed in relation to the knowledge translation and interprofessional literature. Research is ongoing to examine the effectiveness of dissemination of the protocols to FHTs across the province of Ontario and its impact on health care outcomes.

Keywords:

• Interprofessional teamwork
• family health teams
• primary care
• evidence
• protocols
• knowledge translation

Acknowledgements

This project was funded by two grants: the Ontario Ministry of Health and Long Term Care “Enhancing Quality in Primary Care Fund” ICEF0708068; and the HealthForceOntario “Interprofessional Care and Education Fund”. We would like to thank Forum and Task group members as well as the participating FHTs who generously gave up their time to support this study.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Notes

1. The two team-based primary care practices are not FHTs but have a similar focus on team care; given their similar objective of team care, the term FHT is used in the paper to include all of the participating primary care practices.

2. For further information on CEP see: http://www.effectivepractice.org/

3. For more information on GAC see: http://www.gacguidelines.ca/

4. The larger number of physicians is indicative of their larger representation in the FHTs.

5. The end-of-life care group concluded that a protocol was not an appropriate approach and decided to proceed to a workshop.