Optimizing rural healthcare through improved team function: a case study of the Rural Surgical Obstetrical Networks programme

ABSTRACT

We explored enablers and mechanisms of optimal team function within rural hospital teams, and the impact of these factors on health service sustainability in British Columbia. The data were drawn from interviews and focus groups with healthcare providers and administrators (n = 169) who participated in the Rural Surgical Obstetrical Networks (RSON) initiative to support low-volume rural surgical and obstetrical services in British Columbia, Canada. The 5-year programme (2018–2022) provided evidence-based system interventions across eight rural sites with the objective of providing sustainable, quality health services to meet population needs. To explore the impact of RSON interventions on local team function, we performed a scoping review, to assess the current literature surrounding enablers of effective rural hospital teamwork. Through inductive thematic analysis of interview data, we identified five enablers of good team function at RSON sites, including emphasis on local leadership, shared direction, commitment to sustainability, respect and solidarity among colleagues, and meaningful communication. The RSON project led to a shift in team culture in participating sites, improved team function, and contributed to improved clinical processes and patient outcomes. The findings have implications for rural health policy and practice in British Columbia and other jurisdictions with similar health service delivery models and geographic contexts.

KEYWORDS:

• Qualitative research
• rural health
• team function
• teamwork

Acknowledgments

We would like to thank all of the healthcare providers and administrators in rural British Columbia who took time out of their busy schedules to speak with us. We would also like to thank Audrey Cameron, Payal Parti, and Kathrin Stoll for their assistance in preparing this article for publication.

Disclosure statement

Tom Skinner is employed by the Rural Coordination Centre of BC (RCCbc) as the Project Manager of the RSON Initiative. The findings reported in this survey are part of the evaluation of RSON. As an employee, his travel to the rural communities was covered because he was supporting hospital teams in implementing the RSON initiative. Kim Williams received salary funding from the Rural Coordination Centre of BC (RCCbc) in her capacity as administrative co-lead for the Rural Surgical and Obstetrical Networks (RSON) initiative. She also received funding to travel to the rural communities where the patients whom we report on in this manuscript had surgical care.

All other authors are part of the RSON evaluation team at the University of British Columbia, Canada, and have no conflicts of interest to declare.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/13561820.2023.2280586

Additional information

Funding

BC Joint Standing Committee on Rural Issues. Grant/award # R005415

Notes on contributors

Jude Kornelsen

Jude Kornelsen is an Assistant Professor in the Department of Family Practice at the University of British Columbia and the Co-Director of the Centre for Rural Health Research. Her research focuses n the development of an evidence base to apply to rural health services planning.

Hilary Ho

Hilary Ho is a qualitative health services researcher with an interest in working to empower decision-makers to improve the well-being of communities.

Kim Williams

Kim Williams is a Network Director with the Rural Coordination Centre of British Columbia, interested in building relationships between healthcare teams across networks to co-create initiatives that improve access to services for rural individuals.

Tom Skinner

Tom Skinner is a Project Manager with the Rural Coordination Centre of British Columbia. He supports teams around British Columbia in sustaining small-volume surgical and obstetrical programs.