A review of instruments to measure interprofessional team-based primary care

ABSTRACT

Interprofessional team-based care is increasingly regarded as an important feature of delivery systems redesigned to provide more efficient and higher quality care, including primary care. Measurement of the functioning of such teams might enable improvement of team effectiveness and could facilitate research on team-based primary care. Our aims were to develop a conceptual framework of high-functioning primary care teams to identify and review instruments that measure the constructs identified in the framework, and to create a searchable, web-based atlas of such instruments (available at: http://primarycaremeasures.ahrq.gov/team-based-care/). Our conceptual framework was developed from existing frameworks, the teamwork literature, and expert input. The framework is based on an Input-Mediator-Output model and includes 12 constructs to which we mapped both instruments as a whole, and individual instrument items. Instruments were also reviewed for relevance to measuring team-based care, and characterized. Instruments were identified from peer-reviewed and grey literature, measure databases, and expert input. From nearly 200 instruments initially identified, we found 48 to be relevant to measuring team-based primary care. The majority of instruments were surveys (n = 44), and the remainder (n = 4) were observational checklists. Most instruments had been developed/tested in healthcare settings (n = 30) and addressed multiple constructs, most commonly communication (n = 42), heedful interrelating (n = 42), respectful interactions (n = 40), and shared explicit goals (n = 37). The majority of instruments had some reliability testing (n = 39) and over half included validity testing (n = 29). Currently available instruments offer promise to researchers and practitioners to assess teams’ performance, but additional work is needed to adapt these instruments for primary care settings.

KEYWORDS:

• Instruments
• interprofessional practice
• primary care
• surveys
• team-based care
• teamwork

Acknowledgements

We would like to thank the members of the Technical Expert Panel who helped to shape the conceptual framework and provided guidance and feedback at critical points in the project: Diane Cardwell, Benjamin Miller, Sally Okun, Raymond Palmer, Eduardo Salas, Ronald Stock, Melissa Valentine, Sally Ver Steeg, and Elizabeth Yano. We would also like to thank the following individuals for sharing their perspectives on the role of teamwork in healthcare delivery: Veronica Chollette, Laura Makaroff, Carly Parry, and Shanita Williams.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.