Identify and classify interprofessional primary care performance indicators: a scoping review protocol (original) (raw)
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Primary Health CareResearch & Development, 2019
Aim: The aim of the study was to describe practices that support collaboration in interprofessional primary health care teams, and identify performance indicators perceived to measure the impact of this collaboration from the perspective of interprofessional health providers. Background: Despite the surge of interprofessional primary health care models implemented across Canada, there is little evidence as to whether or not the intended outcomes of primary health care teams have been achieved. Part of the challenge is determining the most appropriate measures that can demonstrate the value of collaborative care. To date, little remains known about performance measurement from the providers contributing to the collaborative care process in interprofessional primary care teams. Having providers from a range of disciplinary backgrounds assist in the development of performance measures can help identify measures most relevant to demonstrate the value of collaborative care on the intended outcomes of inter-professional primary care models. Methods: A qualitative study; part of a larger mixed methods developmental evaluation to examine performance measurement in interprofessional primary health care teams. A stakeholder workshop was conducted at an annual association meeting of interprofessional primary health care teams in the province of Ontario, Canada. Six questions guided the workshop groups and participant responses were documented on worksheets and flip charts. All responses were collected and entered verbatim into a word document. Qualitative analytic strategies were applied to each question. Findings: A total of 283 primary health care providers from 14 health professions working in interprofessional primary health care teams participated. Top three elements of interprofessional collaboration (total n = 628) were communication (n = 146), co-treatment (n = 112) and patient-based conferences (n = 81). Top three performance indicators currently used to demonstrate the value of inter-professional collaboration (total n = 241) were patient experience (n = 71), patient health status (n = 35) and within team referrals (n = 30).
BMJ Open
ObjectiveTo identify strategies and interventions used to improve interprofessional collaboration and integration (IPCI) in primary care.DesignScoping reviewData sourcesSpecific Medical Subject Headings terms were used, and a search strategy was developed for PubMed and afterwards adapted to Medline, Eric and Web of Science.Study selectionIn the first stage of the selection, two researchers screened the article abstracts to select eligible papers. When decisions conflicted, three other researchers joined the decision-making process. The same strategy was used with full-text screening. Articles were included if they: (1) were in English, (2) described an intervention to improve IPCI in primary care involving at least two different healthcare disciplines, (3) originated from a high-income country, (4) were peer-reviewed and (5) were published between 2001 and 2020.Data extraction and synthesisFrom each paper, eligible data were extracted, and the selected papers were analysed inductiv...
2012
Primary care is the central pillar of health care. The increasingly complex health needs of the population and individual patients in a changing society can only be met by promoting Inter professional Collaboration (IpC) within primary care teams. The aim of this Position Paper of the European Forum for Primary Care (EFPC) is to analyse how to improve IpC within primary care teams. Clarification of the concept is the first step. Conditions to improve IpC are based on education of health care professionals, adapting human resources and the occupational structure, and skill mix in primary care. These conditions, dependent of contextual factors have a major influence on the development of IpC. They can be developed and organised at different levels: national, regional, or team level. A framework is also needed to evaluate the level of collaboration within teams. Examples of good practices throughout Europe issued from the EFPC network illustrate this.
Quality in primary care, 2012
Primary care is the central pillar of health care. The increasingly complex health needs of the population and individual patients in a changing society can only be met by promoting interprofessional collaboration (IpC) within primary care teams. The aim of this Position Paper of the European Forum for Primary Care (EFPC) is to analyse how to improve IpC within primary care teams. Clarification of the concept is the first step. Conditions to improve IpC are based on the education of healthcare professionals, adapting human resources, the occupational structure and the skill-mix in primary care. These conditions, dependent on contextual factors, have a major influence on the development of IpC. They can be developed and organised at different levels: national, regional or team level. A framework is also needed to evaluate the level of collaboration within teams. Examples of good practice throughout Europe issued from the EFPC network illustrate this.
BMC Health Services Research, 2013
Background: The scientific literature continues to advocate interprofessional collaboration (IPC) as a key component of primary care. It is recommended that primary care groups be created and configured to meet the healthcare needs of the patient population, as defined by patient demographics and other data analyses related to the health of the population being served. It is further recommended that the improvement of primary care services be supported by the delivery of feedback and performance measurements. This paper describes the theory underlying an interprofessional educational intervention developed in Quebec's Montérégie region (Canada) for the purpose of improving chronic disease management in primary care. The objectives of this study were to explain explicitly the theory underlying this intervention, to describe its components in detail and to assess the intervention's feasibility and acceptability.
2021
Backgrond and Objective: Primary health care has a central role in the workings of the health care system and health of the American public. Thus, a high-performing, high-quality primary care system is essential. As a result, measurement frameworks are needed to assess the quality of the infrastructure, workforce configurations, and processes available in primary care practices due to the complexity of primary care. As part of a larger project supported by AHRQ (grant no. 1 R01 HS 025982), our research team reports the use of an evidence-based approach to compile a targeted set of existing care measures. These measures are prioritized according to their overall contribution and value to primary care. Within this paper, we describe the process by which the performance measures were selected and present the final set of measures resulting from the process. Methods and Results: We adapted The Productivity Measurement and Enhancement System, or ProMES, to select and rank existing primar...
International Journal of Environmental Research and Public Health
Despite decades of research on the impact of interprofessional collaboration (IPC), we still lack definitive proof that team-based care can lead to a tangible effect on healthcare outcomes. Without return on investment (ROI) evidence, healthcare leaders cannot justifiably throw their weight behind IPC, and the institutional push for healthcare manpower reforms crucial for facilitating IPC will remain variable and fragmentary. The lack of proof for the ROI of IPC is likely due to a lack of a unifying conceptual framework and the over-reliance on the single-method study design. To address the gaps, this paper describes a protocol which uses as a framework the Quadruple Aim which examines the ROI of IPC using four dimensions: patient outcomes, patient experience, provider well-being, and cost of care. A multimethod approach is proposed whereby patient outcomes are measured using quantitative methods, and patient experience and provider well-being are assessed using qualitative methods....
2011
Primary care is the central pillar of health care. The increasingly complex health needs of the population and the individual patient in a changing society can only be met by promoting Inter professional Collaboration (IpC) within PC teams. The aim of this Position Paper of the European Forum for Primary Care (EFPC) is to analyse how to improve IpC within PC teams. Clarification of the concept is the first step. Conditions to improve IpC are based on education of health care professionals, adapting human resources and the occupational structure and skill mix. These conditions and contextual factors have a major influence on the development of IpC. They can be developed and organised at different levels: national, regional, or team level. A framework is also needed to evaluate the level of collaboration within the team. Examples of good practices throughout Europe issued from the EFPC network illustrates this.
Journal of public health (Oxford, England), 2014
The epidemiological transition calls for redefining the roles of the various professionals involved in primary health care towards greater collaboration. We aimed to identify facilitators of, and barriers to, interprofessional collaboration in primary health care as perceived by the actors involved, other than nurses. Systematic review using synthetic thematic analysis of qualitative research. Articles were retrieved from Medline, Web of science, Psychinfo and The Cochrane library up to July 2013. Quality and relevance of the studies were assessed according to the Dixon-Woods criteria. The following stakeholders were targeted: general practitioners, pharmacists, mental health workers, midwives, physiotherapists, social workers and receptionists. Forty-four articles were included. The principal facilitator of interprofessional collaboration in primary care was the different actors' common interest in collaboration, perceiving opportunities to improve quality of care and to develo...
A Conceptual Framework for Performance Assessment in Primary Health Care
As health systems strive to achieve improvements in quality, equity and efficiency, systems of performance assessment are increasingly being introduced. To function effectively as tools for internal quality improvement, they need to be aligned with staff and organisational objectives, foster insight into practice and provide a focus for learning leading to improvement. Adopting such a " coalface " perspective, we developed a conceptual framework to underpin the potential development of a quality system for a large primary health care program. The Framework for Performance Assessment in Primary Health Care (FPA_PHC) is grounded in evaluation theory and explicitly identifies the processes of primary health care articulated by the World Health Organization (WHO). It is based on Donabedian's (1998) now classic " structure " , " process " , " outcome " model for assessment of quality of care. The FPA_PHC specifies the development of objectives that are focused on patients/families/ communities and has four indicator levels relating to stewardship, organisational structures and processes, processes of care and intermediate outcomes. Equity can be assessed by asking of processes of care and intermediate outcomes: " is it the same for everyone? " The indicators can be mapped to higher order system performance frameworks such as the National Health Performance Framework. The FPA_PHC has been adopted for the National Quality and Performance System for Divisions of General Practice and its application in this and a second setting are described.