Evaluating self-managed integrated community teams.
After briefly describing self-managed integrated community teams, the authors explore potential and actual methods of evaluating their structures, processes and outcomes. Primary health care staff in three comparable sites were studied using non-participant observation, interviews, focus groups and questionnaires. After describing the fieldwork, the authors examine integrated team structures, which are characterised by a large number of barriers that integrated teams face. Processes surrounding different working practices are explored next. Ways of unifying health care professional practice in integrated teams are suggested using evidence from both the literature and fieldwork. Outcomes that emerged after one year of the new teams' lives are discussed in detail. The difficulty in establishing acceptable outcomes, especially the validity and reliability of outcome measures, is considered. Throughout, the positive and negative aspects of integrated teams emerging from the fieldwork are compared and contrasted with issues in the literature. Finally, recommendations are made to help strengthen integrated teams in the UK.
Hurst
Keith
K
Nuffield Institute for Health, University of Leeds, Leeds, UK.
Ford
Jackie
J
Gleeson
Cath
C
D001291:Attitude of Health Personnel; D003153:Community Health Services / Q000458:organization & administration*; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D006801:Humans; D016134:Organizational Policy; D010043:Outcome and Process Assessment, Health Care; D010348:Patient Care Team; D011320:Primary Health Care / Q000458:organization & administration*; D011785:Quality Assurance, Health Care; D015203:Reproducibility of Results; D013222:State Medicine / Q000458:organization & administration; D011795:Surveys and Questionnaires; D006113:United Kingdom