title: Implementing Interdisciplinary Teams Does Not Necessarily Improve Primary Care Practice Climate.
abstract: The complexity of successfully implementing interdisciplinary care team approaches in primary care has challenged many delivery system stakeholders. One-year changes in clinicians' and staff experiences of practice climate among 5 practices implementing interdisciplinary primary care teams and 28 other practices were compared. In adjusted analyses, practices implementing care teams reported improved team structure (78.0 in 2011 vs 79.3 in 2012), team functioning (75.7 vs 77.7), readiness for change (77.6 vs 77.7), and perceptions of skills and knowledge (48.0 vs 53.6) over time. However, the improvements were not significantly different from changes experienced by other practices. Achieving improvements in practice climate through care team redesign is challenging, even with structured learning opportunities for team members. Practice climate did not deteriorate over time, indicating that implementing a complex team redesign does not harm working relationships of frontline clinicians and staff.
authors.affiliation: Acsel Health, New York, NY.
authors.forename: Sherry M
authors.initials: SM
authors.lastname: Grace
authors.affiliation: HealthCare Partners Institute for Applied Research and Education, Torrance, CA.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Rich
authors.affiliation: HealthCare Partners Affiliates Medical Group, Torrance, CA.
authors.forename: William
authors.initials: W
authors.lastname: Chin
authors.affiliation: University of California-Berkeley, CA hrod@berkeley.edu.
authors.forename: Hector P
authors.initials: HP
authors.lastname: Rodriguez
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D006126:Group Processes; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team / Q000458:organization & administration*; D018802:Patient-Centered Care; D010465:Perception; D011320:Primary Health Care / Q000458:organization & administration*; D012931:Social Environment
keywords: leadership facilitation; organizational change; patient-centered medical home; practice climate; teamwork