The Impacts of Team Culture on Primary Care Teams
Bibliographic record
Abstract
Background: Integrated services delivery in primary care is essential, particularly given the current challenges in primary care in Canada. Primary care teams (PCT) provide a way to facilitate integrated care. PCTs in British Columbia (BC) have evolved with widespread implementation of primary care networks, urgent and primary care centres, and community health centres. Team culture can have significant impacts on team functioning and processes, ultimately impacting patient outcomes. patient and provider experience, and integrated care. This presentation focuses on the relationship between team culture and team function to highlight strategies that may improve team climate across primary care settings. Approach: Case study methodology with mixed methods was used to study three PCTs in BC. Phase I consisted of expressions of interest, team selection, and team climate inventory surveys (TCI). TCI dimensions (team participation, support for new ideas, team objectives, task orientation) and an overall score were analyzed. Phase II consisted of team document reviews, team meeting observations, semi-structured interviews with managers and patients, and focus groups with team members. Data were analyzed for common themes. A follow-up dialogue with each team was facilitated to share the results and co-create actions for recommendations; final reports were shared with the teams. Results: Overall TCI scores ranged from 76 to 84; standard deviation was greatest for Case 3. All three cases showed team participation and support for new ideas with greater variability in team objectives and task orientation. Qualitative data indicated the importance of effective communication and engagement in co-developing new initiatives. All teams focused on patient-centred care, but a lack of clarity in team objectives was found. Similarly, performance measurement/evaluation (task orientation) was limited, particularly evaluation of patient experience. There was a strong commitment to action to improve further team functioning; strategies to enhance functioning were co-developed by each team. These strategies included developing team goals, standardizing information management systems, building team capacity through training, increasing collaboration, supporting teams mental health, and using quality improvement to measure outcomes. Implications: This research provides an in-depth exploration of PCT culture that contributes to the integration of care in primary care settings. Insights in team functioning (e.g., role identification, communication), as well as structures and processes that facilitate and act as barriers to enhancing team culture will be shared. Furthermore, the impact for teams in their reflection throughout this research process helped teams evaluate their strengths and areas where improvement was needed. Primary care can benefit from lessons learned in this study to improve PCT functioning, a key component of integrated care for patients in primary care settings.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.014 | 0.033 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.010 | 0.006 |
| Scholarly communication | 0.007 | 0.002 |
| Open science | 0.002 | 0.009 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".