Team composition and chronic disease management within primary healthcare practices in eastern Ontario: an application of the Measuring Organizational Attributes of Primary Health Care Survey. Issue 6 (15th April 2018)

• Record Type: Journal Article
• Authors: Lukewich, Julia; Edge, Dana S.; VanDenKerkhof, Elizabeth; Williamson, Tyler; Tranmer, Joan
• Is Part Of: Primary health care research & development. Volume 19:Issue 6(2018)
• Page Start: 622
• Page End: 628
• Publication Date: 2018-04-15
• Subjects: chronic disease management, -- cross-sectional survey, -- nursing roles, -- organizational attributes, -- primary healthcare, -- team composition; Family medicine -- Great Britain -- Periodicals; Primary care (Medicine) -- Great Britain -- Periodicals; 362.1094105
• DOI: 10.1017/S1463423618000257
• Languages: English
• ISSNs: 1463-4236

Abstract

Abstract: Background: Various organizational-level attributes are being implemented in primary healthcare to improve healthcare delivery. There is a need to describe the distribution and nature of these attributes and explore differences across practices. Aim: The aim of this study was to better understand organizational attributes of primary care teams, focusing specifically on team composition, nursing roles, and strategies that support chronic disease management. Methods: We employed a cross-sectional survey design. Team composition, nursing roles, availability of health services, and chronic disease management activities were described using the 'Measuring Organizational Attributes of Primary Health Care Survey.' Findings: A total of 76% ( n =26 out of 34) of practice locations completed the survey, including family health teams (FHT; n =21) and community health centers (CHC; n =4). Nurse practitioners (NPs) and registered nurses (RNs) were the most common non-physician providers, and CHCs had a greater proportion of non-physician providers than FHTs. There was overlap in roles performed by NPs and RNs, and registered practical nurses engaged in fewer roles compared with NPs and RNs. A greater proportion of FHTs had systematic chronic disease management services for hypertension, depression and Alzheimer's disease compared with CHC practices. The 'Measuring Organizational Attributes of Primary Health Care Survey' was a useful tool to highlight variability in organizational attributes across PHC practices. Nurses are prominent within PHC practices, engaging in a wide range of roles related to chronic disease management, suggesting a need to better understand their contributions to patient care to optimize their roles.