Canadian family physicians (FPs) and home health staff (HHS) experience significant barriers to collaboration regarding patients whose needs are complex. This study used mixed methods to examine whether pre-scheduled, structured audio-conferencing could improve patient-related collaboration between physicians and HHS. The number of shared patients and contacts was collected across three phases: baseline, pre-intervention, and intervention. Interviews with FPs and focus groups with HHS were conducted post-intervention. Mixed effects Poisson regressions for count data, and content analysis for interview and focus group data, were used. No statistically significant “intervention” effect was observed in either the number of shared patients or the average patient contacts. Physicians participating in at least one audio-conference had a lower patient contact rate than the rest of the intervention group and controls. Qualitative data suggested that audio-conferences led to fewer contacts due to more efficient communication.
HollanderM. An Overview of Home and Continuing Care in Canada. Victoria, British Columbia, Canada: Simon Fraser University Gerontology Research Center and the Institute for Research on Public Policy; 2012. www.sfu.ca/uploads/page/13/Friesen2012_presentation_Hollander.pdf. Accessed October 31, 2014.
BergS. Bridging Silos: Increasing Collaborative Teamwork Between Family Physicians and Home Health Staff [dissertation]. http://hdl.handle.net/2429/45264. Published 2013. Accessed January 28, 2015.
4.
HutchisonBAbelsonJLavisJ. Primary care in Canada: so much innovation, so little change. Health Aff. 2001;20:116-131.
5.
MuldoonLRowanMSGeneauRHoggWCoulsonD. Models of primary care service delivery in Ontario: why such diversity?Healthc Manage Forum. 2006;19:18-23.
6.
AubinMVézinaLBergeronRLabergeA. Collaboration between family physicians and home care professionals. Is it possible?Can Fam Physician. 2001;47:751-758.
7.
StreetABlackfordJ. Communication issues for the interdisciplinary community palliative care team. J Clin Nurs. 2001;10:643-650.
8.
GoldmanJMeuserJRogersJLawrieLReevesS. Interprofessional collaboration in family health teams: an Ontario-based study. Can Fam Physician. 2010;56:e368-e374.
9.
NeergaardMAOlesenFJensenABSondergaardJ. Shared care in basic level palliative home care: organizational and interpersonal challenges. J Palliat Med. 2010;13:1071-1077.
10.
Canadian Home Care Association. Portraits of Home Care in Canada. Ottawa, Ontario: Canadian Home Care Association; 2008.
11.
SuterEDeutschlanderSMickelsonG. Can interprofessional collaboration provide health human resources solutions? a knowledge synthesis. J Interprof Care. 2012;26:261-268.
12.
GoldschmidtDGroenvoldMJohnsenATStrömgrenASKrasnikASchmidtL. Cooperating with a palliative home-care team: expectations and evaluations of GPs and district nurses. Palliat Med. 2005;19:241-250.
13.
MarshallDHowellDBrazilKHowardMTaniguchiA. Enhancing family physician capacity to deliver quality palliative home care: an end-of-life, shared-care model. Can Fam Physician. 2008;54:1703.e1-1703.e7.
14.
JesminSThindASarmaS. Does team-based primary health care improve patients’ perception of outcomes? evidence from the 2007–08 Canadian Survey of Experiences with Primary Health. Health Policy. 2012;105:71-83.
15.
SuterE. Role understanding and effective communication as core competencies for collaborative practice. J Interprof Care. 2009;23:41-51.
16.
Joint Commission on Accreditation of Healthcare Organizations. Sentinel event root cause and trend data. In: Improving America’s Hospitals: The Joint Commission’s Annual Report on Quality and Safety. Washington, DC: The Joint Commission; 2007. www.jointcommission.org/assets/1/6/2007_Annual_Report.pdf. Accessed October 31, 2014.
17.
MaisonD. Effective communications are more important than ever: a physician’s perspective. Home Healthc Nurse. 2006;24:178-182.
18.
DinhT. Improving Primary Care Through Collaboration: Briefing 1—Current Knowledge About Interprofessional Teams in Canada. Ottawa, Ontario: The Conference Board of Canada; 2012.
19.
BodenheimerT. Lessons from the trenches—a high-functioning primary care clinic. N Engl J Med. 2011;365:5-8.
20.
LiddyCSinghJHoggWDahrougeSTaljaardM. Comparison of primary care models in the prevention of cardiovascular disease—a cross sectional study. BMC Fam Pract. 2011;12:114.
21.
HoggWLemelinJDahrougeS. Randomized controlled trial of anticipatory and preventive multidisciplinary team care for complex patients in a community-based primary care setting. Can Fam Physician. 2009;55:e76-e85.
22.
NolteEKnaiCHofmarcherM. Overcoming fragmentation in health care: chronic care in Austria, Germany and The Netherlands. Health Econ Policy Law. 2012;7:125-146.
23.
OstlundUKiddLWengstromYRowa-DewarN. Combining qualitative and quantitative research within mixed method research designs: a methodological review. Int J Nurs Stud. 2011;48:369-383.
R Development Core Team. R: A Language and Environment for Statistical Computing. Vienna, Austria: R Foundation for Statistical Computing; 2012. http://www.R-project.org/. Accessed January 28, 2015.
BegunJWZimmermanBDooleyK. Health care organizations as complex adaptive systems. In: MickSSWyttenbachME, eds. Advances in Health Care Organization Theory. San Francisco, CA: Jossey-Bass; 2003:253-288.
28.
ThorneS. Interpretive Description. Walnut Creek, CA: Left Coast Press; 2008.
29.
Sanson-FisherRW. Diffusion of innovation theory for clinical change. Med J Aust. 2004;180:S55-S56.
DeyRMde VriesMJWBosnic-AnticevichS. Collaboration in chronic care: unpacking the relationship of pharmacists and general medical practitioners in primary care. Int J Pharm Pract. 2011;19:21-29.
32.
BaxterSK. Professional differences in interprofessional working. J Interprof Care. 2008;22:239-251.
33.
GabouryIBujoldMBoonHMoherD. Interprofessional collaboration within Canadian integrative healthcare clinics: key components. Soc Sci Med. 2009;69:707-715.
34.
MitchellGKDel MarCBO’RourkePKClavarinoAM. Do case conferences between general practitioners and specialist palliative care services improve quality of life? a randomised controlled trial (ISRCTN 52269003). Palliat Med. 2008;22:904-912.
