Service intangibility and its implications for the work coordination of primary healthcare multi-professional teams in Brazil

Abstract

BACKGROUND:

In certain service activities, the intangibility of what is being produced hinders the vision of an expected result or product. In multi-professional teams, this difficulty becomes increasingly greater, as participants’ perceptions are conditioned to their respective fields of knowledge and different professional experiences. This is a common situation in healthcare services.

OBJECTIVE:

To describe and explain the work coordination process applied by multi-professional teams in order to deal with the intangibility inherent in the healthcare services.

METHODS:

This study involved six multi-professional teams from the public primary healthcare service in Brazil. Interviews and observations of team meetings were carried out, with focus on the critical elements of a coordination process: work plans and routines, roles and responsibilities, knowledge sharing, and a common reference history.

RESULTS:

There is coexistence of two distinct coordination processes being performed in the same work activity: operational coordination, associated with activities that somehow follow standard procedures; and diagnostic coordination, associated with diagnosis construction, alternatives analysis and decision making.

CONCLUSIONS:

The consequences of intangibility can be overcome by mechanisms that enable a common perspective among the participants involved in the productive process, and by the team members’ familiarity with each other.