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  • August 2021
  • Article
  • Medical Care Research and Review

A Mixed Methods Study of Change Processes Enabling Effective Transition to Team-based Care

By: Michael Anne Kyle, Emma-Louise Aveling and Sara J. Singer
  • Format:Print
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Abstract

Team-based care is considered central to achieving value in primary care, yet results of large-scale primary care transformation initiatives have been mixed. We explore how underlying change processes influence the effectiveness of transition to team-based care. We studied 12 academically affiliated primary care practices participating in a learning collaborative, using longitudinal staff survey data to measure progress toward team-based care and qualitative interviews with practice staff to understand practice transformation. Transformation efforts focused on team formation and capacity building for quality improvement. Using thematic analysis, we explored types of change processes undertaken and the relationship between change processes and effective team-based care. We identified three prototypical approaches to change: pursuing functional and cultural change processes, functional only, and cultural only. Practice sites prioritizing both change processes formed the most effective teams: simultaneous functional and cultural change spurred a mutually reinforcing virtuous cycle. We describe implications for research, practice, and policy.

Keywords

Team-based Care; Primary Care; Health Care and Treatment; Transformation; Groups and Teams; Change Management

Citation

Kyle, Michael Anne, Emma-Louise Aveling, and Sara J. Singer. "A Mixed Methods Study of Change Processes Enabling Effective Transition to Team-based Care." Medical Care Research and Review 78, no. 4 (August 2021): 326–337.
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More from the Authors

    • December 2021
    • Journal of General Internal Medicine

    Primary Care Access During the COVID-19 Pandemic: a Simulated Patient Study

    By: Michael Anne Kyle, Renuka Tipirneni, Nitya Thakore, Sneha Dave and Ishani Ganguli
    • Spring 2020
    • MIT Sloan Management Review

    Establishing High Performing Teams: Lessons from Health Care

    By: Michael Anne Kyle, Emma-Louise Aveling and Sara J. Singer
    • American Journal of Managed Care

    Spending Variation Among ACOs in the Medicare Shared Savings Program

    By: Michael Anne Kyle, J. Michael McWilliams, Mary Beth Landrum, Bruce E. Landon, Paul Trompke, David J. Nyweide and Michael E. Chernew
More from the Authors
  • Primary Care Access During the COVID-19 Pandemic: a Simulated Patient Study By: Michael Anne Kyle, Renuka Tipirneni, Nitya Thakore, Sneha Dave and Ishani Ganguli
  • Establishing High Performing Teams: Lessons from Health Care By: Michael Anne Kyle, Emma-Louise Aveling and Sara J. Singer
  • Spending Variation Among ACOs in the Medicare Shared Savings Program By: Michael Anne Kyle, J. Michael McWilliams, Mary Beth Landrum, Bruce E. Landon, Paul Trompke, David J. Nyweide and Michael E. Chernew
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