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Health Serv Res. 2015 Jun;50(3):897-921. doi: 10.1111/1475-6773.12257. Epub 2014 Nov 25.

Development and validation of the primary care team dynamics survey.

Author information

1
PhD Program in Health Policy (Management), Harvard University, Boston, MA.
2
Division of General Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, MA.
3
Department of Health Policy and Management, Harvard School of Public Health, Boston, MA.
4
Division of General Pediatrics, Boston Children's Hospital , Boston, MA.
5
Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA.
6
Allegheny County Health Department, Pittsburgh, PA.
7
Department of Medicine, Harvard Medical School, 677 Huntington Avenue, Boston, MA, 02115.

Abstract

OBJECTIVE:

To develop and validate a survey instrument designed to measure team dynamics in primary care.

DATA SOURCES/STUDY SETTING:

We studied 1,080 physician and nonphysician health care professionals working at 18 primary care practices participating in a learning collaborative aimed at improving team-based care.

STUDY DESIGN:

We developed a conceptual model and administered a cross-sectional survey addressing team dynamics, and we assessed reliability and discriminant validity of survey factors and the overall survey's goodness-of-fit using structural equation modeling.

DATA COLLECTION:

We administered the survey between September 2012 and March 2013.

PRINCIPAL FINDINGS:

Overall response rate was 68 percent (732 respondents). Results support a seven-factor model of team dynamics, suggesting that conditions for team effectiveness, shared understanding, and three supportive processes are associated with acting and feeling like a team and, in turn, perceived team effectiveness. This model demonstrated adequate fit (goodness-of-fit index: 0.91), scale reliability (Cronbach's alphas: 0.71-0.91), and discriminant validity (average factor correlations: 0.49).

CONCLUSIONS:

It is possible to measure primary care team dynamics reliably using a 29-item survey. This survey may be used in ambulatory settings to study teamwork and explore the effect of efforts to improve team-based care. Future studies should demonstrate the importance of team dynamics for markers of team effectiveness (e.g., work satisfaction, care quality, clinical outcomes).

KEYWORDS:

Survey; primary care; team dynamics; team effectiveness

PMID:
25423886
PMCID:
PMC4450936
DOI:
10.1111/1475-6773.12257
[Indexed for MEDLINE]
Free PMC Article

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