Article Figures & Data
Tables
DESCRIPTION ONTARIO REGION WEST (N = 11) NORTH (N = 4) CENTRAL (N = 4) SOUTH (N = 2) Median no. of sites (range) 1 (1–7) 2 (1–6) 7 (1–19) 1 (1–1) Median no. of staff* (range) 11 (6–46) 13 (2–50) 25.5 (5–156) 9.5 (8–11) Median no. of staff* hired since inception of FHT (range) 10 (6–23) 11 (1–50) 16 (6–65) 11 (9–13) Governance, n† • Provider 7 1 2 0 • Mixed 3 3 1 0 • Community 1 0 1 2 Median no. of patients per physician (range) 1572 (499–3200) 1307 (765–1833) 1863 (1000–2927) 2716 (2100–3333) No. of sites in operation for more than 1 year at time of study 8 1 3 2 Median no. EMR capabilities used‡ (range) 10 (6–12) 9 (7–10) 9.5 (7–11) 8 (6–10) Total no. of FHTs having monthly clinical and support staff meetings 6 0 3 0 Mean team climate inventory score, out of 5 (range) 4.0 (2.6–4.2) 3.9 (3.7–4.4) 3.7 (3.6–3.8) 3.8 (3.6–4.0) -
EMR—electronic medical record, FHT—family health team.
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↵* Health care professionals working on site.
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↵† Governance is divided into 3 categories: provider refers to health care professional–initiated and governed FHTs, community refers to community organization–initiated and governed FHTs, and mixed refers to a combination of provider- and community organization–initiated and governed FHTs.
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↵‡ Of a possible 22, including scheduling appointments, billing, within-clinic messaging, clinical notes, prescribing information (drug interactions, warnings, direct-to-pharmacy prescribing), laboratory or radiology requisitions, viewing laboratory and imaging results (history and follow-up notes), patient demographic information, patient problem lists, medications, disease registries, decision-support tools, queries, and reminders for guideline-based interventions.
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- Table 2
Team climate inventory subscale scores of FHT staff: N=411; 68.6% (n = 282) of respondents identified their organizational cultures as group cultures; 8.3% (n = 34) were part of developmental cultures; 14.4% (n = 59) were part of hierarchical cultures; and 8.8% (n = 36) were part of rational cultures.
SUBSCALE MEAN (SD) SCORE Participative safety* 3.8 (0.8) Team objectives* 3.5 (0.8) Vision* 3.9 (0.7) Support for innovation* 3.7 (0.8) Leadership* 3.7 (0.7) Perception of EMR† • Quality of clinical decisions 3.9 (0.7) • Communication with providers 4.3 (0.7) • Communication with patient 3.7 (0.8) • Prescription refills 4.4 (0.8) • Timely access to medical records 4.2 (0.8) • Avoiding medication errors 4.0 (0.7) • Delivery of preventive care that meets guidelines 4.1 (0.7) • Delivery of chronic illness care that meets guidelines 4.0 (0.7) Overall team climate score* 3.8 (0.6) - Table 3
Associations between organizational or cultural factors for participating FHTs and team climate scores
FACTOR UNIVARIATE ANALYSIS β (95% CI) PVALUE MULTIPLE VARIABLE ANALYSIS β (95% CI) PVALUE Leadership scale score 0.63 (0.56 to 0.69) < .001 0.48 (0.40 to 0.55) < .001 Organizational culture • Group 0.13 (0.11 to 0.16) < .001 0.04 (0.001 to 0.07) .04 • Developmental 0.08 (0.03 to 0.13) .002 0.05 (−0.005 to 0.10) .08 • Hierarchical −0.20 (−0.23 to −0.16) < .001 −0.06 (−0.10 to −0.009) .02 • Rational −0.08 (−0.13 to −0.03) .001 NA NA No. of EMR capabilities used* 0.07 (−0.01 to 0.15) .10 0.03 (0.003 to 0.06) .03 Months operational as an FHT −0.012 (−0.02 to −0.004) .002 −0.003 (−0.0006 to −0.006) .04 EMR perceptions −0.05 (−0.10 to 0.003) .07 NA > .10 No. of staff in FHT 0.001 (−0.003 to 0.006) .60 NA NA Full team meetings at least monthly −0.12 (−0.47 to 0.22) .50 NA NA No. of patients per physician (< 1000, 1000–1999, ≥2000) 0.04 (−0.21 to 0.30) .75 NA NA Single site versus multiple sites 0.09 (−0.23 to 0.41) .59 NA NA -
CI—confidence interval, EMR—electronic medical record, FHT—family health team, NA—not applicable.
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↵* Of a possible 22, including scheduling appointments, billing, within-clinic messaging, clinical notes, prescribing information (drug interactions, warnings, direct-to-pharmacy prescribing), laboratory or radiology requisitions, viewing laboratory and imaging results (history and follow-up notes), patient demographic information, patient problem lists, medications, disease registries, decision-support tools, queries, and reminders for guideline-based interventions.
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