Building an effective, collaborative, interdisciplinary team is essential to the success of your primary care teams. Combining a team with a physician group, particularly if that group has an existing staff complement, can present unique challenges for the organization. The following case studies reflect the efforts of four family health teams (FHTs) and affiliated physician groups (FHOs, RNPGAs) to integrate components of their respective operations to build a stronger team and enhance patient care. By harmonizing such things as procurement, staffing and strategic planning, these FHTs have improved the quality of patient care they provide, and leveraged their combined resources. Click on the links below to find the four case studies and the key tools used by these teams to integrate their teams:
Thamesview FHT
A rural/urban FHT that is currently working to align FHT and FHO staff salaries to enhance the working relationship between FHT and FHO staff Key tools they used include:
- A cost-sharing agreement between the physicians and the FHT for clinical and office supplies
- A data sharing and privacy agreement **
South East Toronto FHT
An urban, academic Family Health Team that has leveraged multiple sources of revenue and several distinct staff groups to produce one staff team Key tools they used include:
Northeastern Manitoulin FHT
A rural FHT associated with physicians in a Rural and Northern Practice Group Agreement (RNPGA) that has harmonized staffing and procurement to improve patient care Key tools they used include:
- Student Orientation Outline
- Staff Orientation Outline
- Flow chart of communication within the team
- Organizational chart
- HR Checklist **
Mount Forest FHT
A small, rural FHT that has integrated staff from 6 employers into one integrated team Key tools they used include:
- Two legal agreements **
- Shared services and privacy agreement **
** Confidential documents. For more information contact the individual FHT for details Some of the lessons learned from these case studies include the following:
- Integrating and harmonizing people and processes takes time; it requires planning, commitment, and most importantly leadership from the FHT Executive Director and the FHO physicians.
- Physician commitment is key
- Understanding and managing change is important
- Communication and transparency are essential
- Solid expertise in Human Resources is helpful (this may come from the Executive Director, a dedicated staff position, an external consultant, or a partner)
- There is no single solution; the process requires planning, time and patience. A Plan-Do-Study-Act (PDSA) approach can be helpful.
AFHTO welcomes the input of other teams that have integrated or begun integrating their staff teams. Please send your comments or suggestions to Bryn.Hamilton@afhto.ca.
Learning from your peers: additional case studies
AFHO has developed a series of case studies for our members to share the experience of colleagues on topics identified as being important to you:
- Care Coordination in Primary Care – Embedding Care Coordinators in your Team
- Unionization – Learning about unionization from ten FHTs
- Quality Improvement Decision Support Partnerships – Building Collaboration and Increased Capacity (Coming soon, stay tuned!)
- Optimizing Resources & Spreading Access to Interprofessional Teams (Coming soon, stay tuned!)