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Table 9 Support Quotations for “Team Relationships”

From: Measurement without management: qualitative evaluation of a voluntary audit & feedback intervention for primary care teams

• … The organisation is made up of two teams, the FHT team and the FHO team, and the FHT team is very, very separate from the FHO team. If I could go back in time, I would try to figure out a way to set up the structure that I wasn’t an employee of the FHT, that I was an employee of the FHO, and that would be my angle, you know what I mean, that I actually work for the doctors? (ID = 016)
• I think with our providers being an independent FHO, they don’t always see how this affects them. It doesn’t affect funding, it doesn’t affect the amount of allied health professionals that you have, it has no concrete affect on their practice, other than whether patients are happy or not. (ID = 015)
• And we don’t have to get two doctors to agree on anything to actually make it happen because it’s the community-based nature of this. So decisions are really made taking into account how it affects not just the doctors, but the Its and everyone else. Really the decisions about going along with D2D were really mostly determined by the direction that Name-X thought we should take and then passed down rather than the other way around. (ID = 014)
• Huge changes would be more difficult just because we’re not really allowed to tell them how to work. Basically we have to try it with one physician and then say, hey, you know what, this worked really well, look at the difference in his numbers from doing this for a couple of months. And even so, it’s the same physician every time, so I think some of the doctors get a little, well, I don’t want to hear that from him anymore. We actually do have three physicians on our quality committee now which is great because I think they’ll be willing to try more things too spread them to the physicians they work with. So we have multiple sites of physicians so that makes it difficult too. (ID = 006)
• We have a number of physicians who are closer to retirement or slowing down or getting out of their practices. They just don’t really have the enthusiasm to implement changes or to try to do something in a different way, whether it’s changing the way that they report something in the EMR to like I’ve been doing it by paper for 30 years of my life. And tehn I finally converted to the EMR eight years ago and you’re not going to tell me how to do something different for two years before I retire. And then the other factor is just time. As I mentioned earlier, many of our physicians they work in the Emergency Department for a smaller community hospital. So they work in the ED, they’re working on the floors, they’re seeing patients, they’re working in long-term care and they just don’t have the time. They have their own admin time to work on or they have their own clinic time where they have to be here doing that, so that’s kind of one of the struggles. And some individuals see the family health team as being the family health team and the physician group being the physician group and we work together, but we don’t have to play together kind of thing. (ID = 019)