Table 6 Structure of the final 7 domain German healthcare team survey as emerged from analysis (27 items, Cronbach’s α = 0.926)

Communication (α = 0.815)

Someone on our primary care team helps patients set goals for managing their health.^N

0.822

0.732

0.727

Someone on our primary care team helps patients understand all of the choices for their care.

0.900

0.702

0.800

Our primary care team helps patients plan so they can take care of their health even when things change or when unexpected things happen.^M

0.835

0.681

0.720

Our primary care team considers and respects patients’ individual values when recommending treatments.

0.845

0.641

0.685

Our primary care team informs patients about any diagnosis in a way that they can understand.

0.851

0.634

0.687

Our primary care team’s care coordination activities are based upon ongoing assessment of patient needs.

0.893

0.522

0.517

Link to Community Resources (α = 0.819)

Someone on our primary care team encourages patients to attend programmes in their community, e.g. support or sports groups.

0.782

0.796

0.817

Someone on our primary care team gives patients information about additional supportive services offered at the practice or in their community, e.g. counselling programmes, support groups or rehabilitation programmes.

0.790

0.771

0.815

Someone on our primary care team connects patients to needed services, e.g. transportation or home care.

0.858

0.753

0.690

Someone on our primary care team asks patients about what they need for support, e.g. with home care, equipment or transportation.

0.944

0.392

0.665

Information Technology for Quality Assurance (α = 0.680)

Our primary care team uses electronic data (e.g. diagnostical findings, lab results), to track quality indicators of patient care, e.g. percentage of patients with type 2 diabetes mellitus whose HbA1C was checked last year.^P

0.758

0.720

0.728

Our primary care team uses an electronic health record system or other electronic systems to determine clinical outcomes.^P

0.845

0.613

0.677

Our primary care team uses an electronic health record system or other electronic systems to develop care plans.^P

0.856

0.585

0.698

Self-Management (α = 0.732)

Our practice has peer support readily available for patients as part of routine care.

0.849

0.714

0.642

Someone on our primary care team offers patients the opportunity to learn more about managing their health, e.g. with group appointments, support groups, or patient education.^O

0.816

0.657

0.694

Someone on our primary care team checks to see if patients are reaching their goals.

0.913

0.548

0.734

Our practice has behaviour change interventions readily available for patients as part of routine care.

0.834

0.530

0.650

Care Transitions (α = 0.808)

When patients are discharged from the hospital, our primary care team knows about new prescriptions or if there was a change in medication.

0.723

0.849

0.876

When patients are discharged from the hospital, our primary care team is informed about the care patients received from the hospital.

0.770

0.833

0.826

When patients are discharged from hospital, our primary care team receives the discharge summaries in a timely manner.

0.773

0.687

0.719

Accountability (α = 0.698)

Our primary care team is made up of members with clearly defined roles in caring for patients.

0.723

0.776

0.691

Our primary care team and the patients share responsibilities in managing patients’ health.

0.661

0.728

0.669

Our primary care team works with patients to help them understand their roles and responsibilities in their care.

0.855

0.587

0.740

Our primary care team is characterised by trusting collaboration.

0.827

0.481

0.738

Information Technology Supporting Patient Care (α = 0.690)

Our primary care team uses an electronic patient chart or other electronic system, to support the documentation of patient needs.^P

0.776

0.779

0.659

Our primary care team uses electronic data (e.g. diagnostical findings, lab results), to identify patients with complex health needs (e.g. multimorbity).^P

0.869

0.729

0.737

Our primary care team uses electronic data (e.g. diagnostical findings, lab results), to monitor the outcomes of patient treatment.^P

0.865

0.590

0.638