Managing Improvement in Healthcare

Abstract

Comprehensive primary care is the cornerstone of a low cost, accessible and high-quality health system, and robust primary care infrastructure is a key to tackling unsustainable growth in health spending and significant gaps in patient care quality and outcomes (Donaldson et al. 1996; Starfield et al. 2005). Strengthened inter-professional teamwork amongst primary care physicians and practice staff-including nurses, medical assistants (MAs) and others-has emerged as a promising strategy to promote more effective care delivery, particularly as concurrent delivery reforms such as patient-centred medical home (PCMH) and pay-for-performance initiatives seek to expand the scope of primary care services. Team-based primary care (TBPC) can alleviate mounting time pressures on primary care physicians through improved delegation and