An Analytical Framework for Modeling, Analysis, and Improvement of Team Communication and Collaboration Process in Primary Care Clinics

Primary care is the backbone of the U.S. healthcare delivery system. In primary care clinics, teams led by providers play a central role in care delivery. A care service task typically requires joint efforts among the care providers and support staff in the team. Thus, communications within a team are critical to ensure effective collaboration and coordination between team members to provide high quality of care. Due to such an importance, team communication and collaboration have received a considerable amount of research attention. However, most research is qualitative or based on empirical studies. This paper introduces an analytical framework of modeling, analysis, and improvement of team communication and collaboration process in primary care clinics. Specifically, using a queueing network model, the physicians, nurses, and medical assistants are modeled as servers and the communication and collaboration tasks are viewed as customers. The team members interact with each other multiple times to accomplish a task. The efficiency of the team communication and collaboration process is characterized by task throughput, task completion time, and the number of iterations to finish a task. Analytical formulas to evaluate such performances are derived and system properties are investigated. In addition, bottleneck analysis is carried out to identify the constraint that impedes the system performance in the strongest manner. Finally, a case study at a primary care clinic is presented to illustrate the applicability of the model. Note to Practitioners - In primary care clinics, care delivery activities are carried out by a team of care providers and support staff, such as physicians, nurses, and medical assistants. An activity or a task may need to be carried out by more than one team member multiple times. Thus, communication and collaboration between team members are critical to ensure safety and high quality of care services. Modeling, analysis, and improvement in the team communication and collaboration process are of significant importance. Although numerous studies have been found regarding team communication and collaboration issues, quantitative and analytical models to address the efficiency of such processes are not available. The goal of this paper is to present an analytical framework using queueing network models. Using this framework, the efficiency of the process can be evaluated and system properties can be investigated. In addition, the most critical constraints, i.e., bottlenecks, can be identified to improve process performance. © 2004-2012 IEEE.