Contextual Factors Affecting the Implementation of Team-Based Primary Care: A Scoping Review

Team-based primary care (TBPC) has diffused rapidly in concert with other reform initiatives. However, little is known about the contextual factors that best position practices to leverage team-based strategies for improved healthcare delivery. Sixty-two empirical articles were analysed in a scoping review to explore key factors in the domains of environment, task and technology that influence the success of establishing and maintaining TBPC practices. Key findings address the importance of internal performance management structures and external payment mechanisms that reinforce TBPC. Incremental task delegation, combined with consistent communication and integrated documentation practices, is critical for shared role understanding and sustained TBPC commitment. Finally, electronic health records can provide a collaboration and communication platform to enhance team functioning. This review provides insights to providers and policymakers regarding enabling contextual factors for successful TBPC implementation, and identifies promising areas for future research – specifically technology use and performance measurement as they relate to teams.