Primary care practice characteristics associated with team functioning in primary care settings in Canada: A practice-based cross-sectional survey.

Team-based care is recognized as a foundational building block of high-performing primary care. The purpose of this study was to identify primary care practice characteristics associated with team functioning and examine whether there is relationship between team composition or size and team functioning. We sought to answer the following research questions: (1) are primary care practice characteristics associated with team functioning; and (2) does team composition or size influence team functioning. This cross-sectional correlational study was conducted in Fraser East, British Columbia, Eastern Ontario Health Unit, Ontario and Central Zone, Nova Scotia in Canada. Data were collected from primary care practices using an organization survey and the Team Climate Inventory (TCI) as a measure team functioning. The independent variables of interest were: physicians' payment model, internal clinic meetings to discuss clinical issues, care coordination through informal and ad hoc exchange, care coordination through electronic medical records and sharing clinic mission, values and objectives among health professionals. Potentially confounding variables were as follows: team size, composition, and practice panel size. A total of 63 practices were included in these analyses. The overall mean score of team climate was 73 (SD: 10.75) out of 100. Regression analyses showed that care coordination through human interaction and sharing the practice's mission, values, and objectives among health professionals were positively associated with higher functioning teams. Care coordination through electronic medical records and larger team size were negatively associated with team climate. This study provides baseline data on what practice characteristics are associated with highly functioning teams in Canada.

Quality of care for patients with hypertension in selected Health Centres in Rwamagana District, Rwanda

Background Hypertension is the main risk factor for cardiovascular diseases and its prevalence is high in Rwanda. Rwanda has integrated the management of hypertension in health centres (HCs). However, little is known about the quality of hypertension care in HCs in Rwanda. Study objective To examine the quality of care for patients with hypertension and associated outcome of hypertension control in Health Centres. Methods A cross-sectional study design was used, and data were collected from a convenience sample of 202 patients. A self-reported questionnaire and blood pressure measurement were taken. Data were analysed using descriptive, bivariate, and hierarchical logistic regression analyses. Results A total of 166 (82.2%) patients participated in the study. Of these, 130 (78.3%) were females. Mean age was 57.8 (SD =14.0). The quality of hypertension care process was high with mean score of 5.86 over 7 (SD = 1.4). However, only 30.1% (n = 50/166) had well-controlled hypertension. Comorbidity (OR = 2.3; 95% CI:1.0- 5.1, p =.039) and the quality of care (OR = 1.6; 95% CI: 1.1- 2.4, p = .024) were associated with higher odds of having hypertension control. Conclusion Tailored patient-centred primary care interventions that consider comorbidity could contribute to hypertension control in primary HCs in Rwanda.