A model for accelerating educational and clinical transformation in primary care by building interprofessional faculty teams: Findings from PACER

Purpose: To accelerate change in primary care training by undertaking a national effort to build interprofessional (IP) faculty teams. Methods: This quasi-experimental mixed method study, conducted between 2015 and 2018, included >100 faculty and staff from medicine, nursing, pharmacy, physician assistant, and behavioral health from 9 institutions. Participants completed surveys at baseline, one year after training, and at program's completion to measure perceived changes in skills, clinics and training programs. Qualitative methods involved analyses of training and site visit observations and telephone interviews with team members. Results: Self-assessment of competency in IP care and education, patient centered care, and leadership improved significantly for 15/15 (100%) skills assessed before and after program completion (p < 0.005). Medical home features improved significantly in all clinics (Leadership and Staff Engagement: 59.3% to 70.5%; Patient Self Management Support: 49.1% to 60.4%; and Team-Based Care: 44.2% to 56.9%, p < 0.05 for all comparisons). Joint educational activities across medical residencies and professions increased significantly (43.4% to 53.6% and 47.3% to 57.6% moderately or fully developed, respectively; p < 0.05 for all comparisons). At program completion, 75% of participants reported the program moderately or fully helped the team accomplish more than they would have working independently. Qualitative analysis identified that providing structure to bring together faculty from different professions, meeting regularly as a team, sharing best practices, and building trusting relationships made the greatest impact on transformation efforts. Conclusion: Creating and supporting IP primary care teams of faculty and staff within institutions appears to accelerate clinical learning environment transformation. Further study should determine if this model can sustain IP collaborative practice and education in other settings.