Satisfaction with referral relationships between general practice and allied health professionals in Australian primary health care
Bibiana Chan A , Judy Proudfoot B , Nick Zwar C , Gawaine Powell Davies A and Mark F. Harris A DA Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, Australia.
B Black Dog Institute and School of Psychiatry, University of New South Wales, Sydney, NSW, Australia.
C School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia.
D Corresponding author. Email: m.f.harris@unsw.edu.au
Australian Journal of Primary Health 17(3) 250-258 https://doi.org/10.1071/PY10026
Submitted: 18 June 2010 Accepted: 1 December 2010 Published: 5 September 2011
Abstract
Chronic diseases require a multidisciplinary approach to provide patients with optimal care in general practice. This often involves general practitioners (GPs) referring their patients to allied health professionals (AHPs). The Team-link study explored the impact of an intervention to enhance working relationships between GPs and AHPs in general practice regarding the management of two chronic diseases: diabetes and ischaemic heart disease (IHD) or hypertension. The Measure of Multidisciplinary Linkages (MoML) questionnaire was developed to assess professional interactions and satisfaction with various aspects of the multidisciplinary relationship. Questionnaires were completed at baseline and 6 months by GPs (n = 29) participating in the Team-link project and by AHPs (n = 39) who had a current working relationship with these GPs. The Chronic Care Team Profile (CCTP) and Clinical Linkages Questionnaire (CLQ) were also completed by GPs. There were significant changes from baseline to 6 months after the intervention measures for individual items and overall MoML scores for GPs, especially items assessing ‘contact’, ‘shared care’ and ‘satisfaction with communication’. The comparable item in the CLQ, ‘Shared Care’, also showed significant improvement. However, there were no statistically significant correlations between the change in overall ‘Referral Satisfaction’ scores in the GP MoML and the CLQ. The CCTP also improved and was a weak negative correlation between the GP MoML and two of the subscores of this instrument. There were no changes in AHP measure. This study demonstrates that the instrument is sensitive to differences between providers and conditions and is sensitive to change over time following an intervention. There were few associations with the other measures suggesting that the MoML might assess other aspects of teamwork involving practitioners who are not collocated or in the same organisation.
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