Primary care clinician preferences for communicating with a collaborative intervention team

Dobscha SK, Leibowitz RQ, Flores JA, Doak M, Gerrity MS. Primary care clinician preferences for communicating with a collaborative intervention team. Poster session presented at: VA HSR&D National Meeting; 2007 Feb 23; Arlington, VA.

Related HSR&D Project(s)

• PMI 03-195 – Improving the Treatment of Chronic Pain in Primary Care

Objectives: Collaborative interventions require effective communication between primary care clinicians and other members of the intervention team. Despite growing interest in collaborative models, we have identified no published studies describing the preferences of clinicians for interacting with collaborative intervention teams. The purpose of this study was to examine preferences of primary care clinicians participating in a randomized clinical trial of a collaborative intervention for chronic pain and depression. Methods: The Study of the Effectiveness of A Collaborative Approach to Pain (SEACAP) is being conducted in 5 primary care clinics of a Veterans Affairs Medical Center. At study entry, 41 of 42 participating clinicians completed a survey regarding pain-related attitudes, satisfaction with pain treatment resources, and job satisfaction. Twenty-one of these clinicians were randomized to the intervention group, and also completed a survey regarding preferences for interacting with the intervention team. Results: A majority of intervention clinicians identified email (95%) and telephone calls or pager (67%) as preferred modes for communicating with members of the intervention team. In contrast, only 29% identified in-person communications as preferred. Most clinicians preferred that the care manager and physician pain specialist assess patients (76%) and make initial treatment changes (71%) without conferring with the clinician first. Half wanted to be designated cosigners of all intervention team notes in the electronic medical record, half wanted to receive brief and focused information rather than in-depth information about their patients, and half wanted their practice nurses automatically included in communications. Implications: There is considerable variation in clinician preferences for working with a collaborative care team. Although most primary care clinicians indicate preferences for other intervention team members to proceed with assessment and treatment without their preliminary input, a minority of clinicians want more direct involvement in developing and implementing treatment plans. Impacts: The results suggest that it would be helpful to have knowledge of clinician preferences when designing and implementing collaborative care interventions. Collaborative intervention effectiveness might be enhanced by developing individualized primary care clinician communication plans.