ArticleBMJ open2018
Formalisation and subordination: a contingency theory approach to optimising primary care teams.
Article in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Primary care micro-teams: an international systematic review of patient and healthcare professional perspectives.The British journal of general practice : the journal of the Royal College of General Practitioners · 2023Pooled it
- Equity, power and resources in primary health care reform: insights from Aotearoa New Zealand.International journal for equity in health · 2025Article
- Article
- How to measure the collective intelligence of primary healthcare teams?Learning health systems · 2020Article
- New understanding of primary health care nurse practitioner role optimisation: the dynamic relationship between the context and work meaning.BMC health services research · 2019Article
- Rethinking Primary Care Delivery Models: Can Integrated Primary Care Teams Improve Care Experience?International journal of integrated careArticle
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
objectiveWhile there is consensus on the need to strengthen primary care capacities to improve healthcare systems' performance and sustainability, there is only limited evidence on the best way to organise primary care teams. In this article, we use a conceptual framework derived from contingency theory to analyse the structures and process optimisation of multiprofessional primary care teams.
designWe focus specifically on inter-relationships between three dimensions: team size, formalisation of care processes and nurse autonomy. Interview-based qualitative data for each of these three dimensions were converted into ordinal scores. Data came from eight pilot sites in Quebec (Canada).
resultsWe found a positive association between team size and formalisation (correlation score 0.55) and a negative covariation (correlation score -0.64) between care process formalisation and nurses' autonomy/subordination. Despite the study being exploratory in nature, such relationships validate the idea that these dimensions should be analysed conjointly and are coherent with our suggestion that using a framework derived from a contingency approach makes sense.
conclusionsThe results provide insights about the structural design of nurse-intensive primary care teams. Non-physicians' professional autonomy is likely to be higher in smaller teams. Likewise, a primary care team that aims to increase nurses' and other non-physicians' professional autonomy should be careful about the extent to which it formalises its processes.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.