Considerations for optimal team-based rheumatology care: a qualitative study exploring the experiences of rheumatology health professionals

Abstract

Interdisciplinary team-based rheumatology care models are a promising solution for improving access to high quality, equitable care for people with rheumatic and musculoskeletal disorders. There is limited understanding on health professionals’ perspectives on their needs to deliver care under this model. We explored rheumatology team members’ perceptions on individual and practice features required for optimal team-based care. We conducted a qualitative descriptive study using secondary analysis of semi-structured interviews with rheumatologists ( n = 3), interdisciplinary health professionals (IHPs) ( n = 7), and administrators ( n = 5) in an interdisciplinary rheumatology team in Ontario, Canada. Interviews explored team members’ experience working within the team and the health professional and clinic characteristics they perceived as necessary for optimal team-based care. We coded interview transcripts inductively and constructed themes using thematic analysis. We identified three themes: (1) Key health professional qualities; (2) Synergy of complementary skillsets; and (3) Supportive operational structures. Participants felt that health professionals must acquire rheumatology-specific training in addition to bringing discipline-specific skillsets to work collaboratively to meet patients’ needs. They perceived that their complementary skillsets benefited patients (e.g., better clinical outcomes) and was also professionally rewarding. Participants emphasised the importance of operational structures necessary for optimal team-based rheumatology care, including shared workspaces and electronic medical records, competitive compensation, and stable funding. Rheumatology team members highlighted key considerations for health professionals and practices when developing optimal team-based rheumatology practices. This study offers insights to support policy, practice, and health system-level efforts to spread and scale team-based rheumatology care models.