Exploring the Impact of Context on Spread of Integrated Team-Based Methods for Chronic Disease Management
Abstract
Team-based care is widely used in primary care to help manage complex chronic conditions; yet little is known about how to spread evidence-based models to new contexts. This research explored the impact of context on the spread of an integrated, team-based program for COPD in primary care, known as Best Care COPD (BCC). This research used a qualitative collective case study approach guided by a constructivist paradigm. The results highlighted that some care settings presented challenges, however the providers were able to overcome these barriers and only required minor adaptations primarily in day-to-day processes. The BCC program was able to balance program fidelity with adaptability to ensure that the program was successful as it spread to different sites with unique contexts. This study provided insight into how to support the spread of BCC and other chronic disease management programs in primary care through an understanding of context. Supporting the spread of successful programs will enable appropriate care for a greater patient population.