Adaptive practices in heart failure care teams: implications for patient-centered care in the context of complexity

Journal of Multidisciplinary Healthcare
Glendon R TaitLorelei Lingard

Abstract

Heart failure (HF), one of the three leading causes of death, is a chronic, progressive, incurable disease. There is growing support for integration of palliative care's holistic approach to suffering, but insufficient understanding of how this would happen in the complex team context of HF care. This study examined how HF care teams, as defined by patients, work together to provide care to patients with advanced disease. Team members were identified by each participating patient, generating team sampling units (TSUs) for each patient. Drawn from five study sites in three Canadian provinces, our dataset consists of 209 interviews from 50 TSUs. Drawing on a theoretical framing of HF teams as complex adaptive systems (CAS), interviews were analyzed using the constant comparative method associated with constructivist grounded theory. This paper centers on the dominant theme of system practices, how HF care delivery is reported to work organizationally, socially, and practically, and describes two subthemes: "the way things work around here", which were commonplace, routine ways of doing things, and "the way we make things work around here", which were more conscious, effortful adaptations to usual practice in response to emergent ...Continue Reading

Citations

Mar 2, 2016·Health Expectations : an International Journal of Public Participation in Health Care and Health Policy·Kori A LaDonnaUNKNOWN Heart Failure/Palliative Care Teamwork Research Group

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