The effect of general practice team composition and climate on staff and patient experiences: a systematic review

Journal article

Background

Recent policy initiatives seeking to address the workforce crisis in general practice have promoted greater multidisciplinarity. Evidence is lacking on how changes in staffing and the relational climate in practice teams affect the experiences of staff and patients.

Aim

To synthesise evidence on how the composition of the practice workforce and team climate affect staff job satisfaction and burnout, and the processes and quality of care for patients.

Design & setting

A systematic literature review of international evidence.

Method

Four different searches were carried out using MEDLINE, Embase, Cochrane Library, CINAHL, PsycINFO, and Web of Science. Evidence from English language articles from 2012–2022 was identified, with no restriction on study design. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed and data were synthesised thematically.

Results

In total, 11 studies in primary healthcare settings were included, 10 from US integrated healthcare systems, one from Canada. Findings indicated that when teams are understaffed and work environments are stressful, patient care and staff wellbeing suffer. However, a good relational climate can buffer against burnout and protect patient care quality in situations of high workload. Good team dynamics and stable team membership are important for patient care coordination and job satisfaction. Female physicians are at greater risk of burnout.

Conclusion

Evidence regarding team composition and team climate in relation to staff and patient outcomes in general practice remains limited. Challenges exist when drawing conclusions across different team compositions and definitions of team climate. Further research is needed to explore the conditions that generate a ‘good’ climate.

Authors: Abrams, R; Jones, B; Campbell, J; de Lusignan, S; Peckham, S

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Royal College of General Practitioners
• Journal: BJGP Open
• Volume: 8
• Issue: 1
• Article number: BJGPO.2023.0111
• Place of publication: England
• Publication date: 2024-02-21
• Acceptance date: 2023-09-01
• DOI: 10.3399/bjgpo.2023.0111
• EISSN: 2398-3795
• Pmid: 37827584
• Language: English
• Keywords: patients; teams; staff; climate; composition; general practice