Measurement of functional status in primary care: the role of the interprofessional team.

Abstract

Measuring functional status allows clinicians to deliver evidence-based interventions to prevent or delay associated adverse outcomes. Functional status is seldom routinely measured in primary care settings where most older adults receive care. Interprofessional team-based care is increasingly regarded as an important feature of high quality and efficient health care systems. Yet despite growing evidence of the benefits of team-based care, in primary care there are not yet standards for how to operationalize interprofessional practice. In this study we explored interprofessional perspectives on assessing functional status among older adults in team-based VA primary care clinics. We conducted qualitative interviews with 57 primary care team members (nursing staff, primary care providers, and social workers) from six geographically diverse VA medical centers. We drew from implementation science frameworks and sociotechnical theories to ground our thematic analysis in dynamic, real-world contexts. Interviews revealed the view that all primary care team members play a role in measuring and addressing functional status. Participants also described a perceived hierarchy of accuracy of assessment based on role and outlined strategies for validating the accuracy of functional status assessments. These results can inform guidelines for functional status measurement in primary care that improve interprofessional assessment and team-based communication.