Balancing Access, Well-Being, and Collaboration When Considering Hybrid Care Delivery Models in Primary Care Practices with Team-Based Care.

Background: Hybrid models of care (ie, telehealth and in-person care delivery options) have been incorporated into primary care clinics to increase patient access to care. We examine the effects of these approaches on the work experiences and wellness of primary care clinical team members providing team-based care to patients.

Methods: In this qualitative study, we conducted semistructured interviews with clinical team members (primary care clinicians, behavioral health consultants, registered nurse) at 2 primary care practices at 2 time points (late 2021-mid 2022 (n = 14); midlate 2023 (n = 11)). We used an inductive approach to analyze data.

Key results: Benefits of hybrid models of care included increased patient access and personal flexibility; however, it was noted that the fragmented in-clinic schedules that emerged from the hybrid model resulted in reduced in-clinic interactions. This led to less information sharing among team members and a degradation of informal support networks that could adversely impact patient care. To mitigate these challenges, many preferred that most of their clinical shifts occurred in-person, in the clinic, with 1 to 2 sessions per week for in-home (telework) shifts.

Conclusions: In team-based primary care clinics, hybrid care models can impact interactions among clinical team members and shape the day-to-day environment in which clinical teams work. To optimize hybrid care approaches in the primary care setting, organization leaders must consider the impact of hybrid care models on clinic and team culture, and the well-being of clinical team members.