Document Type


Degree Name



Dept. of Medical Informatics & Clinical Epidemiology


Oregon Health & Science University


Primary care is a practice of adapting to unpredictability, and the clinical staff has been entrusted to process rising volumes of patients. Clinical and non-clinical staff attempt to alleviate cumbersome information transfer and documentation processes that are complicated by introduction of digital information systems. To assess how practice staffs understand connectedness and communication in workflow streamlining, transcripts of interviews with 39 members of five small and medium size rural primary practices who were engaged in workflow assessment were interpreted for thematic content. Analysis revealed a list of characteristics related to team cohesion. A lack of commonly understood team-based goals and a disconnect between collaborative aims and workflow descriptions were noted. Predominant modes of communication were informal and face to face, while digital tools were minimally utilized for managing interrelated work dependencies. It is important to acknowledge the need for metrics to evaluate emotional pressures, member recognition of task dependencies, and connecting practice-wide goals with workflow. Clear measurement of these factors can help remove uncertainty and negativity from a smooth, working office.




School of Medicine



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