Clinician experiences in a DBT-informed consultation group embedded within a US academic primary care clinic: a qualitative study.

OBJECTIVE: Traditional wellness programming focuses on bringing together individual clinicians during personal time for resources and skill building, without a focus on skill building in the contexts and teams they are embedded in daily. We developed a dialectical behaviour therapy (DBT)-informed consultation group, 'Complex Care Rounds' (CCR), implemented within the usual workflow of a primary care clinic. The goal of CCR was to facilitate interprofessional team communication and enhance clinician motivation and efficacy, while simultaneously addressing medical and social needs of patients. During the twice-weekly group, team members provided validation and shared feedback while acknowledging the needs of the clinician and patient. The aim of this study was to explore clinician perspectives on participation in CCR and to create a conceptual model to understand CCR's influence on individual team members as well as team dynamics. SETTING: The research was completed at the Comprehensive Care Programme, a primary care programme for patients with Medicare insurance at high risk of hospitalisation at an academic institution in Chicago, Illinois, USA. STUDY DESIGN: This was a qualitative research study examining reflective essays written by participants on how participating in CCR has impacted them. Template analysis, a form of thematic analysis, was applied to code and organise themes. STUDY PARTICIPANTS: Participants included 12 clinical team members (physicians, nurses, social service team members) and 7 trainees (AmeriCorps members, medical students) from the Comprehensive Care Programme. RESULTS: We found that CCR's shared team frameworks (theme 1) grounded in DBT promoted a practice of self-compassion (theme 2) as well as a validating team environment (theme 3) within our interprofessional team. Improvements to patient care (theme 4) extended from increased personal capacity, support from team members and a structured approach to team interactions. CONCLUSIONS: DBT-informed consultation groups embedded within a clinical practice have the potential to promote a practice and culture of interprofessional team members tending to self and others, while also building one's own skills and capacity to care for complex patients. TRIAL REGISTRATION NUMBER: Clinical trial: NCT04489693; Pre-results".