Document Type
Dissertation
Date of Degree
4-2-2026
Primary Advisor
Timothy McCall, PhD
Abstract
Background: As the delivery of care becomes increasingly complex due to physician shortages, the rising prevalence of chronic diseases, workforce burnout, and the transition to payer models that emphasize quality of care, such as value-based reimbursement, incorporating Advanced Practice Providers (APPs), including Nurse Practitioners(NP) and Physician Associates(PA) to care model, continues to played a central role in addressing these challenges. Although prior research has demonstrated the positive impact of APPs on patient access to care, quality, and provider satisfaction, very few studies have examined APP perspectives in team-based care and the factors that influence effective integration, role, and performance. This study sought to address this gap by exploring the experiences of APPs, physicians, and healthcare leaders working within team-based care models.
Methods: A qualitative, multiple-case study design was used. Participants were recruited using purposeful sampling. Data collection was conducted via semi-structured Zoom interviews, which were transcribed verbatim. Interview questions were guided by the Role Theory and the Team-based Care Evaluation and Adoption Model (TEAM Framework). The transcripts were subsequently imported into NVivo version 15 for systematic organization by case and initial coding. Data were analyzed using an iterative, reflexive, cross-case thematic analysis. Emergent themes were aggregated within cases and then further analyzed across cases to identify similarities, differences, and patterns. Strategies such as memoing, triangulation across roles, intercoder agreement, and member checking enhanced trustworthiness. Final themes were mapped onto the dimensions of the TEAM framework.
Results: 24 participants involved in team-based care were interviewed and divided into 8 cases by specialty. These included both medical and surgical fields, with 3 participants per case: APPs, physicians, and healthcare leaders in administrative roles who directly intersected with the team. Seven overarching themes emerged across cases, which showed that APP integration depends on how organizational inputs, such as role definition, team structure, resources, leadership support, and team processes, such as trust building, communication, and collaboration, interact, leading to proximal outcomes like improved team satisfaction, reduced physician workload, and strengthened patient- centered care and distal outcomes that impact patients and the healthcare system such as workforce sustainability, system performance, and long-term patient outcomes.
Conclusions: The successful integration of APPs into team-based care models requires intentional alignment among structural inputs and relational processes. When APPs are supported by clear role delineation, collaborative leadership, and team performance measures, they positively influence care coordination, patient access to care, and quality improvement. Integrating organizational inputs with collaborative processes enhances workforce resilience, patient outcomes, and overall healthcare system performance.
Recommended Citation
Taylor, Chizoro Constance, "Integrating Advanced Practice Providers into Team-Based Care: A Qualitative Examination of APP, Physician, and Healthcare Leader Perspectives" (2026). Doctor of Philosophy in Translational Health Sciences Dissertations. Paper 46.
https://hsrc.himmelfarb.gwu.edu/smhs_crl_dissertations/46
Open Access
1
Comments
©2026 by Chizoro Constance Taylor. All rights reserved.