Implementing a hybrid team-primary nursing model to enhance role clarity and care coordination in the hospital: A qualitative evaluation

Abstract

Strengthening role clarity and care coordination among healthcare professionals is essential to address fragmented workflows and inconsistent continuity of care. Such a lack of systemic cohesion often results in operational gaps that compromise patient safety and clinical efficacy. These challenges manifested as overlapping nursing roles, documentation inconsistencies, and deficient interdisciplinary communication within the shift-based care system. In response, the hospital implemented a hybrid team–primary nursing model as a pilot organizational intervention to enhance coordination. However, a formal evaluation of this program has yet to be conducted to drive continuous hospital service improvements, particularly at the RS PKU Muhammadiyah Wonosobo, Indonesia. Therefore, the study aimed to explore healthcare professionals’ experiences and perceptions regarding the implementation of the hybrid model, including its perceived benefits, challenges, and impact on nursing practice. A descriptive qualitative design was utilized to explore staff experiences rather than measure the intervention’s effectiveness. This choice was appropriate given that the model had already been implemented before data collection. Data were collected at the RS PKU Muhammadiyah Wonosobo, Indonesia, from May until July 2025. Data were obtained through in-depth interviews, observations, and document reviews involving 18 participants from various multidisciplinary roles. Thematic analysis was conducted following Braun and Clarke’s six steps, supported by triangulation and member checking to ensure methodological trustworthiness. The finding documented five themes as follows clearer role division and coordination, enhanced patient familiarity and continuity of care, improved interprofessional collaboration, balanced workload and strengthened supervision, and early adaptation challenges. The hybrid team–primary model remains feasible and relevant for enhancing coordination, accountability, and communication. Future studies should consider mixed-method or quantitative designs to evaluate the model's effectiveness.

Keywords: Care coordination, hybrid team–primary, nursing model, qualitative study, role clarity