How Governance Design Shapes Primary Care Team Configuration: Insights from Stakeholder-Generated Causal Loop Diagrams

Monday, July 20, 2026, 11:00 AM

Session: SOC Poster Session (Overflow) (In-person)

Primary care reforms increasingly emphasise coordinated, team-based care, yet persistent fragmentation suggests that workforce configuration remains misaligned with population needs. We used Group Model Building (GMB) to explore potential system levers to enhance team-based primary care in Australia. A one-day GMB workshop (October 2025) involving ~45 consumers, clinicians, managers, researchers and system leaders generated causal loop diagrams (CLDs) representing perceived interactions shaping system behaviour and potential areas for intervention. Among the issues raised, governance emerged as a central influence on team-based care, acting as both an enabler and a constraint. Two CLDs surfaced distinct feedback structures. The Care Coordination Dynamics CLD depicted a fragile stabilising (balancing) loop, weakened by factors such as workforce shortages and funding caps. The Health Enabling Team Care CLD depicted reinforcing early intervention dynamics, with coordinated teams improving access, reducing demand and strengthening team functioning. Together, the CLDs show that under chronic system stress, care coordination often functions as a fragile coping mechanism, whereas when governance levers and enabling conditions align, team-based care can produce reinforcing improvements in capability, access and outcomes. Strengthening coordination roles, task authorisation pathways, funding arrangements, digital infrastructure and equity-oriented access offers opportunities to shift system behaviour toward more coherent and responsive primary care.