Table S1.

Example of summary matrix used to compare impacts across studies and jurisdictions

Themes	Jurisdiction: Ontario
	Study: # 2 (Behind closed doors)
Care processes and referral	Reutilization of community resources: Reasonable partnerships in CHCs. Cooperation with other CHCs and some FPs in particular, but more because of the model of care not team orientation. The FHTs are weak in this regard; most that do use community resources limit referrals to other health care resources. Two FHTs made some early attempts to build partnerships and integrate community resources more, but in light of a general lack of orientation to this model, one discontinued the practice because it was inconvenient (despite positive patient feedback). In contrast, the CHC excelled in this area. Re-referrals: referrals are internal in the FHTs and do not assume a partnership orientation.
Communication	+ Informal communication seemed regular (modified by space and culture) and ± Great deal of variability between practices, some never held meetings, others, like the most “mature” FHT, which met regularly, actively organized mentoring, and actively reflected on processes of collaboration. Social workers were relatively isolated.
Trust/relationship	± Evolution of trust over time with regard to the work of NPs and less trust in those FHTs where certain professionals had specialty training to work with specific subpopulations (eg, an NP who is specialized in care of patients with complicated diabetes).
Task/role realignment	Significant in most FHTs with new professionals. However, mostly old routines persisted in the early years of the model. The competing demands (see later) affected this. Yet, some innovative routines evolved in the best led FHTs.
Power, decision making	− Governance varied significantly. Most decisions in the physician owned FHTs were made by physicians, more complex structures in a well-embedded FHT. In one FHT, all decisions made by a group of FHT owners, this FHT never held meetings between administrative and clinical staff. + Powerful, consistent, and clear leadership increased resilience among individuals and the team, mediating the negativity of the challenges experienced as they worked to develop new working relationships. − Clinical leadership was sometimes surprisingly absent. Much dysfunction found in an academic FHT could be traced back to a vacuum in clinical leadership. The FHT was characterized by a sense of disempowerment and with little encouragement for members to participate in decision making and the proposal of new ideas or exploration of new roles or modes of collaboration. Therefore, higher incidences of staff feeling undervalued, underutilized, and dissatisfied with the current situation.
Adoption and acceptance	+ In terms of integration of specialist expertise in primary care, FPs viewed their colleagues and FHT’s pharmacists as a trusted, regular source of quality evidence. Nurse practitioners, allied health providers, and nurses will utilize the above and each other for decision support, recognizing their expertise. − The distinct philosophy, scope of practice, and different ways that NPs engage with their work all interact to generate some common problems with integration of the NP. − Dieticians/pharmacists expressed desire to do more “… they kind of have almost preconceived notions about what dieticians can see. You know, like diabetes, and weight management, and high cholesterol. And then a lot of times they don’t think outside of that … [Registered Dietician] and work in different ways in different FHTs.
Work satisfaction	− Many found their skills exceed their tasks, led to dissatisfaction. − Many FHT members confronted by a clash between their expectations of interprofessional care and their experiences. Also different expectations of what moving into a FHT model would mean for them, their role, and their way of practicing. − Especially, a problem for NPs. For FPs in general, the changes were positive in terms of work satisfaction.
Practice size	The impact of a FHT (the Ontario model of PHC team). Increased practice size considerably, however, in networked models the individual practices often stayed the same in size. More commonly, there was coalescence of practices into a larger body.
Colocation	± FHTs increased the likelihood of colocation. − Non colocated team members were rarely integrated.
Space	− Physical space is a pervasive problem in FHTs. Lack of space limited hiring in some and a constant preoccupation for FHT managers. Indeed, many of the real teams existed at a site rather than at FHT level. ± Where someone sits in the FHT has much to do with feelings of being part of the team. Physically isolated providers found it hard to integrate with their colleagues and were less able to give others an idea of their skills and potential contributions.
Workload and workforce	− Some physicians thought the FHT model would mean that they would not have to see as many patients. However, 2 years after the transformation, the majority of family practitioners were working in much the same way they had been prior to the integration of the new model.
Scope of responsibility	± Many (AHP and NP especially) felt they were not working to their scope of practice. However, compared to normal practices there was a definite broadening of nurse responsibilities and new role of NP.
Leadership (decision making)	± The team led to the demand for leadership. A balance between clinical and nonclinical leadership seemed necessary. While each role required different skills sets, the “organic” nature of FHTs meant that physicians (in smaller FHTs especially) frequently took on operational roles, while in other sites administrators found themselves managing practitioners with whose clinical roles they are not familiar. In a number of FHTs a collaborative leadership role between clinical and nonclinical did not exist. The CHC was led by a physician who suggested: For me, it’s a good personal fit. I think for a manager, I think it really helps if you’ve got a clinical background. I hear that a lot. I hear from my other fellow CHCs, particularly when they have non-clinical managers. Sometimes the clinicians feel like their concerns are not understood, or are not given the import that they wish that they would be given.
Financial model (business)	− We found an inherent barrier to interprofessional care generated by existing physician-oriented incentive structures. It has become more and more of an issue. The team itself raised the problem, but the financial structure generated it.
Concurrent change (competing demands)	± Team care added the demands on (and requirements for efficient leadership and management). Other demands came from the model requirement to optimize access and increase the quality of chronic disease care. These in themselves generated a need for effective teamwork.

Note: + indicates a positive impact, − indicates a negative impact, ± indicates a variable impact.

Abbreviations: CHC, Community Health Center; FP, family physician; FHT, family health team; NP, nurse practitioner; AHP, allied health professional; PHC, primary health care.