5.Team-Based Care

MODULE 4 | Section 5 of 10

Team-Based Care

When thinking about the “classic” ideal physician, many may conjure the image of a lone physician, carrying a black bag, kneeling next to the bedside of a sick patient – a Dr. Marcus Welby-type figure. However, as medical care has become more sophisticated and complex, it is not possible for a single person to provide appropriate care to most patients. This outdated model of solitary physicians providing care has not only become unsustainable, but it is now often dangerous and inappropriate. Just as “bed rest” as the sole treatment for a heart attack has now been replaced by much more modern, efficacious, and sophisticated methods, so has the model for delivering effective health care.

REMEMBER FROM MODULE 1

Value-based health care requires appropriate teams, organized around providing the best care for specific patients, with a commitment to measuring and improving outcomes.

When a team is created around a set of patients with shared needs – such as similar circumstances and/or conditions – they share a core set of critical concerns.

A team working together toward shared purpose can achieve much better patient outcomes and enhanced efficiency.

The principles of team-based health care, as defined by the Institute of Medicine1 (now known as the National Academy of Medicine) are:

A team including providers, the patient, and where appropriate, people who support the patient, work together to establish goals that reflect what matters most to the patient

Each team member has clear expectations that allow them to take advantage of division of labor and accomplish more as a team than they would individually

Performance on the team’s shared goals is tracked over time and the team receives timely feedback on performance

Team members earn each other’s trust and share in achievements

There are consistent channels of communication that are prioritized and refined by all team members

ADDITIONAL RESOURCES

TeamSTEPPS

Another framework for teamwork and communication in health care is TeamSTEPPS (R). Developed by the Agency for Healthcare Research and Quality (AHRQ) and the Department of Defense (DoD) from the most up to date evidence from the patient safety field, TeamSTEPPS(R) is a practical communication and teamwork program that aims to improve collaboration and communication among teams of health care professionals. You can learn more about the program here:

In the following sections, we will see how highly-effective teams in health care can work together to provide better care for patients and achieve superior outcomes, all while making work more satisfying and efficient for clinicians.

“Value-based care is enabled by interdisciplinary teams improving the health outcomes achieved by their patients. Teams are more than groups because they share objectives, trust one another, communicate consistently and effectively, and improve measured outcomes together. Not only is this safer and better for patients, it supports the professionalism of clinicians and is a potent antidote to burnout.”

Elizabeth Teisberg, PhD

Executive Director of the Value Institute for Health and Care

Dell Medical School at The University of Texas, Austin

REFERENCES

1- Mitchell P, Wynia M, Golden R, et al. Core Principles & Values of Effective Team-Based Health Care. Institute of Medicine discussion paper. Published October, 2012. Accessed December 4, 2017.