Work in a TEAM to Improve Primary Care Practice? How?

In health care settings, individuals from different disciplines come together to care for patients: the surgeon, nurse, anaesthesiologist in the operating room; the oncologist, radiation therapist, and surgeon for patients with cancer, and the physician, medical assistant, and receptionist in the primary care office. But is a group of people who happen to be thrown together in a surgical suite or primary care office truly a team?

Discussion of team generally includes a consideration of 2 major issues: “Who is on the team?” and “How does the team function?” Now, I would like to share with you the 5 key characteristic of a cohesive health care team: clear goal with measurable outcomes, clinical and administrative systems, division of labor, training of all team members, and effective communication.

Key Element of Team Building

1. Defined Goals Overall Organizational mission statement Specific, measurable operational objectives	Examples: · Improvement of patient’s health · Reduction in barriers to access to care · Improvement in practice’s financial performance · Physician and staff satisfaction · At least 80 of diabetic patients in practise will have haemoglobin A1c lower than 8 · 90% of people calling for a nonurgent appointment will receive the appointment within 1 week · Practice will achieve a targeted level of practice revenue · Each team member will achieve an explicitly identified goal for personal professional development
2. Systems Clinical Systems Administrative Systems	· Procedures for providing prescription refills · Procedures for informing patients of laboratory results · Procedures for making patient appointments · Policies on how decisions are made in the medical practice
3. Division of Labor Definition of tasks Assignment of roles (Determining which people on the team perform which tasks within the clinical and administrative systems of the medical practice)
4. Training Training for the functions that each team member routinely performs Cross-training to substitute for other roles in cases of absences, vacations, or periodic heavy demands on one part of the team
5. Communication Communication Structures Communication processes	· Routine communication through paper and electronic information flow · Minute-to-minute communication through brief verbal interactions among team members · Team meeting · Giving feedback · Conflict resolution

In conclusion, teams with greater cohesiveness are associated with better clinical outcome measures and higher patient satisfaction. Moreover, medical settings in which physicians and nonphysician professionals work together as a team can demonstrate improved patient outcomes. However, a number of barriers to team formation exist, chiefly related to the challenges of human relationships and personalities. So, taking small steps toward team development may improve the work environment in primary care practices.

References:

1. Can Health Care Teams Improve Primary Care Practice?

2. Leadership and Team Work, Prof Dr. Budi Mulyono

3. Communication in Working Place, Guest Lecture