Implementing Care Teams Aubrey Reburn November, 1st 2017 QI Coach- Safety Net

Milestone Relation Milestone Description Milestone # 6 Team- Based Relationships Milestone # 7 Milestone # 14 Coordinated Care Delivery Milestone # 15 Organized, Evidence- Based Care Milestone # 6- Practice sets clear expectations for each team member’s functions and responsibilities to optimize efficiency, outcomes, and accountability. Milestone # 7 - Practice has a process in place to measure and promote continuity between a patient and his/her care team so that patients and care teams recognize each other as partners in care. Milestone # 14 - Practice clearly defines care coordination roles and responsibilities and these have been fully implemented within the practice. Milestone # 15 - Practice ensures that care addresses the whole person, including mental and physical health.

What are Care Teams? Team with Multidisciplinary Skills Organized around primary care providers (physicians, NPs, PAs, nurses, pharmacists, therapists, social workers, educators, care coordinators, etc.)

What are Care Teams? “ A team is a small number of people with complementary skills who are committed to a common purpose, performance goals, and approach for which they are mutually accountable” - J.R. Katzenbach in The Wisdom of Teams

Why are Care Teams Important? Most physicians only deliver 55% of recommended care and 42 % report not having enough time with their patients (Bodenheimer, 2008). Providers spend 13% of their day on care coordination activities and only half of their time on activities using their medical knowledge (Loudin, et al., 2011). Reduces the number of medical errors and increases patient safety Team-based care decreases costs and increases revenue Increase patient satisfaction and job satisfaction

Steps to Implement Team-Based Care Engage the care team and prepare for transition Determine the team composition Choreograph strategic workflows to reflect the new team based care model Optimize existing care teams by clarifying roles, tasks, and expectations Increase communication Set up performance measures to monitor the care teams effectiveness

Group Activity Have you experienced a practice that had a non-structured team, that then made a transition to a well structured team? What differences did you see and how did they overcome any barriers?

How Do Care Teams Function? Clearly define care roles Shared goals Delegate tasks Promote Interdisciplinary Teamwork Effective, timely communication Optimistic, can-do attitudes

Activities to do with your practice ① Implement team huddles ② Team Visualization Exercise ③ Task Reassignment Table ④ TEAMSTEPPS

Implement Team Huddles Why Huddle? Improve communication Coordinate team care Prospective planning Prepare staff Steps to Effective Huddles Establish a routine Develop relationships and designate roles Evolve and improve over time Resources: https://www.stepsforward.org/modules/team-huddles

Team Visualization Exercise Goal: Demonstrate current models in a practice that may not actually function as team-based care Directions: Each team member is given jelly beans and a cup Outline the current care model Drop a jelly bean in your cup if you are currently doing this role Evaluate results

Task Reassignment Table

Task Reassignment Table

TeamStepps

TeamSTEPPS Module Content Team Structure Communication Leading Teams Situation Monitoring Mutual Support Coaching and Teaching Change Management Measurement Implementation planning Website: https://www.ahrq.gov/teamstepps/officebasedcare/index.html

Questions?