1. Using the Practice Huddle to Teach Systems-based Practice & Teamwork University of California, Davis Henderson, Balsbaugh, Eidson-Ton, & Marshall STFM Annual Conference, Vancouver, 2010

2. Objectives Describe the Huddle as a teaching tool in a clinical setting Learn a multidisciplinary approach to teach systems-based practice Facilitate brief discussions that support using teamwork to improve patient- centeredness Develop case-based learning modules for 10 minute Huddle

3. Our Huddle Who? What? When? Where?

4. Why Huddle? Historical context How we got here Importance to PCMH

5. Foundations of Our Huddle We acknowledge that Huddle participants are at different stages of development and learning Learners Leaders We value the Huddle as a dynamic tool for both teaching and organization that encompasses: Teaching moments Team building moments Organizational moments

6. WEEKLY HUDDLE BULLETIN

7. Daily Schedule (Teamlets)

8. Demonstration The Huddle

9. Identify Key Aspects of Huddle Teaching Moments Organizational moments Learner role Leader role Team building moments

10. Case Based Learning Module Supplements Huddle Bulletin Discussed at end of week Brief case presentation followed by discussion questions related to Clinical management Billing/coding Clinic processes (reporting issues, referrals, etc.)

11. Survey Results: Communication 2010 Results 2008-9 Results

12. Survey Results: Teamwork 2010 Results 2008-9 Results

13. Survey Results: Efficiency 2008-9 Results 2010 Results

14. Survey Results: Teaching 2008-9 Results 2010 Results

15. Patients: Perceived Teamwork

16. Your Huddle Small Groups Create a Huddle Bulletin that fits your practice How would you facilitate your Huddle? Remember: Teaching moments Team building moments Organizational moments

17. Challenges for Huddle Implementation Changing the clinic start time Requires every team member to be on time Sustaining Huddle Bulletin items Resident Leadership skills

18. Conclusions: The Huddle is a Unique Tool Daily Practice Huddles can efficiently improve teamwork within a family medicine residency clinic. Huddles can be an effective teaching method for residents and medical students, particularly for Systems Based Practice and Practice Management learning issues. Huddles are useful for experienced clinicians, nursing staff, ancillary staff and learners.

19. References 1. Crabtree, BF et al. “Closing the Physician Staff-Divide: A step Toward Creating the Medical Home” Fam Pract Manag 2008 Apr; 15(4)20-4. 2. Delzell, JE et al. “The ACGME Core Competencies A National Survey of Family Medicine Program Directors” Fam Med 2005 Sept; 37 (8):576-80.

20. Questions?