Team-Based Care: New Clinical Practice

December 10, 2014

Who do you consider part of your care team? If you’re like most people, your list ends after Doctor. But what about the Medical Assistant who takes your vitals before the visit? Or the front desk staff who help to schedule your follow up appointments? And most importantly, what about you, the patient?

Patient-Centered Team-Based Care is an emerging innovation in clinical practice that is moving through community clinics and hospitals everywhere. The model puts you, the client, at the center of your care team, and brings together a full supporting cast of medical professionals, administrative and operations assistants, billing specialists, and even pharmacies and lab technicians to create the most efficient and thorough visit possible.

The Clinic recently wrapped up an eight-week Team-Based Care pilot where we applied emerging research into our clinic operations. The goals of the Team-Based Care pilot were to make visits more efficient for the client, to promote interprofessional collaboration, and to explore the ways that this practice could be incorporated into day-to-day clinic operations in the future.

Team-Based Care is a simple, yet revolutionary idea. Instead of a sole Clinician screening, diagnosing, analyzing labs, and treating each client for everything under the sun in one twenty-minute appointment, a whole team of people are supporting the client’s visit and anticipating needs. Our Care Team includes Clinicians, shift coordinators, volunteer Health Workers, our Clinic Director, and Clinic Operations Manager.

Of course, the Clinic already uses many client-centered Team-Based Care practices in our daily operations: we already promote educational and preventive care and offer non-judgmental information and options, allowing the client to make the best decisions for her health. But with our Team-Based Care pilot, we tested out a slightly different clinic flow, and focused on achieving our goals of efficiency and interprofessional development.

First, we introduced the Team Huddle. While it is normal practice for the Clinic’s staff to huddle at the start of each shift to review any new information or procedures, this was often done in silos, with Clinicians speaking to Clinicians, and Health Educators updating fellow Health Educators. During the Team-Based Care pilot, the Clinician, Health Educators, shift coordinators, and front desk staff met briefly to review scheduled visits during that shift in order to anticipate each client’s need.

Second, we introduced the mid-way knock. Half-way through each visit, the Health Educator quickly knocks on the exam room door and checks in with the Clinician and client. At this point, the Clinician can ask the Health Educator to prepare any tests, labs, or follow up appointments, helping to make the client’s visit more efficient.

Third, we structured our clinic flow and Care Team so that each member worked at the top of their ability and training. For us, this meant that Health Educators and shift coordinators were trained to take on more complex tasks – such as taking vitals and running labs – which freed up more time for Clinicians and clients to spend one-on-one together.

Client-Centered Team-Based Care is exactly what it sounds like: putting the client first, involving them in their health and healthcare decisions, and bringing together Clinicians, health educators, pharmacists, and even social workers or billing specialists to meet the needs of the client. We’ve been proudly introducing this practice bit by bit into our everyday operations, and are excited to be on the forefront of community clinic innovations. We look forward to doing even more in 2015!