The center of team-based care? The patient, of course.
by Michelle Edwards, DNP, FACHE, FAANP
Care that is designed around a patient’s needs—whether they be physical, emotional, social, mental or spiritual—and is delivered safely, at the right time and place, and with the right approach is a good description of patient-centered care. As obvious as patient-centered care might seem, how it actually plays out in hospitals, clinics and other care delivery sites around the country is anything but simple.
Ensuring the patient remains at the center of what we do can become complicated when we introduce variables like provider satisfaction, clinician burnout, fluctuating volumes of patients with diverse health care needs, drug shortages, changing technology, and unpredictable payment methodologies.
If we’re not careful, when faced with such challenges, the reality of patient-centered care can become something quite different than the theory behind it. That’s why implementing care delivery models that prioritize patients and families while simultaneously solving for many of the aforementioned variables is undeniably a move in the right direction.
Given the multidimensionality of the current care delivery system, and the unique and often complex needs of the patient populations we serve, the reason for redesigning traditional care models is as much about patient safety and quality as it is about efficiency and cost. Patient satisfaction and patient experience metrics are intertwined with quality and safety measures—our job is not only to treat patients effectively, efficiently, and safely, but also to treat them with dignity and respect.
So, how do we get there? At CHI we have challenged our historical ways of thinking about how and by whom care should be delivered, and many long-held perceptions around what patients value most. One way that CHI is fostering patient centricity and optimization of the care delivery process is by implementing a team-based care environment. The team-based model of care enhances our ability to meet patient needs and preferences through two primary methods: 1) Engaging patients as full participants in their care and, 2) Supporting all care team members to function to the full extent of their education, certification and experience (commonly referred to as “top of license” practice). The consequences of practicing care in this manner are not only more efficient and effective customized patient-centered care, but also enhanced provider satisfaction and reduced clinician burnout.
We build teams and treatment plans around, and with, patient input. By including the patient in the process, not just as a recipient but also as a participant, they are able to help make key decisions about their care. This more involved relationship builds trust and ensures that every patient will have a unique and personalized experience.
This collaborative approach isn’t limited to the patient-provider relationship. Inherent to team-based care, when done well, is the interplay between team members of physicians, advanced practice clinicians, nurses, pharmacists, social workers and others, including non-clinical team members who understand, value and protect the partnership within the care team and throughout the care delivery experience. They work closely and collaboratively at key stages of care, thoughtfully aligning patient needs with the skillsets of each team member. By dividing responsibility for the different aspects of care across the care team, each team member can focus more on the tasks best suited for their training and skills.
Not only does this set care teams up for success, it also enables better resource management, reducing fatigue, burnout, and stress by ensuring that workloads are more manageable. For example, physicians and advanced practice clinicians can depend on nurses and other care team members to execute duties they were once overwhelmed by, so they can focus more exclusively on diagnostics, patient interaction, and treatment plans.
On top of that, team-based care shifts the burden of care from one or two individuals to many. This reflects a deep understanding of how the best patient care often requires several healthcare professionals collaborating, not a single clinician at the center.
It’s important to note that team-based care does not create silos. In fact, it does the opposite. At the core of a team-based approach are strategies and tactics that increase communication and ensure collaboration.
This happens on a local level, with things like daily huddles, checklists, and team skill development.
The goal of team-based care is consistent and clear: improve the quality of care for each patient. No matter what the clinical setting, patient outcomes are improved by having a care team that’s prioritizing coordination, collaboration, and communication. A team where everyone seamlessly works together creates better, safer, and more affordable care for all.
Like any transformational change, implementing a new model of care across teams with established ways of working together can be difficult. It requires a lot of trust, both between teams and between leadership and employees, but the benefits are well worth it for everyone involved.
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