AHRQ Practice Toolbox: Team-based care


This is the third in a series of articles from the National Center for Excellence in Primary Care Research (NCEPCR) in the Agency for Healthcare Research and Quality (AHRQ). This series introduces sets of tools and resources designed to help your practice.

Primary care clinicians increasingly recognize the benefits of team-based care, in which providers with complementary strengths join to the betterment of patient care. Care teams are groups of primary care staff members who collectively take responsibility for a set of patients. These teams blend multidisciplinary skills, focusing several people’s insights, rather than a single provider’s, on each patient’s problems. The composition of a care team depends on the size and resources of the practice and the needs of the patient population. Teams are generally organized around a primary care provider (for example, physician, advanced practice nurse, physician assistant) and the patient. Nurses, pharmacists, nutritionists, social workers, educators, and care coordinators also may be part of the care team. In smaller practices, care teams have fewer members, requiring creative team-based solutions. Such practices also may build virtual teams by linking themselves and their patients to providers and services in their communities. Team-based care is especially important when addressing the needs of patients with multiple chronic conditions.

AHRQ recognizes the importance that creating a team-based patient-centered culture in primary care has on improving patient outcomes. “Creating Patient-Centered Team-Based Care” is a white paper that proposes a conceptual framework to facilitate the integration of team-based care and patient-centered care in primary care settings and offers some practical strategies to support the implementation of patient-centered team-based primary care. In addition, the white paper identifies strategies that can serve as a starting point for investigations into the effectiveness of interventions to provide patient-centered team-based primary care.

One such strategy is an evidence-based teamwork practice improvement program jointly developed by AHRQ and the Department of Defense called Team Strategies & Tools to Enhance Performance and Patient Safety, better known as TeamSTEPPS. “TeamSTEPPS for Office-Based Care Version” adapts the core concepts of 20 years of evidence in the application of teamwork principles to building high-functioning teams specifically in office-based settings. The examples, discussions, videos, and exercises are tailored to the primary care environment to help any practice begin or expand its team-based care efforts.

Dr. Richard Ricciardi

Links from the NCEPCR site:

Tools and Resources for Research, Quality Improvement, and Practice:

Creating Patient-Centered Team-Based Care:

TeamSTEPPS for Office-Based Care Version:

Dr. Theodore Ganiats is the director for the National Center for Excellence in Primary Care Research at AHRQ
Dr. Theodore Ganiats

Dr. Ricciardi is director of the Division of Practice Improvement at the AHRQ. Dr. Ganiats is director of the National Center for Excellence in Primary Care Research at the AHRQ.

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