The Physician’s Case for Team-Based Care
With strong communication and empowered skill-task alignment between providers and frontline staff, team-based care is increasing care team and physician efficiency, outcomes and more importantly, job satisfaction.
Team-based care offers highly responsive patient-centered care via a team of auxiliary staff—all operating at the top of their professional abilities to deliver the most value and the best outcomes to the patient. As an organizational model for healthcare providers, it encourages collaborative work as “multidisciplinary, integrated teams in the best interest of patients,” as defined by the American Academy of Family Physicians (AAFP). There are many advantages to team-based care. When implemented well, team-based care has simultaneous impacts across several key priorities for healthcare systems today:
Business Goals• Higher patient experience scores
• Care quality improvement
• Strengthened brand reputation in the market
Employee Experience• Increased job satisfaction
• Higher retention rates
• Stronger perception of trust and teamwork
Operational Margins• Increased throughput
• Decreased overtime
Patient Experience• More timely care communication
• Stronger relationships with provider and team
• Higher likelihood of care plan compliance
• Shorter wait times
Preventing Physician Burnout
A top benefit of team-based care is preventing physician burnout—an increasing concern in healthcare. An average 1 in 3 doctors suffers from physician burnout on any given day, and more recent studies show US burnout rates exceeding 50%.
There simply isn’t enough time for physicians to adequately perform all the responsibilities tasked to them. Physicians and patients crave more face time, and while the average patient visit time of 20 minutes has remained unchanged over the past two decades, the physician is now expected to do much more with that same block of time. In fact, 56% of physicians cite bureaucratic paperwork as the number one cause for their burnout and long hours as the second leading cause.
When physicians are burned out, the quality of patient care suffers. Physicians are more likely to be easily exasperated by patients, less engaged with patients, and more probable to be less careful when taking patient notes.
A team-based care model will alleviate the physician’s workload by re-allocating tasks to qualified team members and improving communication across the team.
Align Tasks to Top of Skillset
The core of implementing team-based care is aligning care team members’ skills with tasks that let them work at the top of their skillset. Working as a multidisciplinary team, MAs, social workers, RNs, care managers, providers and auxiliary staff share the workload of patient care—direct care, care coordination, patient education, and prevention. Physicians go home on time and do not feel pressured to log additional hours from home (also known as “pajama time,” a known cause of burnout). On a recent project of ours, client surveys from before and after implementation of team-based care, show dramatic improvements in staff satisfaction rates—especially among the most highly impactful categories identified by the AMGA, namely “time spent working,” “leadership,” and relationship with “colleagues.”
Improved Communication through Co-Location
Many clinics have unsuccessfully attempted to implement team-based care in traditional office settings where physicians work from MD offices. Once the hallmark of provider retention, this perk is perceived by an upcoming generation of providers as less valuable than work-life balance. Without easy communication, staff’s skill set go underutilized. By siting physicians adjacent to the care team and near the exam room in “flow stations”, the promise of work-life balance can be kept. The team can build the constant communication required to leverage multidisciplinary skill sets effectively, and tasks are shared more equitably and effectively—from reviewing labs to renewing prescriptions.
Flow stations are aggregated to clusters of care team members, all working “in flow” in a collaborative “pod”. Each pod houses team-based work space, supplies, point-of-care testing space, and the flow stations for each care team. Combined with easy access to exam rooms and total privacy from the patient-facing side of the practice, the concept is that care teams can remain in flow inside their pods for 80% of their day. This geographic proximity improves collaboration (frequent mini huddles instead of pinging emails back and forth all day) and increases personal connections among team members.
Increase Patient Facing Time
A team-based care model alleviates the physicians’ workload by re-allocating tasks to appropriate team members. These improvements result in more patient-facing time and higher quality care for the patient as well as increased job satisfaction for the physician and team. Teams have seen staff retention improve from a steady average of 14% turnover before renovation to 10% in the 12 months post the rollout of team-based care.
Team-Based Flow Stations
A team-based care model alleviates the physicians’ workload by re-allocating tasks to qualified team members. These improvements result in more patient-facing time and higher quality care for the patient as well as increased job satisfaction for the physician and team. Teams have seen staff retention improve from a steady average of 14% turnover before renovation to 10% in the 12 months post the rollout of team-based care.
Cultural readiness is the final piece of this care model transition that health systems should pause to consider. Moving clinics into team-based care requires a shift in the way providers and staff think and behave. To fully take advantage of the opportunity of team-based care, engage staff early and often in the design process.
Recommended strategies for building buy-in with staff during the design process involve:
Frame the current problem to make the need (the “why”) behind the change clear:
- Operational assessments (e.g., time studies, value stream maps, EMR data analysis)
- Qualitative patient feedback (e.g., surveys, interviews, focus groups)
- Qualitative staff feedback (e.g. town hall meetings, workshops, surveys)
- Mission, vision, and core value resonance testing
Codesign and sprint workshops to engage staff in designing and improving their future:
- Engage key stakeholders in standardizing key processes, such as vitals
- High-quality huddles and handoffs between MAs and MDs
- Design visual indicators for intuitive, frequent communication between MAs and MDs (e.g., room status flags)
- Build skill-task matrices with staff to ensure all staff are empowered to work at the top of their license
Piloting and testing to lessen the learning curve
- Simulation of workflows via computer models and Legos to raise awareness about the roles and responsibilities of each care team member
- Cardboard mock-ups of the new design for teams to test what it will be like to work in the new space
LENS Strategy is an innovation strategy consultancy that takes a design approach to solving complex challenges related to strategic planning, customer experience, and operational planning.