team based care
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2022 ◽  
Author(s):  
Shannon L. Sibbald ◽  
Vaidehi Misra ◽  
Madelyn daSilva ◽  
Christopher Licskai

Abstract Background: In Canada, there is widespread agreement about the need for integrated models of team-based care. However, there is less agreement on how to support the scale-up and spread of successful models; there is limited empirical evidence to support this process in chronic disease management. We studied the supporting, and mitigating factors required to successfully implement and scale-up an integrated model of team-based care in primary care.Methods: We conducted a collective case study using multiple methods of data collection including interviews, document analysis, living documents, and a focus group. Our study explored a team-based model of care for chronic obstructive pulmonary disease (COPD) known as Best Care COPD (BCC) that has been implemented in primary care settings across Southwestern Ontario. BCC is a quality improvement initiative that was developed to enhance the quality of care for patients with COPD. Participants included healthcare providers involved in the delivery of the BCC program. Results: We identified several mechanisms influencing the scale-up and spread of BCC and categorized them as Foundational (e.g., evidence-based program, readiness to implement, peer-led implementation team), Transformative (adaptive process, empowerment and collaboration, embedded evaluation), and Enabling Mechanisms (provider training, administrative support, role clarity, patient outcomes). Based on these results, we developed a framework to inform the progressive implementation of integrated, team-based care for chronic disease management. Our framework builds off our empirical work and is framed by local contextual factors. Conclusions: This study explores the implementation and spread of integrated team-based care in a primary care setting. Despite the study’s focus on COPD, we believe the findings can be applied in other chronic disease contexts. We provide a framework to support the progressive implementation of integrated team-based care for chronic disease management.


2022 ◽  
Vol 38 ◽  
pp. 17-25
Author(s):  
Kelly Powers ◽  
Shanti Kulkarni ◽  
Andrew Romaine ◽  
Dulce Mange ◽  
Caleb Little ◽  
...  

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 763-763
Author(s):  
Kristine Talley ◽  
Marla Berg-Weger ◽  
Devita Stallings ◽  
Teresa Schicker ◽  
Laura Pesja ◽  
...  

Abstract Developing positive learning experiences in team-based geriatric care is challenging. This presentation will highlight an inter-University geriatric case competition for developing interprofessional competencies in health professional students sponsored by the Geriatric Workforce Enhancement Programs at Saint Louis University and the University of Minnesota. The virtual competition involved teams of 4-5 undergraduate and graduate students from multiple health professions who designed a comprehensive care plan using a simulated complex geriatric patient case. Students were assigned to an interprofessional team with a faculty or community expert coach, attended an orientation, and developed a 20-minute recorded presentation. A panel of judges rated team presentations using a scoring rubric based on the Core Competencies for Interprofessional Collaborative Practice. Local competitions included a first and semi-final round, with the winning teams presenting at the inter-university competition held via live videoconferencing that involved a question-and-answer session. Prizes were given to the top teams. Students, coaches, and judges completed evaluation surveys focused on satisfaction with the competition format/procedures and achievement of interprofessional competencies. Twenty-one teams and 117 students from 12 disciplines participated. Team scores ranged from 2.2 to 4.3 (overall mean 3.1) on a 1-5 scale. Judge, coach, and student evaluations were positive, indicating students learned valuable lessons in group dynamics, team-based care, and geriatric care. Most students (82%) preferred the virtual competition format or had no preference on format. The virtual case competition provided a positive, engaging experience to introduce health professional students to geriatric team-based care and develop their readiness for collaborative practice.


2021 ◽  
pp. 143-153
Author(s):  
Lynette Lester ◽  
Benson Njuguna ◽  
Rajesh Vedanthan

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Leah L. Zullig ◽  
Mohammad Shahsahebi ◽  
Benjamin Neely ◽  
Terry Hyslop ◽  
Renee A. V. Avecilla ◽  
...  

Abstract Background As treatments for cancer have improved, more people are surviving cancer. However, compared to people without a history of cancer, cancer survivors are more likely to die of cardiovascular disease (CVD). Increased risk for CVD-related mortality among cancer survivors is partially due to lack of medication adherence and problems that exist in care coordination between cancer specialists, primary care physicians, and cardiologists. Methods/Design The Onco-primary care networking to support TEAM-based care (ONE TEAM) study is an 18-month cluster-randomized controlled trial with clustering at the primary care clinic level. ONE TEAM compares the provision of the iGuide intervention to patients and primary care providers versus an education-only control. For phase 1, at the patient level, the intervention includes video vignettes and a live webinar; provider-level interventions include electronic health records-based communication and case-based webinars. Participants will be enrolled from across North Carolina one of their first visits with a cancer specialist (e.g., surgeon, radiation or medical oncologist). We use a sequential multiple assignment randomized trial (SMART) design. Outcomes (measured at the patient level) will include Healthcare Effectiveness Data and Information Set (HEDIS) quality measures of management of three CVD comorbidities using laboratory testing (glycated hemoglobin [A1c], lipid profile) and blood pressure measurements; (2) medication adherence assessed pharmacy refill data using Proportion of Days Covered (PDC); and (3) patient-provider communication (Patient-Centered Communication in Cancer Care, PCC-Ca-36). Primary care clinics in the intervention arm will be considered non-responders if 90% or more of their participating patients do not meet the modified HEDIS quality metrics at the 6-month measurement, assessed once the first enrollee from each practice reaches the 12-month mark. Non-responders will be re-randomized to either continue to receive the iGuide 1 intervention, or to receive the iGuide 2 intervention, which includes tailored videos for participants and specialist consults with primary care providers. Discussion As the population of cancer survivors grows, ONE TEAM will contribute to closing the CVD outcomes gap among cancer survivors by optimizing and integrating cancer care and primary care teams. ONE TEAM is designed so that it will be possible for others to emulate and implement at scale. Trial registration This study (NCT04258813) was registered in clinicaltrals.gov on February 6, 2020.


BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e054900
Author(s):  
Harrison Gao ◽  
Marie-Lee Yous ◽  
Denise Connelly ◽  
Lillian Hung ◽  
Anna Garnett ◽  
...  

IntroductionCOVID-19 has necessitated greater adoption of virtual care (eg, telephone (audio), videoconference) delivery models. Virtual care provides opportunities for innovative practice in care planning with older persons and meaningful family engagement by synchronously involving multiple care providers. Nevertheless, there remains a paucity of summarising evidence regarding virtual team-based care planning for older persons. The purpose of this scoping review is to summarise evidence on the utilisation of virtual team-based care planning for older persons in formal care settings. Specifically, (1) what has been reported in the literature on the impact or outcomes of virtual team-based care planning? (2) What are the facilitators and barriers to implementation?Methods and analysisThis scoping review will follow a rigorous and well-established methodology by the Joanna Briggs Institute, supplemented by the Arksey & O’Malley and Levac, Colquhoun, & O’Brien frameworks. A three-step search strategy will be used to conduct a search on virtual team-based care planning for older persons in formal care settings. Keywords and index terms will be identified from an initial search in PubMed and AgeLine, and used to conduct the full search in the databases PubMed, EMBASE, CINAHL, AgeLine, PsycInfo and Scopus. Reference lists of included articles and grey literature retrieved through Google and Google Scholar will also be reviewed. Three researchers will screen titles and abstracts, and will conduct full-text review for inclusion. Extracted data will be mapped in a table.Ethics and disseminationResearch ethics approval is not required for data collection from publicly accessible information. Findings will be presented at conferences, submitted for open-access publication in a peer-reviewed journal and made accessible to multiple stakeholders. The scoping review will summarise the literature on virtual team-based care planning for the purpose of informing the implementation of a virtual PIECES™ intervention (Physical/Intellectual/Emotional health, Capabilities, Environment, and Social).


2021 ◽  
Vol 12 ◽  
Author(s):  
Jennifer S. Funderburk ◽  
Julie Gass ◽  
Robyn L. Shepardson ◽  
Luke D. Mitzel ◽  
Katherine A. Buckheit

Even with the expansion of primary care teams to include behavioral health and other providers from a range of disciplines, providers are regularly challenged to deliver care that adequately addresses the complex array of biopsychosocial factors underlying the patient's presenting concern. The limits of expertise, the ever-changing shifts in evidence-based practices, and the difficulties of interprofessional teamwork contribute to the challenge. In this article, we discuss the opportunity to leverage the interprofessional team-based care activities within integrated primary care settings as interactive educational opportunities to build competencies in biopsychosocial care among primary care team members. We argue that this approach to learning while providing direct patient care not only facilitates new provider knowledge and skills, but also provides a venue to enhance team processes that are key to delivering integrated biopsychosocial care to patients. We provide three case examples of how to utilize strategic planning within specific team-based care activities common in integrated primary care settings—shared medical appointments, conjoint appointments, and team huddles—to facilitate educational objectives.


2021 ◽  
pp. JNM-D-21-00023
Author(s):  
Denise C. Smith ◽  
Lori Trego ◽  
E. Brie Thumm

Background and PurposeTeam-based care has been proposed as a means of improving maternity care in the United States.MethodsThe study evaluated the individual and group-level psychometric properties of the Collaborative Practice Scale (CPS) among 108 midwives and physicians who provided team-based care in military hospitals.ResultsPsychometric properties of the CPS included Cronbach’s alpha of .98. Internal consistency was measured with item-to-total correlations from .83 to .94 and inter-item correlations from .71 to .88. Principal components analysis resulted in a single-factor loading, accounting for 80% of total variance. Properties of the scale at the group level; strong within team agreement (rwg(j) = .94) and between team variance (ICC1 = .15, ICC2 = .65).ConclusionThe CPS demonstrated reliability and validity of the instrument at the individual and group levels. The collaborative process can be measured among midwife-physician teams.


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