A physician practice without a team, in the modern health care environment, is no longer effective. Under the direction of a physician, a team can deliver better care, finish work in a more time-effective manner and make it possible for patients to access care more promptly.
For practices that involve residents in clinics, effective teams can provide high quality of care to a panel of patients and train future physicians to work effectively and efficiently. Benefits to involving residents in a physician-led team include greater staff and patient satisfaction as well as better performance on quality metrics when residents participate in improvement projects.
Physicians and their organizations can learn more about the organizational changes needed to incorporate team-based care into resident clinics through a recently published AMA STEPS Forward™ module.
The AMA STEPS Forward open-access modules offer innovative strategies that allow physicians and their staff to thrive in the new health care environment. These courses can help you prevent physician burnout, create the organizational foundation for joy in medicine and improve practice efficiency.
This free online module provides a list of six key steps to successfully engage residents in outpatient team-based care.
Assess your current practice state
To design an ideal team that includes residents, it makes sense to start by understanding your existing resources. That means accounting for all team members—residents, faculty, advanced practice providers, nurses, pharmacists, behavioral health specialists, social workers, medical assistants, and front desk staff—and their associated skill sets.
Create a curriculum for the residents
The curriculum should touch on the basics of team structure and team function. To reinforce those concepts, it is wise to have them shadow team members to understand the work they do and how they can aid it as a physician. Residents can also benefit from a curriculum that has didactic presentations, quality improvement projects, care team conferences and education provided by non-physician team members.
Create core and extended teams
Your ideal model should include several core teams that are based on the number of team members, their skillsets and patient needs. Key considerations in designing your teams include the number of patients residents can realistically see in a half day, the number of teams you’ll need to create, and gaps in process that need to be filled.
Set team schedules
The composition of each team will likely need to be refined based on a number of factors such as the size of a team’s patient panel and available resources. To optimize workflow, clinicians should be scheduled equally across clinic sessions and days. Having an ample supply of clinicians available each day will keep teams intact. For resident scheduling, it helps to plan far head to assure they are in a clinic on a predictable schedule without much variability.
Prioritize team stability
Having the same team members working together each day enhances stability. This is a major challenge for teaching practices that work with residents. It requires creating schedules that prevent team members and patients from being shifted away from their primary team.
Tracking how often teams work together consistently, and adjusting schedules to make that more common, can improve stability. While it is difficult to pair a single resident with a single medical assistant, teaching clinics have found stability by pairing residents with a group of two or three medical assistants to offer some team cohesion.
Promote team engagement
Because residents need to be away from clinic in many other settings as part of their training, this can be a challenge. Some programs begin training with a clinic orientation, during which residents spend extra time in clinic at the outset of residency to learn about the roles of their team members and how they will function in the clinic as resident providers.
Other programs schedule days throughout training when residents engage in clinic-related tasks that extend beyond direct patient care.
The CME module, “Team-Based Care in Resident Clinics,” is enduring material and designated by the AMA for a maximum of 0.5 AMA PRA Category 1 Credit
.
The module is part of the AMA Ed Hub
Learn more about AMA CME accreditation.
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February 04, 2020 at 08:00PM
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Resident clinics: 6 keys to training up on team-based care - American Medical Association
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