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Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
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Establishing Teams: How Does It Change Practice Configuration, Size, and Composition?

Alyna T Chien1, Michael Anne Kyle, Antoinette S Peters

  • 1Department of Pediatrics, Harvard Medical School, and Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts (Dr Chien); Harvard Business School, Boston, Massachusetts (Ms Kyle); Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts (Ms Kyle and Mr Nguyen); Department of Population Medicine, Harvard Pilgrim Health Care Institute, and Harvard Medical School, Boston, Massachusetts (Dr Peters); Institute for Community Health, Malden, and Department for Community Health, Tufts University, Medford, Massachusetts (Dr Tendulkar); Harbor Health Services Inc, Dorchester, Massachusetts (Ms Ryan); Allegheny County Health Department, Pittsburgh, Pennsylvania (Dr Hacker); and Department of Medicine, Stanford School of Medicine, California (Dr Singer).

The Journal of Ambulatory Care Management
|February 24, 2018
PubMed
Summary
This summary is machine-generated.

Transitioning to team-based care involves reorganizing practice configurations and staff composition. This study shows that primary care practices can adopt team-based models without significantly altering overall practice size.

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Area of Science:

  • Health Services Research
  • Primary Care
  • Organizational Change

Background:

  • Traditional practice models face challenges in meeting evolving healthcare demands.
  • The shift towards team-based care aims to improve efficiency and patient outcomes.
  • Understanding the organizational shifts during this transition is crucial for successful implementation.

Purpose of the Study:

  • To compare practice-level configuration, size, and composition before and after the implementation of team-based care.
  • To analyze changes in staff roles and team assignments within academic primary care practices.
  • To identify how organizational structures adapt during the transition to team-based care.

Main Methods:

  • A pre-/post-study design was utilized.
  • Data were collected from personnel lists (1571-1711 staff) and practice manager surveys.
  • The study included 18 Massachusetts academic primary care practices over a 2-year period.

Main Results:

  • Establishing team-based care led to significant changes in practice configurations.
  • Practice-level composition, including staff roles and team assignments, was altered.
  • Overall practice size remained substantially unchanged throughout the transition.

Conclusions:

  • Team-based care implementation necessitates adaptable practice configurations and composition.
  • Primary care practices can successfully transition to team-based models by restructuring internally rather than expanding externally.
  • These findings offer insights for healthcare organizations planning similar transitions.