The transition to team-based care delivers three wins for Bellin Health in Green Bay, Wisconsin: It is immensely satisfying to the care team, patients enthusiastically embrace it and there are significant benefits for the system.
Yet getting started on the long journey with effective team-based care can be a head scratcher. When implementing team-based care, AMA member James Jerzak, MD, emphasized being patient.
Before launching their team-based care prototype, Bellin’s planning team conducted weekly four-hour meetings for a period of four months.
“If you’re jumping too fast, it’s not going to work. We spent four-hour meetings talking about these things on more than one occasion. You just have to take your time,” said Dr. Jerzak, a family physician, during the Team-Based Care Training Camp held by the AMA and Bellin Health in meeting spaces housed in Green Bay’s famed Lambeau Field.
With the mindset that slow and steady wins the race, here are three keys leaders at Bellin followed to implement team-based care and get their staff on board.
Identify long-term goals
Don’t focus on an individual problem, said Kathy Kerscher, team leader of achieving population health through team-based care at Bellin Health. Instead, practices and health systems should be thinking about where they want to be in five or 10 years.
“We had to take an honest look at the frustration of our staff and the underutilized skill sets,” said Kerscher. “I don’t want to discredit burnout because it is important, but that was a specific problem that first surfaced.”
“Then when we were challenged with this design thinking and really looking at what is our future result—where do we want to be again in five to 10 years—it changed us to more of a solution focus,” she added.
Eventually, the team shifted focus to a big-picture focus on improving population health that also alleviated burnout issues.
Create your teams
Determine who will be on your team to focus on this process. Dedicated individuals are extremely important to the success of spreading your team-based care model.
Bellin first created a planning team of four physicians, two advanced practice clinicians (APCs), an executive sponsor, a change leader, a process-improvement officer, a project manager and patient advisor. This team focused on what needed to be done before implementation.
Next was the implementation team, which included a team leader, registered nurse and care coordinator. This team helped with training and implementing team-based care.
Lastly, the pilot team—comprised of the front line staff, physicians, APCs, implementation team and frontline leader—took over what the planning team was creating.
“The most critical part is the planning team,” said Dr. Jerzak. “The only way this will work is you have to have physician buy-in and you have to have administrators bought in. Having both parties at the table planning together is extremely important.”
Prepare team with clear expectations
The implementation team should meet with clinic leadership to review training needs. Try to schedule training sessions early to give as much notice as possible and specify who needs to attend.
With a kick-off meeting, review the rationale for a move to the team-based care model, including internal and external forces driving this change. There needs to be a purpose and data to support it. And make sure to set clear expectations.
“This was our biggest learning experience—we had a lot of internal expectations,” said Kerscher. “We thought this was the best thing since sliced bread, everyone is going to adapt to this, and we’re going to see all of these extra visits. But we didn’t set out those clear expectations.”
It is also important to focus on the stages of team development. Introduce team huddles, care team meetings and discuss team communication tactics. Before going live, run through a typical patient visit to clear up any remaining questions. It will take time to get used to the new roles and responsibilities, so be patient.
The AMA’s STEPS Forward™ collection offers free online modules that help physicians and system leaders improve well-being, including learning about the organizational changes that lead to physician satisfaction and improving practice efficiency. All of the modules have free CME and are accredited for MOC Part II.
Several modules have been developed from the generous grant funding of the federal Transforming Clinical Practices Initiative (TCPI), an effort designed to help clinicians achieve large-scale health transformation through TCPI’s Practice Transformation Networks.
The AMA, in collaboration with TCPI, is providing technical assistance and peer-level support by way of STEPS Forward resources to enrolled practices. The AMA is also engaging the national physician community in health care transformation through network projects, change packages, success stories and training modules.