Private Practices

Private practice: How to make the most of your care team’s meetings


Busy practices often struggle to communicate about general processes that are outside the scope of day-to-day patient care. Face-to-face interaction between care teams can be one of the first sacrifices a practice makes to spend more time with patients. But reducing meaningful, in-person interactions can negatively impact patient care.

AMA Moving Medicine Podcast

AMA Moving Medicine highlights innovation and the emerging issues that impact physicians and public health today.

In an episode of the “AMA Moving Medicine” podcast, AMA Chief Experience Officer Todd Unger is joined by Christine Sinsky, MD, to review how to conduct effective team meetings. Dr. Sinsky is the AMA’s vice president of professional satisfaction.

Below is a lightly edited full transcript of their conversation. You can tune in on Apple Podcasts, Google Play or Spotify and follow along with the STEPS Forward™ module at the AMA Ed Hub™.

Unger: I'm really excited to talk to you today about conducting effective team meetings, because I know that you’ve got a lot of expertise in this area.

Dr. Sinsky: Thank you, Todd. It’s a pleasure to speak with you today.

Unger: First off, why is it important to conduct team meetings?

Dr. Sinsky: One of the most important things to delivering excellent health care is to a have strong relationship—strong relationships with our patient, but also strong relationships among the team. And teamwork really makes a difference in the type of care that patients receive. By having regular team meetings, the people who are doing the work together can refine and improve the work together. It's the way that teams become more efficient and become more effective. It's how we get to act like a well-oiled machine together.

I think it's important for every member of the team to have a say in how the work is done. And team meetings provide that protected time away from the hustle and bustle of the daily work to step back and think about how you do this most efficiently, and to hear from every person's perspective how that particular workflow will work best from their perspective, and then collectively how it will work best.

The first steps in conducting effective team meetings are to first pick a time, and for many practices, it's best to do this on the clock so that you give the message to all involved that this is important work and that they are actually being paid for this important work.

It's also important to have the right people present. You don't want a huge team of all the physicians and staff that are in a particular division, but rather the team of people who are actually working closely together day by day. Typically, it's one or two physicians and the associated medical assistants or nurses who are with them. And then also an administrator—someone who can connect the work that's being done at the team meeting to the work that's being done at the larger organization. That administrative person is also important because they can help to break down barriers that the team might otherwise face in implementing a new practice.

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Unger: What sort of ground rules should be set for team meetings?

Dr. Sinsky: One is to start on time and end on time. Just know it's worthwhile to show up on time if the meeting's going to start right away. And people have other things to do in the day, so it's important to end the meeting when you anticipate it. I also think it's important that everyone come and be present at the meeting, and that typically means putting your devices aside and giving your whole attention to the people who are present.

It's important to have a leader for that meeting. I think it's a good idea to spread the responsibility around. That is … one week it may be one of the medical assistants, another week it may be one of the nurses, another week it may be one of the physicians who is taking that leadership role for running the meeting. That's another way of communicating that everyone's voice is important. It's also important that the leader keep the conversation going and follow the time on the agenda so that one topic doesn't take over the entire time of the meeting.

Another ground rule that I think is important, both at team meetings and in our daily work, is to focus on the process rather than the person. If there's a broken process, I think it's human nature to sometimes blame the person who's associating with that process.

Finally, I think it's important that we set the culture through the team meeting. And that culture is one of support for each other. It's one of having fun. It's one of gratitude. And so there are ways to build in mechanisms where you do express gratitude to each other, where you do have fun together as a team.

Unger: What would you recommend in terms of a meeting agenda to accomplish those goals and ground rules?

Dr. Sinsky: I think it's really important to have a standard agenda template that everyone can rely on. A typical agenda template would include a check-in time where people can go around and very briefly say something about their life outside of medicine, outside of their work. That's a way we get to know each other a little bit better, and it's also a time to share something that was really exciting that had happened in your life so others can help you celebrate, or to let people know that you're under an unusual amount of stress. That allows your coworkers to support you throughout the day.

It's also a good idea to have a time to celebrate good work within the team, to have a shoutout for something that went well. So, if a patient wrote in a letter of thanks to the organization or if one co-worker noticed another co-worker going the extra mile, it's a time you can recognize that extra work or that good work that you saw your colleagues doing.

Then I think it's important to have a check-back time—a time where you look back at the decisions you made at the last meeting and follow through on those, so that people know that the meeting mattered, that the things that were decided upon have actually had follow-through. This is a particularly important time for the administrative person who is part of the team to be able to come back to the team and say, "I've checked on this policy and we were able to determine that this particular workflow is consistent with that policy." Team members need to know that the time they spent together was valuable.

Then there's an item for new business. This is where you might say, "We've noticed this particular process needs to be refined, and so today we're going to talk about how to refine the check-in process." And then that's the new business for the day. That's the particular workflow that people are going to strategize on and put their minds together on.

In my own practice, we often follow with an educational session, 10 minutes or so, where, typically, one of the physicians will report to the rest of the group about a clinical advance that the group will want to know about, like new screening recommendations or a new approach to hypertension. And I found that our staff really want to continue to update their medical knowledge and [they] find that a very valuable component of our team meeting.

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Unger: What are some things to consider while running the meeting?

Dr. Sinsky: While running the meetings, I think it's important to have a level of respect for each individual—to threaten the hierarchy, if you will—and make sure that people who are traditionally reporting to others realize that they have an equal voice. That way, a medical system has an equal voice in the process, as does the nurse practitioner, as an example.

I think it's also important to recognize that this is not a time for a complaint session, but this is a problem-solving session. If someone brings a concern, the leader's responsibility is to also help pull out from that person, “What are your suggestions for how we might begin to solve that problem?”

Finally, to be most effective, team meetings have to show that they have been impactful, and for this it's important to record the decisions that were made, to identify who the owner is of that decision, what the next steps are going to be and what the due dates are for those next steps so that there's clarity that each person knows their role and responsibilities.

And then those decisions and action steps get added to the next meeting's agenda under the check-back. Again, that gives people the sense that their work has been meaningful. There are some great habits that can make meetings more productive and can actually help to strengthen the culture that’s developed through the team meeting.

One is to have the discipline to stay on task. When you're discussing through to the planning, you may find that one or two people have some other ideas that are tangentially related to that. It's important for the leader to say, "That's a really important idea. Let's put that to the side for now. We'll add it to our agenda for a future meeting." And that allows people to know that their idea was heard and recorded, but it allows the group to focus on the agenda for today and not get derailed by a side issue.

It's important that there be one conversation during the team meeting, and that side conversations are kept to a minimum. When two people who are sitting side by side start to have a sidebar conversation, that's distracting to the group, and it's incumbent on the leader of that meeting to ask those two people to bring that conversation into the larger group.

Unger: Do you have any final thoughts or tips about conducting effective team meetings?

Dr. Sinsky: One of the most meaningful aspects of our team meetings is a standing agenda item that we've added in the last year or two called "In Memorial." During that time, we recognize patients from our practices who have died. It's a time where the nurses, the medical assistants and the physicians are able to reflect and think back about that individual person. People will share stories about that person, and it's really a way to honor the person that has entrusted us with their care. It's a way for us to respect them and to give thanks, really, that we were able to have them as part of our lives and be part of their lives for their care.

You can find more episodes of Moving Medicine and other AMA podcasts at Apple Podcasts, Google Play or Spotify.