Team-Based Health Care Delivery 1) Write a paper (1,2001,500 words) that discusses the team-based approaches to the delivery

of health services. The focus of the paper should be one type of health care environment, such as a hospital, primary care, or long-term care facility. 2) Within your paper, be sure to do the following: a) Present a patient case (this does not need to be detailed). b) Describe the team that would deliver care and their individual roles. c) Identify and describe the indicators and determinants of health that would influence or impact this case. d) Describe the impact this team-based approach would have on management and line staff. e) Provide an analysis of key financial and resource savings for consumers and insurance companies as they apply to this model. f) From a leadership position, explain the advantages of using a team-based approach. 3) Your paper should contain the following parts: a) Introduction b) Body paragraphs (possible headings: Case Description, Health Care Delivery Team, Indicators and Determinants of Health, Financial and Resource Analysis, Team-Based Approach Advantages) c) Conclusion 4) Use the GCU eLibrary to seek and include at least two peer-reviewed sources. 5) Refer to the "GCU Academic Writing Guidelines Resource," located within the Additional Resources folder in Canyon Connect. 6) Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. 7) This assignment uses a grading rubric that can be viewed at the assignment's drop box. 8) Be prepared to present a rough draft of your Team-Based Health Care Delivery paper for peer review at the beginning of Module 7. 9) Submit the final draft of the assignment to the instructor by the end of Module 8.

RESEARCH

The Care Team The care team, the second level of the health care system, consists of the individual physician and a group of care providers, including health professionals, patients family members, and others, whose collective

efforts result in the delivery of care to a patient or population of patients. The care team is the basic building block of a clinical microsystem, defined as the smallest replicable unit within an organization [or across multiple organizations] that is replicable in the sense that it contains within itself the necessary human, financial, and technological resources to do its work (Quinn, 1992). In addition to the care team, a clinical microsystem includes a defined patient population; an information environment that supports the work of professional and family caregivers and patients; and support staff, equipment, and facilities (Nelson et al., 1998). Ideally, the role of the microsystem is to standardize care where possible, based on best current evidence; to stratify patients based on medical need and provide the best evidence-based care within each stratum; and to customize care to meet individual needs for patients with complex health problems (Ferlie and Shortell, 2001). Most health and medical services today, however, are not delivered by groups or teams. The role and needs of individual physicians have undergone changes parallel to those of individual patients. The exponential increase in medical knowledge, the proliferation of medical specialties, and the rising burden of providing chronic care have radically undercut the autonomy of individual physicians and required that they learn to work as part of care teams, either in a single institution/organization or across institutional settings. The slow adaptation of individual clinicians to team-based health care has been influenced by several factors, including a lack of formal training in teamwork techniques, a persistent culture of professional autonomy in medicine, and the absence of tools, infrastructure, and incentives to facilitate the change. To participate in, let alone lead and orchestrate, the work of a care team and maintain the trust of the patient, the physician must have on-demand access to critical clinical and administrative information, as well as information-management, communication, decision-support, and educational tools to synthesize, analyze, and make the best use of that information. Moreover, to deliver patient-centered care (i.e., care based on the patients needs and preferences), the physician must be equipped and educated to serve as trusted advisor, educator, and counselor, as well as medical expert, and must know how to encourage the patients participation in the design and delivery of care. At the present time, precious few care teams or clinical microsystems are the primary agents of patient-centered clinical care. Unwarranted variations in medical practice are common, even for conditions and patient populations for which there are standard, evidence-based, patient-stratified best practice protocols (McGlynn et al., 2003; Wennberg et al., 1989). Even though many clinicians now accept the value of evidence-based medicine and recognize that they cannot deliver evidence-based care on their own, they are many barriers to their changing accordingly: the guild structure of the health care professions; the absence of training in teamwork; the strong focus on the needs of individual patients as opposed to the needs of patient populations; and the lack of supporting information tools and infrastructure. All of these can, and do, prevent systems thinking by clinicians, the diffusion of evidence-based medicine, and the clinical microsystems approach to care delivery. Thus, tailoring evidence-based care to meet the needs and preferences of individual patients with complex health problems remains an elusive goal. For care teams to become truly patient-centered, the rules of engagement between care teams and patients must be changed. Like individual care providers, the care team must become more responsive to the needs and preferences of patients and involve them and their families (to the extent they desire) in the design and implementation of care. Care teams must provide patients with continuous, convenient, timely access to quality care. One member of the care team must be responsible for ensuring effective communication and coordination between the patient and other members of the care team.

Dr. Craig Kuziemsky Assistant Professor

TEAM-BASED HEALTHCARE DELIVERY Telfer School professor embarks on study to improve performance of interdisciplinary healthcare teams

Healthcare delivery today is really team based care. Unlike the one patient-one provider relationship that characterized most healthcare systems since antiquity, current practice is defined by teams of providers made up of professionals from various disciplines. No one has a firmer grasp on the promise and potential pitfalls of this modern approach to healthcare delivery than Dr. Craig Kuziemsky. Current treatments enable patients with chronic illnesses such as diabetes, emphysema and even cancer to live longer than ever before, says the Telfer School professor. But to be truly effective against these and other longstanding and recurring conditions, these treatments must be administered by interdisciplinary teams whose members are in a position to share information and implement care processes quickly, seamlessly and reliably. As an example, Dr. Kuziemsky points to the care given to people suffering from diabetes. Each of these patients relies on a primary physician, nurse, pharmacist and dieticianall of whom may operate out of different kinds of facilities: hospitals, pharmacies, private homes and community-care clinics. One problem. While most processessuch as the supply chains that fuel international commercecan be easily systematized, there is no model that represents the various information sources and work processes used in team-based healthcare. Thats about to change. Dr. Kuziemsky recently received a $115,000 grant from the Natural Sciences and Engineering Research Council of Canada to develop a methodology that integrates the diverse information flows and work processes of interdisciplinary teams. He says that, although his research focuses on healthcare, findings will be applicable to all processes in which groups of professionals from disparate fields must collaborate closely. This research will enable me to create a methodological approach for modelling interdisciplinary teams, he says. Ill then use that model to develop an information system that integrates diversified information flows and processes used not only by interdisciplinary teams in healthcare, but also by those involved in other complex industrial processes and in research and development. Dr. Kuziemsky will achieve his goal by following a three-phase research process. First, hell study current research literature to identify concepts and models of team-based healthcare and the kinds of information and processes these teams use. Second, hell delve deeply into how these teams function in diverse care environmentsfrom oncology to intensive and palliative careto develop an information system tailored to the unique demands of team-based healthcare delivery. The third stage will be devoted to simulation testing and evaluation of that system. By the time we finish this five-year project, well have a robust model that fits into the strategic plans of health-integration networks throughout Ontario, he says. Even more importantly, well give healthcare teams in the province a tool they can use to reduce redundancies, lower the likelihood of medical error and improve patient care.