Building teams in primary care: A practical guide.
BACKGROUND
Primary care is changing to a team-based model. A number of high-performing primary-care practices in the United States have succeeded in making the transition to team-based care.


METHODS
Site visits were conducted to 29 high-performing primary-care practices. Observations made in these practices were summarized for common elements exhibited by care teams. A limited literature search was done to review corroborating evidence.


RESULTS
Teams observed in the 29 practices were found to exhibit 9 elements: a stable team structure, colocation, a culture shift in progress from physician-driven to team-based care, defined roles with training and skill checks to reinforce those roles, standing orders and protocols, defined workflows and workflow mapping, staffing ratios adequate to facilitate new roles, ground rules, and modes of communication, including team meetings, huddles, and minute-to-minute interaction.


CONCLUSIONS
These 9 elements may be helpful to practices making the transition to team-based care.
Center for Excellence in Primary Care, Department of Family and Community Medicine.
Amireh
A
Ghorob
Center for Excellence in Primary Care, Department of Family and Community Medicine.
Thomas
T
Bodenheimer
D006801:Humans; D007400:Interprofessional Relations; D010348:Patient Care Team / Q000639:trends*; D010361:Patients / Q000523:psychology; D011320:Primary Health Care / Q000379:methods* / Q000639:trends; D014481:United States; D016526:Workload