3 ways Cleveland Clinic defeated barriers to team-based care

Since Cleveland Clinic launched team-based care initiatives in 2010, the 4,000-provider health system has overcome challenges for patient care improvements, according to a blog post on the AMA Wire.

In a team-based care model, all members of the physician-led team play a key role in patient care. The physician, nurse practitioner or physician assistant and a team of nurses and/or medical assistants share responsibilities for providing better care.

Cleveland Clinic sees about 250,000 patients annually. The health system's team-based care model was piloted in primary care, but other specialties followed sooner after implementation.

"I became a much better doctor and took better care of my patients because a lot of that care was spread out among multiple caregivers instead of having it rest squarely on my shoulders," said Kevin Hopkins, MD, medical director of the Cleveland Clinic Strongsville Family Health and Ambulatory Surgery Center.

Here are three ways Cleveland Clinic overcame barriers to team-based care to achieve better patient care and improved staff satisfaction:

1. Barrier: patient reluctance. A new care model often leads to patient concerns and conflicts, such as a reluctance to share personal information with an additional staff member. To eliminate these concerns, Dr. Hopkins and his colleagues emphasized the additional staff members were there for the patient's benefit.

"We introduced it in a way that made it feel like this additional person in the care room was there for my benefit and the benefit of the patient," Dr. Hopkins said. "They were there to be an advocate for their care, and an extra set of eyes and ears to make sure that we provide the best care possible."

If patients objected to the extra providers, Dr. Hopkins would say, "Anything that you want to talk about with me, you can talk about with these ladies in the room. They're medical professionals. And not only that, they're kind and compassionate human beings who are also here because they care about you and your health."

2. Barrier: physician apprehension. Physicians may be reluctant to undergo a big change to their practice style, but Dr. Hopkins said physicians should emphasize the aspects of care they find most fulfilling — building relationships with patients and watching their health improve.

"It is managing chronic diseases over time and avoiding complications and bad outcomes," Dr. Hopkins said. "It's about treating acute illnesses and conditions and making people feel better."

3. Barrier: financial concerns. When launching a team-based care model, health system leaders are often concerned about the cost of adding new positions.

To address financial concerns, Dr. Hopkins and his team showed how team-based care improved the quality of practice while reducing physician burnout and turnover. In Dr. Hopkins' practice, for example, seeing one additional patient per half-day session offset the cost of another medical assistant working on his team.

"They started to see the numbers and how this could mean a million dollars in revenue per provider," Dr. Hopkins said. "If we start to spread and scale this, what a difference this makes to us as an organization."

More articles on clinical leadership and infection control: 
Central Florida Health responds to patient care concerns after published complaint
How Johns Hopkins encourages employees to voice patient safety concerns
For-profit hospitals readmit more patients, study finds

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