A few of my favorite things include:
Fall.
Fall football.
Fall football and buffalo chicken dip.
Fall football and buffalo chicken dip and chili.
And pumpkin spice lattes. One or more may have been consumed in writing this article.
While attending a recent football game, I was struck by the thought of how team-based health care is similar to a team-based sport, and football in particular.
Safe, high-quality care in the Behavioral Health space can be achieved when approached from a team-based perspective. Just as a football game can’t be won with a quarterback or linebacker alone, effective behavioral healthcare can’t be achieved through just one individual. It requires many different players and positions to serve our patients, families and communities.
Team-based care acknowledges that there are multiple key players treating a patient and that each of them must work with one another to drive optimal care outcomes. Members of a care team may include doctors, nurse practitioners, nurses, physician assistants, specialists, social workers and other non-clinical professionals who are integral to caring for a patient, according to a report from the National Academy of Medicine.
“The fundamental concept is that a team is a group of individuals who coordinate their actions for a common purpose, which in health care is the prevention or treatment of disease and the promotion of health,” the NAM authors wrote.
Merriam Webster defines “team” as a group of people who compete in a sport, game, etc., against another group; or a group of people who work together. For the purposes of healthcare, we can define team as a group of people who work together to create better outcomes for our patients. In order for a team to be effective, we must put ego aside and work together for the desired outcome.
So we know that team-based care is ideal, but how do we achieve it? The following five principles – keeping with the fall football theme – are an excellent place to start.
- Shared goals
In Behavioral Health, the treatment plan is essentially the game-plan, individualized for each patient. The team, patient and patient’s support system are involved in the creation of a treatment plan that identifies agreed-upon goals, desired outcomes, and timeframes for achieving those goals and outcomes. It should also include services and supports to be provided, possibilities for maintaining and strengthening relationships, and procedures for identifying crisis or urgent needs.
- Clear roles
At the center of the team is the patient – our focus. When you think of the patient as the football, the team and support system surrounding the ball then come into view:
Offensive line – the patient’s family and community.
Quarterback – the therapist or counselor. These positions are often a patient’s first point of entry into the behavioral health care setting. This role is typically who is seeing the patient the most and who has a considerable amount of influence on outcomes.
Receiver – the medical provider on the team. For patients who are being medically managed, this role is an integral component of an effective offense. The medical provider may be a part of the same internal team or could be external – possibly the patient’s primary care provider.
Athletic Director – the organization’s administration. They remove barriers and help establish parameters around the program to ensure that the team can provide care in the most effective way possible.
Depending on the resources available to the organization and to the patient, there may be other team members as well, but regardless of the team’s size, each member brings different training, knowledge and skills to the table.
- Effective Communication
Just as the huddle is an opportunity on the football field to come together and update the game plan, so too in patient care are formal care coordination conversations required.
Communication between all the positions is paramount to getting to the end zone. This communication starts with the treatment plan and continues through formal care coordination huddles and informal updates when changes are noted.
- Measurable Processes and Outcomes
Achieving the goals identified within the treatment plan is equivalent to reaching the end zone. In order to achieve this, those goals must be specific, measurable, achievable, realistic and time based. Along the way there will be first downs, each signifying a milestone in the patient’s journey. These small steps and forward progress lead to big results in the end.
Due to the nature of mental health, substance abuse disorder and cooccurring conditions, there may be setbacks or turnovers in our treatment plans. But just as in the game of football, this simply requires us to swivel, play defense and adjust the game plan.
- Leadership
Effective team leaders facilitate, coach, and coordinate the activities of other team members. With a strong coach on the field and clear direction, every player is more effective in their role. Through effective leadership and teamwork with communication, there will be more wins than losses.
In the previous two articles we discussed the importance and components of patient and staff engagement. Effective team-based care has many of the same components and benefits. Positive outcomes of operating under a team-based model include:
- More accessible services for patients.
- Enhanced communication and professional diversity.
- Higher patient satisfaction with their care.
- Improved adherence to treatment plan by the patient.
- Improved health outcomes and quality of care.
- Increased job satisfaction among team members.
- Greater role clarity among staff.
Pattie Clay is a Senior Advisor and Management Consultant, leading MMG’s Behavioral Health Practice. Pattie has more than eighteen years of industry experience and a proven track record as a senior leader in the health system environment. MMG is a national provider of consulting services and back office administrative support to independent and system owned physician practice groups.