Author Affiliations: Department of Family and Community Medicine, University of California at San Francisco.
Section Editor: Drummond Rennie, MD, Deputy
In health care settings, individuals from different disciplines come
together to care for patients. Although these groups of health care personnel
are generally called teams, they need to earn true team status by demonstrating
teamwork. Developing health care teams requires attention to 2 central questions: who
is on the team and how do team members work together? This article chiefly
focuses on the second question. Cohesive health care teams have 5 key characteristics:
clear goals with measurable outcomes, clinical and administrative systems,
division of labor, training of all team members, and effective communication.
Two organizations are described that demonstrate these components: a private
primary care practice in Bangor, Me, and Kaiser Permanente's Georgia region
primary care sites. Research on patient care teams suggests that teams with
greater cohesiveness are associated with better clinical outcome measures
and higher patient satisfaction. In addition, medical settings in which physicians
and nonphysician professionals work together as teams can demonstrate improved
patient outcomes. A number of barriers to team formation exist, chiefly related
to the challenges of human relationships and personalities. Taking small steps
toward team development may improve the work environment in primary care practices.
Grumbach K, Bodenheimer T. Can Health Care Teams Improve Primary Care Practice?. JAMA. 2004;291(10):1246-1251. doi:10.1001/jama.291.10.1246