Team-based care has become widely accepted in primary care as the delivery model that allows for increased support for both providers and patients. In fact, SFHN began transitioning to team-based care with its network of primary care clinics in 2009 with Dr. Tom Bodenheimer’s “teamlet” model and gradually expanding team roles to include nursing, behavioral health, pharmacy and front office. But are our patients aware that they have a care team beyond their primary care provider?
Patients’ relationship with their provider is highly correlated with their reported satisfaction with care. According to Langer (2015), increasing understanding and awareness of a care team and its functions appears to improve patients’ sense of connectedness, a practical route to patient engagement. It’s also been demonstrated that staff members who feel part of a team, with clear roles and responsibilities, are likely to have higher rates of workplace engagement (Cambridge Health Alliance, Union Square in Boston, MA).
User Experience Focus Groups
In 2015, as part of the Patient Advisory Council Collaborative, a series of focus groups were designed with the help of a User Experience Designer to guide the implementation of the new SFHN Primary Care website.
With the intent to involve patients in the design process, discussions with patients about the initial page entitled “What is the team-based care model?” quickly revealed that this group of patients — comprised of experienced Patient Advisors, many of whom have been engaged in care improvement for years — did not understand that their “care team” reached beyond their primary care provider. Even though the SFHN system had transitioned to team-based care, these patients were not familiar with the concept.
For patients receiving care in resident teaching facilities, including patients who receive primary care at San Francisco General Hospital, past focus groups revealed a common complaint about the constant turnover of residents who had established relationships with patients and then, as their training ended, patients were left to start over again with someone new. Improving understanding of the team-based care model seems to have the potential to lead to better continuity in primary care in general and in residency teach programs in particular. In the end, the coordination of an increasingly extensive team to care for patients could be enhanced by increased awareness and understanding on the part of patients and complementary educational and informational tools that enhance understanding and ground expectations.
The Patient Advisory Council Collaborative is founded upon the belief that patient engagement is important in all care experience improvement work. The budding PACs at the 13 SFHN community clinic sites will provide a forum for discussion and a source of patient feedback for initiatives of the SFHN and wider Department of Public Health. Patient insight in this process is invaluable; something as simple as reframing the question from “What is the Team-Based Care Model?” to “Who is my Care Team?” — a change spurred by input from patients —can help reach a wider group of patients.