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The need to delegate tasks to other members of the health care team has never been more urgent. Here's how to move toward advanced team-based care.

Fam Pract Manag. 2022;29(3):25-31

This content conforms to AAFP criteria for CME.

Author disclosures: no relevant financial relationships.

Team-based care is not just another buzzword. It is a model of care delivery that, when done well, can greatly reduce physicians' administrative burden and elevate clinical staff's role, while improving patient experience, quality, and safety.1 While many physicians are likely aware of basic team-based care models, advanced team-based care is a comprehensive, integrated model in which physicians perform only the functions they are uniquely trained and qualified to do, and delegate other tasks to capable staff.

This article builds on the awareness of basic team-based care and aids practices in moving to the “next level” by expanding the team and optimizing its performance. The value of effective teamwork in medicine has never been more widely understood than it is today. Many practices face persistent staffing challenges due to intermittent absenteeism, open positions with few qualified applicants, and caregivers who are exhausted or burned out from the grind of the last two pandemic years. Considering the workload for most primary care physicians was unmanageable even pre-COVID,2,3 we presently find ourselves at a crossroads of circumstance and opportunity.

KEY POINTS

  • Basic team-based care allows physicians to delegate tasks such as agenda setting, history gathering, and record retrieval to nurses or medical assistants, freeing more time for medical decision making.

  • Practices can further enhance team-based care by adding behavioral health professionals, clinical pharmacists, care coordinators, or other providers to the care team.

  • Strategies such as daily huddles, panel management meetings, and synchronized prescription renewals can help teams of any size achieve greater efficiency and better health outcomes.

BASIC TEAM-BASED CARE

Team-based care is designed to enhance efficiency and access, improve quality of care, and increase satisfaction for all involved in medical care (physicians, employees, and patients).1,4,5 The physician leads the care team in building relationships with patients, interprets available data, and performs medical decision making, while delegating other tasks.

Engaged, capable, and well-trained clinical staff such as medical assistants (MAs), registered nurses (RNs), and licensed practical nurses (LPNs) are key to successful team-based care. Nurses and MAs can take on many tasks previously performed by physicians, including agenda setting, history gathering, record retrieval, EHR navigation, updating charts, medication review, data entry, order entry, and the bulk of required visit documentation.1,4,5 (See “Tasks physicians may delegate to clinical support staff.”) When the clinical team completes documentation collectively, the quality of the notes can be as good or better than when the physician does it alone.6

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