Team-Building Processes for Enhancing Team Collaboration in Family Medicine Clinics

No longer recruiting at 4 trial locations

Overseen By Katherine J Gold, MD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Michigan

Disqualifiers: Administrative director, dietician, social worker, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to improve teamwork among staff members in family medicine clinics. The goal is to enhance collaboration among medical assistants, nurses, clerical staff, and clinicians such as doctors and nurse practitioners. Staff at five Michigan Medicine clinics will participate in team-building activities designed to improve collaboration and communication. Those in these roles at the University of Michigan clinics may be a good fit. As an unphased trial, this study offers a unique opportunity for staff to contribute to better clinic operations and patient care.

Will I have to stop taking my current medications?

The trial does not specify whether participants need to stop taking their current medications.

What prior data suggests that these team-building processes are safe for clinic staff?

Research has shown that team-building activities in healthcare are generally safe for everyone involved. These activities enhance teamwork and the quality of care, leading to better outcomes for both staff and patients. Patients and their families have rated team collaboration highly, with scores around 5 out of 6, indicating strong satisfaction.

No reports of negative effects from these team-building activities exist. Designed to improve communication and cooperation among clinic staff, they are unlikely to cause harm. Overall, these activities are well-received and aim to create a more efficient and happier workplace. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about these team-building processes because they aim to enhance collaboration among clinic staff, which is different from traditional treatment options that focus solely on medical interventions. Unlike standard practices that might involve individual training or top-down directives, this approach encourages staff to work together more effectively through "project champions" who guide the implementation. By focusing on teamwork, the trial hopes to improve not just the workplace environment but also patient care outcomes, making it a promising avenue for boosting overall clinic performance.

What evidence suggests that team-building processes are effective for enhancing team collaboration in family medicine clinics?

Research has shown that team-building activities can enhance teamwork in family medicine clinics. Studies have found that teamwork makes healthcare more efficient and accessible, improves care quality, and increases healthcare provider satisfaction. This trial will explore these team-building processes, with all participants in a single arm divided by clinic. This approach fosters better communication and cooperation among staff, addressing any power imbalances that might affect teamwork. Evidence from healthcare settings suggests that effective teamwork improves patient care and increases staff satisfaction. These findings support the idea that team-building can lead to better outcomes in family medicine clinics. ^{1 3 4 6 7}

Who Is on the Research Team?

Katherine Gold, MD

Principal Investigator

University of Michigan

Are You a Good Fit for This Trial?

This trial is for medical assistants, nurses, clerical staff, and clinicians (physicians, nurse practitioners, physician assistants) working at one of five specific family medicine clinics at the University of Michigan. It excludes administrative clinic directors and professionals like dieticians, social workers, or pharmacists.

Inclusion Criteria

Staff in the roles of medical assistant, nurse, clerical staff, or clinician (physician, nurse practitioner, and physician assistant) must work in one of five family medicine clinics at the University of Michigan.

Exclusion Criteria

Administrative clinic director at each site (managerial)

Staff outside of the above roles such as a dietician, social worker, pharmacist

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Staff meet to discuss and negotiate tasks to improve collaboration, followed by implementation and coordination with leadership.

12 months

Multiple meetings and ongoing coordination

Ongoing Process Improvement

Continuous process improvement through surveys and feedback to ensure success and address challenges.

6 months

Follow-up

Participants are monitored for satisfaction, team compassion behavior, team development, participation effort, and burnout.

6 months

What Are the Treatments Tested in This Trial?

Interventions

• Team-building processes

Trial Overview The study is testing team-building processes designed to enhance collaboration among different job roles within family medicine clinics. The goal is to improve teamwork in a healthcare setting.

How Is the Trial Designed?

Group I: Survey participants Experimental Treatment 1 Intervention

All participants in the study will be in a single arm, divided by clinic.

Group II: Clinic Staff Active Control 1 Intervention

"Project champions" at each clinic who are helping to implement the project.

Who Is Running the Clinical Trial?

University of Michigan

Lead Sponsor

Trials

1,891

Recruited

6,458,000+

Published Research Related to This Trial

The study developed and validated a new instrument to measure teamwork behaviors in critical care teams, consisting of 23 observable items that assess three key factors: Leadership and Team Coordination, Mutual Performance Monitoring, and Verbalising Situational Information.

The instrument demonstrated strong internal consistency and construct validity, with a Generalisability coefficient of 0.78, indicating it can effectively evaluate teamwork interventions in healthcare settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluation of an instrument to measure teamwork in multidisciplinary critical care teams. Weller, J., Frengley, R., Torrie, J., et al.[2015]

A new curriculum for Family Medicine residencies has been developed to teach essential teamwork skills, emphasizing the importance of interdisciplinary collaboration in primary care reform.

The curriculum includes workshops, experiential learning, and coaching, aiming to transform residents' perceptions of medicine and improve patient relationships, although challenges such as resource allocation and cultural integration remain.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Teaching team membership to family medicine residents: what does it take? Eubank, D., Orzano, J., Geffken, D., et al.[2011]

A scoping review of 32 studies identified three key structural components essential for family physicians' (FPs) successful collaboration with other healthcare organizations: shared vision/values, leadership by FPs, and defined decision-making procedures.

The review also highlighted three important processes for effective collaboration: effective communication, a collective motivation for change, and trust-based relationships, which are crucial for integrated healthcare networks like Ontario Health Teams.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Family physicians collaborating for health system integration: a scoping review. Grady, C., Han, H., Kim, DH., et al.[2023]

The implementation of a team-based approach in a family medicine residency clinic significantly improved job satisfaction, learning opportunities, and teaching quality among faculty, residents, and staff over a 5-year period.

Annual surveys indicated that after reorganizing into teams, employees reported better autonomy, clearer staff roles, and more positive attitudes towards residents, suggesting enhanced organizational function.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of implementation of a team model on physician and staff perceptions of a clinic's organizational and learning environments. Roth, LM., Markova, T., Monsur, JC., et al.[2015]

The study involved qualitative interviews with 19 clinicians and staff from 6 primary care clinics, which highlighted the importance of communication patterns and teamwork in improving patient outcomes.

The findings support the SEIPS model as a useful framework for developing and assessing team-based primary care, suggesting that it can help enhance the effectiveness of clinical practices.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A human factors systems approach to understanding team-based primary care: a qualitative analysis. Mundt, MP., Swedlund, MP.[2018]

The establishment of clinical improvement teams in a multi-disciplinary acute healthcare setting led to enhanced collaboration and shared decision-making among staff, which was crucial for team support and successful outcomes.

The development process involved assessing staff skills and experience to align team structure and leadership effectively, highlighting the importance of tailored approaches in healthcare team dynamics.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Designing teams that work. Wake-Dyster, W.[2019]

A qualitative study involving 110 team members from 20 Family Health Teams in Ontario identified 7 key processes that influence the evolution of these teams, including effective leadership and conflict resolution.

The study categorized the evolution status of the teams as evolving, progressing, or stalled, highlighting that change is a constant factor in team dynamics and can be applied to improve other primary health care teams.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Processes that influence the evolution of family health teams. Brown, JB., Ryan, BL.[2019]

A structured approach to team building is essential for enhancing communication and effectiveness among NHS staff, rather than treating it as an additional task.

Through 3 training days, NHS managers improved their understanding of teamwork principles and leadership, which ultimately aimed to enhance patient care during complex organizational changes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Better team management--better team care? Shelley, P., Powney, B.[2019]

The Medication Use Processes Matrix (MUPM) was developed to measure contributions to medication-related processes in family practice, demonstrating good internal consistency (alpha > 0.80) and strong test-retest reliability (ICC > 0.80) based on assessments from 11 healthcare professionals.

Preliminary validation of the MUPM revealed significant differences in how various health professionals perceive their roles in interprofessional care, highlighting the importance of a shared understanding of contributions to enhance collaborative medication management.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Developing a tool to measure contributions to medication-related processes in family practice. Farrell, B., Pottie, K., Woodend, K., et al.[2008]

A multidisciplinary teamwork training program was successfully developed and implemented for internal medicine residents and hospital staff, focusing on communication and teamwork skills to improve patient safety.

The program received positive feedback, with an average rating of 4.49 out of 5, indicating that participants valued the collaborative learning environment and found the training effective.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A multidisciplinary teamwork training program: the Triad for Optimal Patient Safety (TOPS) experience. Sehgal, NL., Fox, M., Vidyarthi, AR., et al.[2022]

The study assessed the implementation of the Global Trigger Tool (GTT) in three German university hospitals, identifying nine feasibility criteria as low-level challenges, while highlighting significant obstacles such as lack of time and staff resources.

Key facilitators for successful GTT implementation included the involvement of local coordinators and external experts, suggesting that early planning and support can help overcome challenges in integrating GTT into clinical practice.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using the Global Trigger Tool in surgical and neurosurgical patients: A feasibility study. Brösterhaus, M., Hammer, A., Gruber, R., et al.[2023]

In a study reviewing 170 patient records, 27.1% showed evidence of harm related to medication use, highlighting a significant safety concern in primary care practices.

The research identified 8 refined triggers that effectively measure patient harm, with a higher odds ratio of 6.3 for harm occurrence, indicating their potential to improve patient safety monitoring.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using triggers in primary care patient records to flag increased adverse event risk and measure patient safety at clinic level. Eggleton, KS., Dovey, SM.[2014]

A comprehensive approach was developed within a hospital to clearly define the entire process for reporting adverse events, enhancing clarity and understanding.

This approach included a pedagogical component aimed at educating teams, which helped to give context and significance to the reporting process.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Coordination of care-related risk management, team experience]. Thirel, C., Cottin, N., Kholladi, F.[2016]

Training health care teams in continuous quality improvement methods led to measurable improvements in patient care and outcomes for 9 out of 25 teams involved in the study.

Successful teams demonstrated better problem-solving abilities, more effective group interactions, and higher levels of physician participation, indicating that these factors contribute to improved patient outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Achieving clinical improvement: an interdisciplinary intervention. Irvine Doran, DM., Baker, GR., Murray, M., et al.[2019]

Collaborative practice teams, made up of various healthcare providers, aim to improve patient outcomes by standardizing clinical practices and reducing care fragmentation.

The article discusses the formation of these teams, the challenges they face, and the importance of interdisciplinary interventions in achieving better health outcomes for targeted populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Collaborative practice teams: the infrastructure of outcomes management. Grady, GF., Wojner, AW.[2019]

Citations

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Perspectives on Team-Based Care in Family Medicine This study examines different healthcare professionals' perspectives on introducing team-based care in family medicine within a hospital setting.

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6361117/

Teamwork in Healthcare: Key Discoveries Enabling Safer ... In this review, we synthesize the evidence examining teams and teamwork in health care delivery settings in order to characterize the current state of the ...

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Team-Building Processes for Enhancing ... Trial Overview The study is testing team-building processes designed to enhance collaboration among different job roles within family medicine clinics. The goal ...

4. aafp.org aafp.org/pubs/fpm/issues/2022/0500/p25.html

Taking Team-Based Care to the Next Level Team-based care is designed to enhance efficiency and access, improve quality of care, and increase satisfaction for all involved in medical care (physicians, ...

5. sciencedirect.com sciencedirect.com/science/article/pii/S0277953625005799

Family physicians' power and team-based care The article focuses on the tension between team-based care approaches that emphasizes interprofessional collaboration and existing power imbalances.

6. sciencedirect.com sciencedirect.com/science/article/pii/S0033350624000398

Teamwork and its impact on chronic disease clinical ... Team-based interventions improve outcomes for chronic diseases, but more research is needed on managing cholesterol, hospitalizations, and chronic obstructive ...

7. bmcprimcare.biomedcentral.com bmcprimcare.biomedcentral.com/articles/10.1186/s12875-021-01406-y

Patient and family views of team functioning in primary ... Patients and families expressed positive perceptions of team functioning (mean 4.97/6 [SD 0.68]) and outcomes of care (5.08/6 [0.74]). Also, ...