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

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

400 Participants Needed

Trial Summary

What is the purpose of this trial?

This project includes an intervention in five Michigan Medicine family medicine clinics which is designed to improve staff collaboration across different job roles.

Will I have to stop taking my current medications?

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

What data supports the effectiveness of the treatment Team-building processes for enhancing team collaboration in family medicine clinics?

Research indicates that high-functioning teams in primary care can improve patient outcomes, and team-building processes help staff communicate better and manage teams more effectively, leading to better patient care. ^{1 2 3 4 5}

Is team-building generally safe for use in family medicine clinics?

The research articles provided do not contain specific safety data about team-building processes in clinical settings. ^{6 7 8 9 10}

How does this team-building treatment differ from other treatments for enhancing collaboration in family medicine clinics?

This treatment is unique because it focuses on team-building processes to enhance collaboration in family medicine clinics, rather than traditional medical or pharmaceutical interventions. It involves teaching specific teamwork skills, reframing perceptions of medicine to emphasize relationships, and providing experiential learning opportunities, which are not typically part of standard medical treatments. ^{11 12 13 14 15}

Research Team

Katherine Gold, MD

Principal Investigator

University of Michigan

Eligibility Criteria

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

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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]

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 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]

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]

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]

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]

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]

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]

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 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 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]

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]

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]

References

1. England pubmed.ncbi.nlm.nih.gov

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

2. England pubmed.ncbi.nlm.nih.gov

Better team management--better team care? [2019]

3. Australia pubmed.ncbi.nlm.nih.gov

Designing teams that work. [2019]

4. United States pubmed.ncbi.nlm.nih.gov

Achieving clinical improvement: an interdisciplinary intervention. [2019]

5. United States pubmed.ncbi.nlm.nih.gov

Collaborative practice teams: the infrastructure of outcomes management. [2019]

6. United States pubmed.ncbi.nlm.nih.gov

A multidisciplinary teamwork training program: the Triad for Optimal Patient Safety (TOPS) experience. [2022]

7. France pubmed.ncbi.nlm.nih.gov

[Coordination of care-related risk management, team experience]. [2016]

8. United States pubmed.ncbi.nlm.nih.gov

Using the Global Trigger Tool in surgical and neurosurgical patients: A feasibility study. [2023]

9. England pubmed.ncbi.nlm.nih.gov

Evaluation of an instrument to measure teamwork in multidisciplinary critical care teams. [2015]

10. New Zealand 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. [2014]

11. United States pubmed.ncbi.nlm.nih.gov

Teaching team membership to family medicine residents: what does it take? [2011]

12. England pubmed.ncbi.nlm.nih.gov

Family physicians collaborating for health system integration: a scoping review. [2023]

13. England pubmed.ncbi.nlm.nih.gov

Developing a tool to measure contributions to medication-related processes in family practice. [2008]

14. United States 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. [2015]

15. Canada pubmed.ncbi.nlm.nih.gov

Processes that influence the evolution of family health teams. [2019]