3.4.c Principles of Team-Based Care

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Establishing and maintaining high-functioning teams takes work and is an ongoing process. Much of the team’s success is determined by the skill and reliability with which team members work together. There are some core principles for team processes in high functioning teams. At the foundation of successful team-based care is institutional leadership and support for the work (5).

In addition, five core principles and values of effective team-based health care (5) are:

  1. shared goals
  2. clear roles
  3. mutual trust
  4. effective communication
  5. measurable processes and outcomes

What do shared goals mean in the healthcare context? Teams share goals that reflect the person who is receiving care's personal priorities and are clearly articulated and understood by all team members. Good team characteristics are evidenced when: the client and their support people are integral members of the team; when these people have a principle role in goal setting, and; when teams regularly and ongoingly evaluate their progress. The organizational factors that support sharing goals are: providing time for information exchange, referring to a written plan, and having the capacity to monitor progress.

Clear roles provide expectations for each team member’s functions, responsibilities, and accountabilities. This allows teams to take advantage of the division of labour and combine efforts more efficiently. Good team characteristics are evidenced when the team members determine and define roles and honest, ongoing discussion about team capacities are present. There needs to be flexibility and balance between individual and collaboration, and defined team roles need to be articulated and understood by all. The organizational factors that support clear roles are: Interprofessional education and training, facilitating communication, redesigning care processes, and reimbursement.

Mutual trust occurs when people trust each other enough to feel capable to achieve the team's goals. This is done by looking at the team’s norms of reciprocity and providing greater opportunities for shared achievement. Good team characteristics are evidenced by establishing and maintaining trust, and having provisions to address breaches of trust in a timely fashion.  The organizational factors that support mutual trust are: support for team members to get to know each other on a personal level, personal values are embedded in education and hiring processes, and development of resources and skills among team members for effective communication, including conflict resolution.

Effective communication means a team prioritizes and continuously refines its communication processes. There are consistent channels for candid and complete communication and these are accessed and used by all team members across the settings. Good team characteristics are evidenced by high standards for professional communication, deep listening, continual reflection, institutional and personal evaluation, and striving for continual improvement. The organizational factors that support effective communication are: allocated times to meet to discuss direct care and team processes, training in routine and non-routine communication processes, and utilizing digital capacity.

Measurable processes and outcomes are achieved when the team agrees on and implements reliable and timely feedback on successes and failures. This is done while the team is working together and at the achievement of the team’s goals. Outcomes are used to track and improve performance immediately and over time. Good team characteristics are evidenced by rigorous, continuous, and deliberate measurements, clearly defined processes and outcomes, and evaluating team functioning and satisfaction. The organizational factors that support measurable processes and outcomes are: continuous improvement in team function and outcomes, development of routine protocols for measurement of team function, and meaningful evaluation of processes and outcomes.