Accountable care team membership and distress: is accountable care team membership associated with lower distress during a crisis?

Abstract

Background: Hospitals have begun to formally develop and implement structures and processes to further promote interprofessional collaboration and leadership at the microsystem level (unit, service) with the goal to improve care quality, efficiency, and patient and provider experiences. Termed by some as the Accountable Care Team (ACT) model, the core components to date have included: (I) a designated physician-nursemanager leadership dyad, (II) cohorting of patients and team members to the unit as much as possible, (III) daily interprofessional team care planning rounds, (IV) proactive assessment of patient experience, and (V)access to unit-level data for performance improvement. The purpose of this paper is to describe an expanded model of the ACT intervention and understand whether ACT membership was associated with reduced distress during a major crisis, particularly the COVID-19 pandemic.Methods: This cross-sectional survey study was conducted within a large academic medical center in the Southeast United States, which is in the process of implementing ACT interventions across 32 units. A total of 1,130 respondents took the survey with a response rate of 18 percent.Results: ACT members had a greater sense of community at work, felt greater support from the organization, and were less likely to report social isolation and loneliness as a major stressor. However, ACT members were also more likely to report heavy workload and long hours, and increased job demands as major stressors than non-members. ACT members were also more likely to be female, and to indicate childcare as a major stressor. Multivariate regression models indicated no statistically significant association between ACT membership and overall distress scores. Conclusions:Early results suggest that there may be benefits to ACT membership, but these benefits may be counteracted by additional work demands. Organizations must ensure adequate time and resources are allotted for those participating in ACT models.