Huddle-Coaching

Abstract

Many outpatient clinics where health professionals train will transition to a team-based medical home model over the next several years. Therefore, training programs need innovative approaches to prepare and incorporate trainees into team-based delivery systems. To address this need, educators at the San Francisco Veterans Affairs (VA) Medical Center included trainees in preclinic team "huddles," or briefing meetings to facilitate care coordination, and developed an interprofessional huddle-coaching program for nurse practitioner students and internal medicine residents who function as primary providers for patient panels in VA outpatient primary care clinics. The program aimed to support trainees' partnerships with staff and full participation in the VA's Patient Aligned Care Teams. The huddle-coaching program focuses on structuring the huddle process via scheduling, checklists, and designated huddle coaches; building relationships among team members through team-building activities; and teaching core skills to support collaborative practice. A multifaceted evaluation of the program showed positive results. Participants rated training sessions and team-building activities favorably. In interviews, trainees valued their team members and identified improvements in efficiency and quality of patient care as a result of the team-based approach. Huddle checklists and scores on the Team Development Measure indicated progress in team processes and relationships as the year progressed. These findings suggest that the huddle-coaching program was a worthwhile investment in trainee development that also supported the clinic's larger mission to deliver team-based, patient-aligned care. As more training sites shift to team-based care, the huddle-coaching program offers a strategy for successfully incorporating trainees.

Who is responsible for what tasks within primary care: Perceived task allocation among primary care providers and interdisciplinary team members

“…[30][31][32] It is encouraging that more training in PACT was linked to more task sharing among PCPs. Participation in huddles was linked to less perception of being relied upon among staff, perhaps suggesting that huddles led to greater targeting of responsibility among different staff members rather than a perception of generally being relied upon for everything.…”

Interprofessional transformation of clinical education: The first six years of the Veterans Affairs Centers of Excellence in Primary Care Education

“…Each Center approached the development of workplace learning strategies to fit within their local VA context. For example, one Center developed a standardized huddle checklist because their trainees were spread throughout several PACT teams and they needed more uniformity of experience (Shunk, Dulay, Chou, Janson, & O'Brien, 2014). Another Center developed a panel management curriculum because proactive chronic disease management was an institutional priority and they had the availability of an ideal training space with technology support (Kaminetzky & Nelson, 2015).…”

Training Health Care Professionals in Interprofessional Collaborative Cancer Care

“…The pre-clinic meeting provided an opportunity to role-model team-based, patient-centered care for the trainees (Shunk, Dulay, Chou, Janson, & O'Brien, 2014). The meeting helped to strengthen collaboration among team members, structured the team scheduling for the day, and encouraged a holistic approach to veteran problems and concerns.…”