Interprofessional collaborative practice and relational coordination: Improving healthcare through relationships

Teamlet Structure and Early Experiences of Medical Home Implementation for Veterans

“…These findings suggest that much closer attention to issues of high turnover, timely replacement of teamlet members, and practice coverage policies is a major challenge warranting much closer attention by VA leadership. While having the full complement of teamlet staff and better defined paired coverage policies may foster increased relational coordination of patient care responsibilities, [12][13][14] other interim approaches are also possible. For example, in Bodenheimer's teamlet model, the two health coaches share the same scope of responsibilities and work together with the PCP to conduct a range of patient care activities, including agenda-setting with the patient, 15 ordering routine services, tracking history, documenting the PCP's findings, recapitulating the PCP's advice, setting goals with the patient, and tracking patient history.…”

“…The teamlets are responsible for all major patient care activities, including phone calls, scheduling, and check-in. Core features for improving patient-centered care in these teamlets under the PACT include: improving PCP-patient continuity by changing appointment booking practices, 12 providing health coaching for Veterans, conducting shared medical appointments (or group visits) for patients with diabetes and other chronic illnesses, 13 increasing planned follow-up telephone encounters, 14 improving panel management, 15 improving appointment access by preventing unscheduled patient visits, 16 and promoting secure messaging with Veterans. 17 The VA also set several performance goals for PACT teamlets, including high PCP-patient visit continuity 6 (77 % of patient encounters should be with their PCP in any given month), same-day urgent access and 7-day routine appointment access (70 % and 92 %, respectively), a minimum of 20 % of primary care encounters by telephone, and contact with at least 75 % of patients within two business days of hospital discharge.…”

Interprofessional Education and Practice Guide No. 6: Developing practice-based interprofessional learning using a short placement model

“…In each setting an existing uni-professional practice-educator takes on a local 'coordinator role' to work as a conduit between the HEI, the steering group, the clinical-team, the patient/service user/carer representatives and be accountable to all stakeholders. This coordination role is essential (Gittell, Godfrey & Thistlethwaite, 2013). In our experience doctors, nurses, pharmacists, therapists and social workers have integrated these interprofessional components into uni-professional educational roles.…”

European views on patients directly obtaining their laboratory test results

“…If successful this would transfer some of the burden from physicians, particularly those in primary care; clearly there needs to be a triangular dialogue between the patient, their physician and the clinical support activities, such as radiology and laboratory medicine. Evidently patients expect this to be approached from the perspective of mutuality [27,28]. This is a potential paradigm shift in laboratory relationships with patients and physicians and there appears to be an appetite for such progress as exemplified by a recent opinion piece in a leading medical journal [29].…”