Joy and Challenges in Improving Chronic Illness Care: Capturing Daily Experiences of Academic Primary Care Teams

Johnson, Julie K.; Woods, Diana Lynn; Stevens, David P.; Bowen, Judith L.; Provost, Lloyd; Sixta, Connie S.; Wagner, Ed

doi:10.1007/s11606-010-1408-8

Cited by 23 publications

(17 citation statements)

References 12 publications

(12 reference statements)

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“…PCMH demonstration projects have shown improvements in patient experience, resident satisfaction and quality of care, without increasing overall cost (10,(35)(36)(37)(38)(39). The mandate for best ambulatory practice as now defined by PCMH will require innovative resources and strong support from academic leaders.…”

Section: Improving the Structure And Function Of Ambulatory Gim Trainmentioning

confidence: 99%

Solutions to Common Problems in Training Learners in General Internal Medicine Ambulatory Settings

Denton¹,

Brandenburg

et al. 2015

The American Journal of Medicine

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Section: Improving the Structure And Function Of Ambulatory Gim Trainmentioning

confidence: 99%

Solutions to Common Problems in Training Learners in General Internal Medicine Ambulatory Settings

Denton¹,

Brandenburg

et al. 2015

The American Journal of Medicine

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“…Primary care teams face daily challenges for chronically-ill people. 10,11 Another aspect that corresponds with our study is the discussion of the relationship between quality of life and participation in initiatives supporting patients. Those who participated in selfhelp groups are better adapted to living with the disease, while people in difficulty of their condition have trouble keeping a job and feel socially isolated.…”

Section: Discussionmentioning

confidence: 87%

Disease Management and the Patient's Role in This Process

Todorova¹,

Foreva²,

Asenova³

2016

Turkiye Klinikleri J Health Sci

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ith increasing life expectancy accumulates and chronic morbidity, data for this tendency is in the national and international health institutions in developed countries. Health authorities are making significant efforts to put into effect various initiatives over the past two decades, for organizing of effective medical monitoring of chron- A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : With increasing life expectancy increases and chronic morbidity. Health authorities are making efforts to put into effect initiatives for organizing of effective medical monitoring of chronically ill patients. In Bulgaria, the chronically ill are tracked according to rules on a national level. The goal that we had set in this study was to understand the disease management process, emphasizing the involvement of the patient, as well as the quality of life. In addition we studied the experience of other countries undergoing reforms in the strategies and approaches for dealing with chronic diseases. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : We used a qualitative method of researchfocus groups that include different medical specialists. R Re es su ul lt ts s: : In the discussions was considered the possibility for the patient to be a part of the team, but generally such a setting is not typical for our country. As a whole, the discussion regarding the concept of quality of life was tied for time and a relatively small number of topics were formulated in this regard. The role of the GP and the creation of multidisciplinary teams, cooperation between departments as a prerequisite for improving the quality of life of chronically ill patients were also discussed. C Co on nc cl lu us si io on n: : Patient satisfaction is directly related to the active involvement and responsibility for their own health.K Ke ey y W Wo or rd ds s: : Public health; chronic disease; patients Ö ÖZ ZE ET T A Am ma aç ç: : Beklenen ömrün uzaması ile birlikte kronik hastalıklar da artmaktadır. Sağlık uzmanları kronik hastaların etkili tıbbi takiplerini organize etmek için girişimlerde bulunup, çaba harcamaktadırlar. Bulgaristan'da kronik hastalar ulusal düzeyde konulan kurallara göre izleniyorlar. Çalışmamızın amacı, bu hastalıkların tedavi süreçlerini araştırmak, hastaya ilişkin yönleri üze-rinde durmak ve böylece olabildiğince yaşam kalitesini artırmaktır. Ek olarak, diğer ülkelerdeki bu alandaki yenilikleri ve reform stratejilerini incelemeyi amaçladık. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Farklı tıp alanlarındaki uzmanları içeren araştırma odaklı grupların kalitatif yöntemini kullandık. B Bu ul lg gu ul la ar r: : Tartışmalarda hastayı ekibin bir üyesi olarak ele aldık, fakat bu durum bizim ülkemize özgü değil-dir. Bütün olarak tartışmada, yaşam kalitesini artırmaya yönelik sayıları az da olsa fikirlere yoğun-laşıldı. Genel sağlık hizmeti veren pratisyen doktorun multidisipliner ekipteki rolü ve bu hastaların yaşam kalitesini artırmak üzere departmanlar arasında işbirliği sağlaması üzerinde duruldu. S So on nu uç ç...

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“…A new construct, "joy in work," recently emerged in a study of successful teams within chronic care collaboratives. 16 This may be the harbinger of better lives for both caregivers and patients; "joy in work" comprises positive experiences and outcomes among the combined team of physicians, nonphysician team members, and their patients.…”

Section: Joymentioning

confidence: 99%

Essentials for Great Teams: Trust, Diversity, Communication ... and Joy

Roth¹,

Markova

2012

The Journal of the American Board of Family Medicine

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In clinics and hospitals, in conference rooms and classrooms, in hallways and lunchrooms, we demonstrate daily our effectiveness or ineffectiveness as team members. We interact with patients, coworkers, and learners in ways that result in smooth, well-functioning, patient-centered processes, or we interact in ways that impede those processes. This "hidden curriculum" is powerful and teaches others about our competence in and commitment to teamwork. The recent focus on teams in patient care, education, and research calls for increasing awareness of our own roles in settings in which we have responsibilities that are mutual to or complementary with others'.In the minds of many physicians-even those who have committed to a team approach to health care-there may still be a number of questions about how a team should function and what the obligations and behaviors of each team member should be. As Baker and colleagues 1 noted in their review of teams in health care, the medical community frequently has focused on measuring outcomes, such as the time between arrival and admission or errors in procedures, rather than on "process measures"-the activities, strategies, responses, and behaviors of team members as they function in teams. Although these are more difficult to collect and quantify, a number of these processes have been demonstrated to contribute to effective teamwork in health care settings. Foundational processes for teamwork include a practice's development of and commitment to a strong sense of trust, inclusion of diverse perspectives in clinical operations and decision making, and strategic use of a continuum of effective communication strategies. The synergy that results from developing and sustaining successful teams can result in a satisfying, even joyful, work environment. TrustWhat does it take to develop trust among clinic team members? Physicians may ask themselves, Do I trust my medical assistant to take an accurate social history and document it appropriately in the chart? Do I double check the nurse's recommendation for patient self-management? Do I allow the receptionist to lead a new check-out process? Am I less of a leader if I don't have all the answers about the patient flow within my office or don't start all improvement initiatives myself? At the individual level, the answers to these questions depend on how much we trust our team colleagues and are willing to be vulnerable to one another.2 Feeling safe being vulnerable to our colleagues requires that we understand each other's roles and allow each staff member to operate freely within his or her scope of practice 3 while relying on frequent, meaningful dialogue across all members of the group who are, together, accountable for patient care.4 Diversity A patient's experience in any clinic is influenced by individuals who vary greatly in their training, roles, and experience. Including relevant staff members in decision making regarding quality improvement, practice change, and clinical operations has been shown to positively influence prac...

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Joy and Challenges in Improving Chronic Illness Care: Capturing Daily Experiences of Academic Primary Care Teams

Cited by 23 publications

References 12 publications

Solutions to Common Problems in Training Learners in General Internal Medicine Ambulatory Settings

Solutions to Common Problems in Training Learners in General Internal Medicine Ambulatory Settings

Disease Management and the Patient's Role in This Process

Essentials for Great Teams: Trust, Diversity, Communication ... and Joy

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