The New England Healthcare Institute says the quality and efficiency of primary care could be dramatically improved through the use of team-based care.
The organization has called for fundamental changes in the training of health professionals to implement this model.
According to the NEHI, shifting to a team-based model is hindered by an education system that traditionally trains health professionals in silos, with little to no emphasis on preparing students in medicine, nursing, pharmacology or other fields to share responsibilities or even work together.
"The education system for health professionals must implement farsighted changes” if the primary care workforce of the future is to learn how to work in care teams, NEHI officials say in an article published in the August edition of Health Affairs. This will require a “revolution’’ in how medical professionals are educated, the officials said.
Training students together from different medical disciplines fosters the skills to collaborate, coordinate and delegate, all prerequisites for improving patient care, said NEHI officials. Such collaborative, team-based care, they said, has led to better clinical care, lower healthcare costs and reduce clinicians’ workloads.
The article identifies significant barriers to implementing collaborative education in the health professions, including entrenched cultures, administrative rigidity, curricular requirements and funding limitations. However, it said, a small number of colleges and universities have successfully adopted collaborative models that share core principles.
The article makes several recommendations:
- The government should follow Canada's lead and establish a national center to support collaborative education activities.
- The Centers for Medicare and Medicaid Services and the Accreditation Council for Graduate Medical Education should require primary care residency programs to incorporate team-based training in their curricula.
- Accrediting bodies in the various medical disciplines should encourage the promulgation of collaborative accreditation standards.
- The Association of American Medical Colleges and the American Nurses Association should collaborate to promote inter-professional education.
- The National Quality Forum, Leapfrog Group, Joint Commission and other health quality organizations should include team-based care as a best practice for the promotion of quality outcomes.
The article, “Educating Health Professionals Collaboratively for Team-Based Primary Care,” was co-authored by NEHI President Wendy Everett, Program Director Brian Schuetz and Health Policy Associate Erin Mann.