Creating Your “A Team” for Health

Today’s guest post is written by PatientsLikeMe Vice President for Advocacy, Policy and Patient Safety Sally Okun, RN, MMHS.


Getting health care can often feel like you’re trying to put together a difficult jigsaw puzzle, only to find that some of the pieces are missing. Even under the best circumstances, navigating the health care system is challenging for patients like you and your caregivers.  Worse, when health care is provided in an uncoordinated and fragmented way, the quality of care and patient safety can be compromised.

These are all reasons the idea of “team-based care” is gaining momentum, and emerging as an important factor in helping patients better manage their conditions. For the past year, I’ve been honored to be part of a working group commissioned by the Institute of Medicine (IOM) to write a discussion paper on this topic.

Our team, made up of health care professionals and leading academics from the University of Washington, American Medical Association, Rush University Medical Center, American Academy of Physician Assistants and American College of Clinical Pharmacy, pulled together all that we learned during our monthly meetings, interviews with teams from around the country and input from national experts on “team based care.”  The result is a co-authored paper, published this week, by the IOM.

Defining "Team"

Among the goals we have at PatientsLikeMe is to amplify your voice – the patient voice – in relevant and system-changing initiatives and bring what we’re learning back to you.  As I share with you now the five hallmarks of the most effective teams, I want you to know that much of what we discussed is how you, the patient, are at the center of these teams.  Your needs, preferences and concerns are central to the team’s work.

So, what do you need to assemble your very own “A Team” for healthcare?

Shared and well-defined goals: Patients like you and, where appropriate, family members or other support persons, must work to establish shared goals that reflect your priorities.  Be sure your goals are understood and supported by all your team members.

Clear roles:  Each member of your healthcare team has specific responsibilities. Clear roles help all members of the team share the load, so the team can accomplish even more together than one can accomplish on their own.

Mutual trust: To reach your shared goals, it’s really important for you and the members of your team to earn each other’s trust.  Without this trust among the team it can be difficult to work well together

Practiced communication: Good communication takes practice and even the best teams continuously work on ways to improve this.  With all of the tools we have to communicate today, be sure your team knows what you prefer  – in person, on the phone, via email or text, etc.

Measured processes and outcomes: As you and your team create your healthcare plan, be sure it includes ways to measure how well you’re doing on meeting your goals. This translates to better care, and potentially, better results.

PatientsLikeMe member sokun

Note: The IOM working group was honored that the Journal of the American Medical Association (JAMA) asked it to contribute a Viewpoint piece on team-based care, highlighting the role of the patient on teams. You can see the Viewpoint piece, published today, here.

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2 thoughts on “Creating Your “A Team” for Health”

  1. Sally, as a premedical student I have learned that team-based care is on the rise and for good reason. I agree with you on the basis that team-based care can help a patient’s care or hinder it. As you touched on, it is important to realize that if any of your 5 components of an effective team are missing, the patient’s care could seriously falter.

    If the health care team fails at communicating their individual goals with each other as well as the patient, discrepancies in the methods carried out by each individual health care provider may occur. At the extreme, this could cause patient fatality. On a less severe note, the patient could express dissatisfaction at the obvious disorganization and lack of communication between persons. This is similar when discussing the need for clear roles for each member of a team. Team-based care poses the risk that one or more persons may falter when it comes to performing their specified duty, causing a burden on the other members of the team instead of helping.

    You mentioned mutual trust between team members; it is also important that the patient trusts the team as a whole. If the patient senses a mistrust within the team it is likely that the patient will become uneasy about how the quality of his/her care. Not trusting each other cause the patient to distrust the team as a whole.

    Modes of communication MUST depend on each patient individually. It is important for the team to be aware that each patient has individual preferences. A multitude of people trying to contact a patient raises the risk of discrepencies in information relayed to the patient. This is where clear communication comes into play once again.

    Although working in a team as opposed to one single provider can help eliminate error in method or aid in making better decisions, working with multiple people carries the risk of discrepancies, patient confusion, and slower progress (it may cause a sort of bureaucracy). However, I do believe that if members in a team work to excel at the five characteristics in your guidelines, team-based healthcare could contribute to enhancing the quality of health care.

  2. Dear Kiara,

    Thank you so much for your thoughtful comments and insightful observations. I will be sure to share then with my fellow authors on the Institute of Medicine discussion paper.

    It is so encouraging to hear from someone early in their medical career. Your perspective will serve you, your colleagues and your patients well as you go forth and foster meaningful relationships together. Best wishes to you.


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