ABSTRACT: Implementing Teams in a Patient-Centered Medical Home Residency Practice: Lessons Learned

Over the last decade there has been a call for change in the US health care system. Several reports by the Institute of Medicine, including To Err is Human—Building a Safer Health Care System1 and Crossing the Quality Chasm,2 have highlighted the critical need for developing a new approach to patient care that focuses on patient safety and the delivery of high-quality care and requires new physician competencies that include working in interdisciplinary teams, which in turn necessitates team training for all current and future physicians.3,4 In concert with changes in approaches to clinical care, medical education curricula must be updated to parallel the changes in the health care delivery system.5,6 Although the health care literature provides some direction for how to create and maintain high-functioning teams in large organizations and inpatient settings7–10—in which interdisciplinary health care teams have become an expectation—such approaches are difficult to implement in outpatient settings. Doing so is even more difficult when ambulatory residency education is a mission of the practice.

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