Effective supportive relationships, which can influence health, include those between: 1) health care team members and people with diabetes, 2) health care team members, 3) people with diabetes and families/friends, and 4) clinics and community organizations and payers.
In other sections, we have provided selected evidence-based resources related to providing peer support through Diabetes Self-Management Education (Key Driver D1: DSMES), engaging patients in care (Key Driver D3: Effective Communication; Key Driver A: Appropriate and Timely Treatment, and Key Driver B: Access to High Quality Care), and links among clinic and community organizations (Key Driver F: Equitable Environment for Care). In this section, we focus on selected resources for effective care teams and joy in work.
E1: Effective Care Teams
Example Data Measure (not on Dashboard): Teamwork measure at baseline and follow-up via survey.
Team-based care has been strongly associated with improved A1c,51-55 yet developing and sustaining strong teamwork and a team culture can be challenging.
Key elements of team building include:
Developing quality improvement (QI) teams and using QI tools for Plan, Do, Study, Act cycles assists with elements of teamwork, such as providing leadership, defining goals, developing role clarity and structure, introducing small changes in job tasks, introducing cross-training, and introducing communication structures and processes. While these will be focused on the specific QI goal, there can often be spillover impact to other conditions which can be used as a steppingstone to larger team building efforts.
Below are selected resources around teams not already provided in other sections of the toolkit. Resources E1.1 and E1.2 may be useful to medical directors or leadership as they work to establish and maintain high-functioning primary care teams. These activities often need to be accomplished over a period of time and may go beyond an individual QI activity or project. Resources E1.3-E1.8 are shorter focused materials for establishing huddles, team culture and psychological safety as you conduct the diabetes QI project itself.
E1.1: Primary Care Team Guide
Website guide with step-by-step direction on how to establish and maintain high functioning primary care teams with featured resources and modules and provides.
E1.2: TeamSTEPPS
An evidence-based set of teamwork tools, aimed at optimizing patient outcomes by improving communication and teamwork skills among health care professionals.
E1.3: Dartmouth Health Learning Video: Initiating Team Huddles
This video serves as a training tool for department leaders and their staff to support them as they begin initiating huddles in their respective areas.
E1.4: AMA Team Huddle Checklist
Use this modifiable checklist to lead your team through efficient, effective huddles at the beginning of the clinic day or session.
View Alternate File (docx)E1.5: Cardi-OH Utilizing Huddles to Improve Team-Based Care
Learn about different types of huddles in clinical practice and suggested strategies forsuccessful implementation.
E1.6: Team Culture Video
The Waterline Model video is a tool for diagnosing and solving team problems.
E1.7: Creating Psychological Safety in Teams
AHRQ’s EvidenceNow Initiative provides helpful tips to create and promote psychological safety in care teams.
E1.8: Three Ways to Create Psychological Safety in Health Care
This Harvard Business School video describes three key actions to foster a psychologically safe work environment.
E2: Creating Joy in Work Within Healthcare Teams
Example Data Measure (not on Dashboard): Employee engagement survey which includes burnout measure at baseline and follow-up via survey.
Joy in work (or engagement) is more than the absence of burnout and allows the care team to provide better care in a sustainable way.57-58 Joy is usually grounded in the relationships that providers form with people with diabetes, with colleagues, and with family and friends.59-60 Joy in work has been described as having 3 domains: 1) culture of wellness which includes burnout, 2) efficiency of practice, and 3) personal resilience. Burnout, one element within the culture of wellness, is present in over 50% of providers as well as other members of the health care team. As a syndrome that is uniquely dependent on social and organizational contexts, burnout is considered to be an occupationally specific dysphoria.61 Professionally, burnout adversely affects productivity, quality, safety, patient satisfaction, and turnover.62-65
E2.1: Creating the Organizational Foundation for Joy in Medicine
AMA STEPS Forward Module describes the organizational strategies to implement a culture of wellness, workflow efficiency, and personal resilience.
E2.2: Resources to Support Joy in Work
Cardi-OH outlines tools and strategies to promote staff engagement and satisfaction and improve clinical workflows and patient outcomes.