Healthcare Teams – Call for Research
Now that the implementation of the Affordable Care Act is in full swing, the momentum and the importance of developing effective healthcare teams is paramount. As simple as it sounds, it is important to know what makes up a team. Teams, in short, are groups of 2 or more individuals that join forces to achieve a common goal.
Teams, a term often used in the sports setting, are made up of individuals that have unique and complimentary skill sets and are led by a team leader. In football the quarterback makes the calls, in baseball it’s the manager, and as demonstrated in the sports arena, each team member must be striving to contribute to the team goals. In healthcare, effective teams are made up of complimentary skills sets, and like in the sport’s world, require strong and effective clinical leadership to accomplish the ultimate goal of the healthcare delivery system – quality care! First emerging in the fields of surgical oncology, heart failure and organ transplantation, the evolving teams in the cardiovascular space are pioneering new levels of cooperation. The specialists in the field of Transcatheter Valve procedures have formalized the need and intentional nature of effective clinical teamwork.
As reported in the New England Journal of Medicine in October 2010 (Leon et al. NEJM 2010), the collaboration between the interventional cardiologist and the cardiovascular surgeon has never been more essential. The interdisciplinary cardiac team was truly pioneered at a whole new level and was key to the success of the care of this complex elderly, aortic stenosis patient population. Now included as a Class I recommendation from the American and European professional societies for both coronary and valvular heart disease, our understanding of how to develop effective teams needs to be an ongoing intentional effort.
Why a Team-Based Approach?
A team approach is now a requirement for reimbursement for TAVR in the United States, a mandate that grew out of the benefits experienced by the patients cared for by teams. Development of teams must take on unique contextual designs, and as such more research is needed to identify the design of optimal teams. This is a clinical challenge that clinicians will have to embrace and the opportunities include:
1. Improved patient selection
2. Enhanced procedural planning
3. Improved outcomes in high or prohibitive risk patients
4. Enhanced ability to introduce technological advances
5. Better care
As this healthcare delivery model evolves, there remains a need for clear definitions and shared metrics to advance our understanding of an optimal Heart Team approach, focusing on patient, clinician, and health system outcomes.
I have the privilege of working with pioneers in the field of the Heart Team approach. If you would like to learn more about building effective teams for your cardiovascular service line, please visit www.columbiaheartsource.org, or join us at our upcoming Network Day event on September 24th, on the Columbia University Medical Center campus.
N Engl J Med 2010; 363:1597-1607October 21, 2010DOI: 10.1056/NEJMoa1008232