Team Up! Team-based primary and community care in action Team-based Care BC Team

In this episode, Morgan and Sarah introduce Season 6 of Team Up and discuss the new team-based care pathway. They highlight the motivation behind creating the pathway and how the pathway will structure the season. The episode also includes a tangible takeaway for listeners, as Morgan and Sarah suggest trying out the team effectiveness tool available on the teambasedcarebc.ca website as a place to start!
Special thanks to Amie Hough, a Leader in Health System Improvement for Primary and Community Care with Health Quality BC, and one of the creators of the learning pathway, who we will be hearing from throughout the season.
Links and Resources
For more information on the Team Based Care Learning Pathway check out https://teambasedcarebc.ca/team-based-care-pathway/
The Team Effectiveness Tool is a short, multiple-choice assessment that gathers information about your team’s values, communication, roles, and existing supports to help guide your learning on team-based care. https://teambasedcarebc.ca/team-effectiveness-tool/
Through the TeamUp network we are working to advance supports for team based primary care. Please reach out to info@teambasedcarebc.ca if you would like to learn more!

In this episode, Morgan and Sarah introduce the first stage of the Team Based Care Learning Pathway and focus on the importance of getting to know your patients. Morgan and Sarah explore two ideas related to getting to know patients,
Utilizing EMR data for demographic insights and chronic condition trends andConducting patient surveys to uncover needs.Special thanks to Amie Hough, a Leader in Health System Improvement for Primary and Community Care with Health Quality BC, and one of the creators of the learning pathway, who we will be hearing from throughout the season.
Links and Resources
For more information on the Team Based Care Learning Pathway check out https://teambasedcarebc.ca/team-based-care-pathway/
Here are a few of the highlighted patient experience survey tools from a recent review by the ISU:
Patient-Perceptions of Team Effectiveness (PTE) questionnaire (43 item survey- Canadian)Kilpatrick K, Tchouaket É, Paquette L, Guillemette C, Jabbour M, Desmeules F, Landry V, Fernandez N. Measuring patient and family perceptions of team processes and outcomes in healthcare teams: questionnaire development and psychometric evaluation. BMC Health Serv Res. 2019 Jan 6;19(1):9. doi: 10.1186/s12913-018-3808-0. PMID: 30612571; PMCID: PMC6322340.(Demonstrates strong reliability and validity in assessing healthcare team functioning, covers critical dimensions of integrated care such as role clarity, boundary work, perceptions of team effectiveness, and outcome of care. It is easy to administer and aligns well with the primary care context)**Patient Reported Indicators Survey (PaRIS) (121 item survey that can be broken up into sections- International)**Slawomirski, L., van den Berg, M., & Karmakar-Hore, S. (2018). Patient-Reported indicator survey (Paris): aligning practice and policy for better health outcomes. World Medical Journal, 64(3), 8-14.The Innovation Support Unit is currently working on a comprehensive review of patient surveys to recommend a survey for use as part of the TBC evaluation. Watch this space for updates!Through the TeamUp network we are working to advance supports for team based primary care. Please reach out to info@teambasedcarebc.ca if you would like to learn more!
https://teambasedcarebc.ca/team-based-care-pathway/where-to-start-with-team-based-care/

In this episode, Morgan and Sarah continue their discussion of the first stage of the learning pathway: Where to start with team based care. Our hosts focus on the importance of thinking about both service design and team readiness when transitioning to team-based care in primary care clinics. They emphasize the need to consider the existing services in the community when designing or redesigning a team. Sarah and Morgan also highlight a number of resources available for primary care teams in the first stage of the learning pathway, highlighting the Team Readiness Checklist as something for listeners to try out in practice.
Special thanks to Amie Hough, a Leader in Health System Improvement for Primary and Community Care with Health Quality BC, and one of the creators of the learning pathway, who we will be hearing from throughout the season.
Links and Resources
For more information on the Team Based Care Learning Pathway check out https://teambasedcarebc.ca/team-based-care-pathway/For more information about Team Mapping, a tool to support teams working together on how they want to work together, in a patient centred way take a look at the following resources:Team Mapping MIROVERSE toolkitPrice M, Bellwood P, Hill TT, Fletcher S. Team Mapping: A Novel Method to Help Community Primary Healthcare Practices Transition to Team-Based Care. Healthc Q. 2020 Jan;22(4):33-39. doi: 10.12927/hcq.2020.26086. PMID: 32073389.
Past Podcast Episodes that may be of interest:
S03 E07: A Quick intro to Team MappingS03 E09: Clearer Roles in Distributed Primary Care TeamsFor links to the job descriptions and role material described in this episode explore stage 1 of the team based care learning pathway
Role DescriptionsSample RN postingFind the Team Readiness checklist here to try it out in practice
Through the TeamUp network we are working to advance supports for team based primary care. Please reach out to info@teambasedcarebc.ca if you would like to learn more!
https://teambasedcarebc.ca/team-based-care-pathway/where-to-start-with-team-based-care/

Stage 2 of the Learning Pathway for Primary Care Teams is focused on Team Building. In this episode of Team Up, Sarah and Morgan focus on a key element within this stage: the importance of building relationships within a team. We explore the value of returning to shared purpose and shared goals as a tool to support effective team building and collaboration. We also provide practical tips and discuss some of the great resources that are highlighted in the Team Building Stage of the Team Based Care Learning Pathway.
Special thanks to Amie Hough, a Leader in Health System Improvement for Primary and Community Care with Health Quality BC, and one of the creators of the learning pathway, who we will be hearing from throughout the season.
Links and Resources
For more information on the Team Based Care Learning Pathway check out https://teambasedcarebc.ca/team-based-care-pathway/For more information about shared purpose and some the resources we highlight in this episode check out the Shared Purpose Facilitation GuideTake a look at this template for Team Agreements and this collection of resources focused on Team Huddles, all resources that are connected to the Learning Pathway.
Past Podcast Episodes that may be of interest:
TeamUp Webinar Feb 17 2022: Skill Building for Teams- HuddlesTeamUp Podcast: S03 E03: Distributed Teams and Team HuddlesTeamUp Podcast: S01 E07: Practical Tools for Virtual Team Based Care
Explore more of the resources in Stage 2 of the Team Based Care Learning Pathway.
Through the TeamUp network we are working to advance supports for team based primary care. Please reach out to info@teambasedcarebc.ca if you would like to learn more!

Morgan and Sarah continue their discussion on Stage 2 of the Learning Pathway for Primary Care Teams. This episode is focused on Team Building, and specifically, seeing Patients as Team Members. The hosts make a point that patients are essential team members, and understanding the patient perspective when transitioning to team based care is important. If a practice is moving to team based care, patients likely won’t know what to expect, and may even be worried that their standard of care is lowering. Morgan and Sarah highlight the importance of exploring methods of communication to help explain this new care model. Furthermore, the discussion emphasizes how small communication changes in everyday practice can have a significant influence and help patients feel more supported. Finally, practical suggestions are made to help healthcare establishments in manifesting their teams via checklists, orientation activities for new patients, posters, and website representation.
Special thanks to Amie Hough, a Leader in Health System Improvement for Primary and Community Care with Health Quality BC, and one of the creators of the learning pathway, who we will be hearing from throughout the season.
Links and Resources
For more information on the Team Based Care Learning Pathway check out https://teambasedcarebc.ca/team-based-care-pathway/
To get started check out the culture change toolbox and the “Questions to consider before getting started” on P 12 of the toolbox.
Read over the AHRQ White Paper discussed in this episode “Creating patient Centred Team Based Care” (2016). This includes a great list of strategies for providing patient centred team based care (p. 7-19)
Check out the activities laid out in the Patient Centred Teams “Setting the Stage” handout
Past Podcast Episodes that may be of interest:
TeamUp podcast: S05 E02 Patients as team membersExplore more of the resources in Stage 2 of the Team Based Care Learning Pathway.Through the TeamUp network we are working to advance supports for team based primary care. Please reach out to info@teambasedcarebc.ca if you would like to learn more!

In this episode, Morgan and Sarah move into Stage 3 of the Learning Pathway for Primary Care Teams. The focus here is on — after we have built a team, how do we develop it further and showcase the continuity of care to patients? The hosts discuss how patients may perceive team-based care as a disruption to their healthcare continuity, and they provide ways to think about communicating this positive change to patients. Morgan then breaks down continuity into four types: information, management, relational, and inter-provider. Sarah highlights key resources and shares an anecdote where she realized that her MOA was integral for her continuity of care. Morgan and Sarah emphasize the importance of communication within the clinic, and including patients in conversations that demonstrate HOW you are communicating and connecting as a team in practice.
Special thanks to Amie Hough, a Leader in Health System Improvement for Primary and Community Care with Health Quality BC, and one of the creators of the learning pathway, who we will be hearing from throughout the season.
Links and Resources
For more information on the Team Based Care Learning Pathway check out https://teambasedcarebc.ca/team-based-care-pathway/
What Matters to You
These resources helps us use conversations to understand more about our patients
https://teambasedcarebc.ca/resources/what-matters-to-you/
What matters to Patients with Virtual Care appointments
RN Virtual Virtual Primary Care Practice Guide
https://isu.ubc.ca/registered-nurse-virtual-primary-care-practice-areas/
Relational Continuity Change Package
https://actt.albertadoctors.org/pmh/panel-and-continuity/continuity-posters/
Through the TeamUp network we are working to advance supports for team based primary care. Please reach out to info@teambasedcarebc.ca if you would like to learn more!