Australian Healthcare and Hospitals Association calls for team-based models of patient care

MedTech News: “Providing high quality, co-ordinated care for people with complex chronic diseases is an ongoing challenge” said Alison Verhoeven, Chief Executive of the Australian Healthcare and Hospitals Association (AHHA). “While the need for team-based models of care has been promoted for decades, our health system is still facing challenges in operationalising them.”

“The COVID-19 pandemic has really tested our health system’s capacity to provide person-centred, proactive and co-ordinated care for people with complex chronic diseases. Yet this need to do things differently has demonstrated just what can be achieved when team-based care is enabled. It’s good for patients, good for care providers, and good for the system,” she added.

Published last week, AHHA’s new report Enabling person-centred, team-based care outlines a plan for implementing person-centred, team-based care in Australia.

“Teams form around identified patient groups. They take the time to understand the needs of these patients. They work with patients to co-design care models. They use their data to monitor outcomes and continuously improve the service they provide. As a patient’s condition changes over time, the composition of the team may change to reflect their shifting clinical and psychosocial needs,” said Ms Verhoeven.

While team-based care is recognised as important to the quality and safety of care delivery, barriers to its implementation have been identified to include: the impact on existing workflows; a lack of integrated electronic health records or interoperable software; poor communication; payment systems that do not incentivise team-based care; a lack of dedicated infrastructure and resourcing; maldistribution of health professionals and services in some regions; regulatory requirements restricting scope of practice; variations in understanding about the roles of different care providers; hierarchies between professional roles and over occupational tenure that discourage open discussion; poor integration within and between organisational systems; a lack of external accountability of service providers; poor culture (e.g. team members who are ambivalent or have diverse motives); and a lack of leadership.

According to Ms Verhoeven, to implement person-centred, team-based care effectively, action is needed in some key areas:

1. Population health planning and data driven models of care, with practices and services engaged in this process at the local level.
2. Clinical governance, with frameworks that span and link jurisdictional and professional boundaries, and provide local ownership and shared agreement of the care to be provided.
3. A cultural shift towards person-centred care, with purposeful and active inclusion of the patient, family and carers as essential components of the team.
4. Person-centred data and interoperable technology, with the use of indicators and measures embedded in clinical workflows, enabling real-time, shared goal-setting and decision-making with the patient and across sectors.
5. Investment in physical infrastructure, creating environments where teams can share and collaborate.
6. Workforce development, fostering capabilities such as in co-design, data analysis and quality improvement, and technology that supports team-based care, with student placements available to experience how high-functioning teams work.
7. Funding models, which incentivise the use of indicators and measures in routine clinical practice, support participation in population health planning, and provide greater flexibility in how teams achieve the desired outcomes.

“Amidst the challenging circumstances created by the COVID-19 pandemic, now – more than ever – it is increasingly important for the system to enable teams to effectively come together to meet the unique needs of each patient,” concluded Ms Verhoeven.