Translating Team Science into Primary Care: PCOR on teamwork in FQHCs

确保病人，特别是社会弱势群体，在以下方面有意义的发言权： 他们的医疗保健，同时也确保他们获得高价值的护理，需要新的以患者为中心的结果 研究（变革和组织振兴方案）。优化患者在初级保健中的声音和价值需要医疗保健的转型 从单独的临床医生护理到团队护理。此职业提升提案旨在 为我提供必要的指导，技能，经验和合作伙伴关系，以重新关注我的研究 变革和组织振兴方案的这一新领域，即将团队协作科学转化为初级保健，特别是在联邦政府内 合格的保健中心。我将通过利益相关者的合作来实现这一目标，包括改进， 试点，并评估患者团队沟通（PTC）模型。这一新模式，基于 小团队（临床医生和护理人员组成的团队）整合了以患者为中心的沟通科学 团队合作的科学项目目标建立在我著名的导师和顾问的工作基础上 并将通过引导自学、场外和现场培训以及PCOR的应用来完成 方法，以试点的PTC模型内的一个CNOHC。 PTC模式通过专注于关键任务和团队合作， 初级保健办公室的访问，包括病人的关注和偏好的启发和团队为基础的交付 循证预防保健和其他高价值的过程。该模型侧重于以下关键 诊室访视流程：访视前规划、团队会议和汇报、团队使用临床决策支持 系统，充分激发患者的关注，并在访视后确认理解和计划。的 拟议的项目将利用与难民署有关的可行战略开发培训模块。 我的具体教育目标是：1）提高我直接观察基层护理的技能 2）获得适用于初级保健的团队合作培训技能; 3） 提高我与利益相关者和患者参与相关的技能; 4）获得团队合作评估 skills. 我的具体研究目标是：1）在一个可持续发展的人力资源中心内完善和试点PTC模型; 2）试点关键 变革和组织振兴方案与技术合作和培训模式各方面有关的措施; 实施PTC模式。这些教育和研究目标的实现将为我提供 开展调查所需的经验、技能、伙伴关系、措施和初步数据 变革和组织振兴方案的全新领域。这项研究为数百万服务不足的人提供了改变护理的希望 和社会弱势患者提供服务，并减少卫生保健差距。

Ensuring that patients, particularly those who are socially disadvantaged, have a meaningful voice in their healthcare while also ensuring they receive high value care, requires new Patient-Centered Outcomes Research (PCOR). Optimizing patients' voice and value in primary care requires transformation of healthcare delivery from care by lone clinicians to care by teams. This career enhancement proposal is designed to provide me with the mentoring, skills, experiences, and partnerships necessary to re-focus my research on this new area of PCOR, i.e. translation of teamwork science into primary care, particularly within federally qualified health centers (FQHCs). I will achieve this aim through stakeholder collaboration, including refining, piloting, and evaluating the Patient-Teamlet Communication (PTC) model. This new model, based on teamlets (teams of clinicians and nursing staff), integrates the science of patient-centered communication with the science of teamwork. The project aim builds on the work of my renowned mentors and consultants and will be accomplished through guided self-study, offsite and onsite training, and application of PCOR methods to piloting of the PTC model within an FQHC. The PTC model enhances patients voice and value by focusing on critical taskwork and teamwork during primary care office visits, including elicitation of patient concerns and preferences and team-based delivery of evidence-based preventive care and other high value processes. The model focuses on the following key office visit processes: pre-visit planning, team huddles and debriefing, team use of clinical decision support systems, full elicitation of patients concerns, and post-visit confirmation of understanding and planning. The proposed project will develop training modules using feasible strategies relevant to FQHCs. My specific educational objectives are: 1) To enhance my skills in direct observation of primary care visits with a focus on tasks and teamwork; 2) To acquire teamwork training skills applicable to primary care; 3) To enhance my skills relevant to stakeholder and patient engagement; 4) To acquire teamwork assessment skills. My specific research aims are: 1)To refine and pilot the PTC model within an FQHC; 2) To pilot key PCOR measures relevant to facets of the PTC model; 3) To examine key facilitators and barriers to implementation of the PTC model. Achievement of these educational and research aims will provide me with the experiences, skills, partnerships, measures, and preliminary data necessary to launch inquiry into this entirely new area of PCOR. This research offers the promise for transforming care for millions of underserved and socially disadvantaged patients served by FQHCs and for reducing health care disparities.