Change Concepts
Change Concepts
Continuous and Team-Based Healing Relationships
Establish and support care delivery teams.- Link patients to a provider and care team so both patients and provider/care team recognize each other as partners in care.
- Assure that patients are able to see their provider or care team whenever possible.
- Define roles and distribute tasks among care team members to reflect the skills, abilities, and credentials of team members.
- Cross-train care team members to maximize flexibility and ensure that patients’ needs are met.
- Elevating the Role of the Medical/Clinical Assistant: Maximizing Team-Based Care in the Patient-Centered Medical Home (August 2011)
Implementing care teams is a critical element of transforming a practice into a patient-centered medical home (PCMH). This guide presents a curriculum and provides training materials (PowerPoint presentations, handouts, skill assessments, exams, etc.) that practices can use to enhance the skills of MAs/CAs.
Elevating the Role of the Medical/Clinical Assistant: Maximizing Team-Based Care in the Patient-Centered Medical Home
- Continuous and Team-Based Health Relationships Implementation Guide (December 2010)
Key to becoming a medical home is building partnerships between patients and providers and teams. This implementation guide provides guidance on how practices can develop and sustain strong care teams.
Read the guide
- Optimizing the Role of the Front Desk Staff (December 15, 2011)
Moderator: Katie Coleman, MSPH, MacColl Center for Health Care Innovation at Group Health Research Institute (Seattle, WA)
Speakers: Katie Bell, Neighborcare (Seattle, WA); Prathiba Pinnamaneni, Neighborcare (Seattle, WA)
Audio & video program
Printable slides
Neighborcare Medical Clinic Tasking Guidelines
- Optimizing Your Care Team in the Medical Home (April 30, 2010)
Moderator: Donna Daniel, PhD, Qualis Health
Speaker: Catherine Tantau, BSN, MPA, Tantau & Associates
Audio & video program
Printable slides
- Knowledge Building Session: How to Deploy Teams that Provide Continuous Team-Based Care (January 12, 2010)
Moderator: Ed Wagner, MD, MPH, MacColl Institute for Healthcare Innovation
Speakers: Pat Jacobsen, RN and Morris Askenazi, MD, La Casa-Quigg Newton Family Health Center (Denver, CO); Somava Stout, MD, Kirsten Meisinger, MD, Megan Littlefield, MD and Nitzali Rivera, MA, Cambridge Health Alliance (Boston, MA)
Audio & video program
Printable slides
Mammogram Workflow Sheet
- Structured Communication Methods to Enhance Team-Based Care (November 23, 2009)
Speaker: Sharon Eloranta, MD, Qualis Health
Audio & video program
Printable slides

