1. Fostering Partnerships and Teamwork in the Pediatric Medical Home: A “HOW TO” Webinar Series brought to you by the National Center for Medical Home Implementation Implementing Team Huddles February 28, 2014 Noon – 1 pm (Central)

2. Fostering Partnerships and Teamwork in the Pediatric Medical Home: A “HOW TO” Webinar Series brought to you by the National Center for Medical Home Implementation Moderator: Christopher Stille, MD, MPH, FAAP General Pediatrics University of Colorado School of Medicine, CO

3. Fostering Partnerships and Teamwork in the Pediatric Medical Home: A “HOW TO” Webinar Series brought to you by the National Center for Medical Home Implementation Faculty: Lester Hartman, MD, MPH, FAAP Westwood/Mansfield Pediatrics, MA

4. Fostering Partnerships and Teamwork in the Pediatric Medical Home: A “HOW TO” Webinar Series brought to you by the National Center for Medical Home Implementation Faculty: Courtney Nelson, BSN, RN Westwood/Mansfield Pediatrics, MA

5. Disclosures We have no relevant financial relationships with the manufacturers(s) of any commercial products(s) and/or provider of commercial services discussed in this activity. I do not intend to discuss an unapproved/investigative use of a commercial product/device in my presentation.

6. The best 5 unreimbursed minutes you will ever spend… It’s 3:15 PM on a Tuesday. Patients are starting to back up. The nurse on your team stops you between patients to tell you that your 2:45 PM patient with autism is starting to get really cranky because he doesn’t like to wait in the exam room. She also tells you that you need to reorder different shots for your 2:30 PM patient because of that vaccine shortage that keeps going. As you hurry to your 2:45 patient, the MA on your team tells you she has to leave early because of her kids’ school play she told you about last week. And you see that your 3 PM patient with special needs is only booked for a 15 minute visit.

7. What choices do you have? a. Run faster b. Behave badly c. Get a colleague to see one of your patients d. Ignore the whole thing and keep plugging along e. Vow that next time, you will prevent all this with a… TEAM HUDDLE

8. Webinar Objectives By the end of this webinar, the participant will be able to: Define the term “team huddle” and explain its effectiveness as part of a team-based approach to providing care. Describe strategies for implementation of team huddles within a pediatric practice. Provide examples of successful team huddle implementation in a pediatric practice.

9. Pediatric Medical Home Team-based approach Team huddles provide a strategy to providing team based care within a medical home

10. Defining Team Huddles Regularly scheduled short meetings for a practice team Goals:  Improve team’s ability to work together  Enhance quality of patient care Multiple levels: Periodic, longer team huddles Daily, shorter team huddles

11. Benefits of Team Huddles Frequent communication Full participation Ability to plan for changes Foresight Improved organization Improved patient outcomes, care coordination, overall safety Enhanced work environment Improved patient, family, and staff satisfaction Improved team culture

12. Starting a Team Huddle Discuss concept with staff and providers Highlight the benefits Propose scheduling Alert all team members

13. Conducting a Team Huddle Limit to 15 minutes Choose a central location Create expectations, objectives, and an agenda Designate leader and note taker Prepare necessary supporting documents Review previous work; allow participants to see progress Designate a person to bring the patient schedule for each day

14. Suggested Team Huddle Agendas Patients that require more time/assistance Preventing backlog Openings which can be filled, chronic no-shows, special instructions for patients Provider and staff scheduling Path of patient flow Lab tests, results, notes from physicians Vaccinations

15. Team Huddles Best Practice Lester Hartman, MD, MPH, FAAP Courtney Nelson, BSN, RN Westwood Mansfield Pediatrics

16. Macro or Regular Huddles  Standardizing Care  2 times per day  Morning  Evening  Staff involvement  Staff and Triage RNs, NPs, MDs, soon to include a therapist  5 minutes long  Agenda Items

17. Westwood Mansfield Pediatrics Mini Huddles  Individualizing Care  Staffing:  1:1 Staff nurse and assigned MD or NP  5 minutes long  Agenda Items

18. Westwood Mansfield Pediatrics Team huddles from a nursing perspective  Scheduling Issues  Know Your Patient’s Needs  Boost Morale  Introducing New Employees

19. Conclusion Team huddles are an effective part of a team-based approach to primary care. Benefits of team huddles include improved ability of a clinical team to work together and increased quality of patient care.

20. Resources Institute for Health Care Improvement: Team HuddlesTeam Huddles California Health Care Safety Net Institute: Embracing Daily Team HuddlesEmbracing Daily Team Huddles US Department of Defense: Briefs and Huddles ToolkitBriefs and Huddles Toolkit The Checklist Manifesto: How to Get Things Right, Atul Gawande

21. NCMHI Educational Video Series Don’t forget to view the National Center for Medical Home Implementation (NCMHI) Video Series. Topics Include:  Team Huddles Team Huddles  Care Partnership Support Care Partnership Support  Family Advisory Groups Family Advisory Groups

22. Save the Date Fostering Partnerships and Teamwork in the Pediatric Medical Home: A “HOW TO” Webinar Series Enhancing Care Partnership Support March 27, 2014, 1 – 2 PM CST REGISTER NOW Starting and Supporting Family Advisory Groups April 24, 2014, 11 am – Noon CST REGISTER NOW

23. We’re Here to Help You! Have a question about medical home? Contact us! Medical_home@aap.org 800/433-9016 ext 7605 Subscribe to our Listserv!

24. Questions?

25. Save the Date Fostering Partnerships and Teamwork in the Pediatric Medical Home: A “HOW TO” Webinar Series Enhancing Care Partnership Support March 27, 2014, 1 – 2 PM CST REGISTER NOW Starting and Supporting Family Advisory Groups April 24, 2014, 11 am – Noon CST REGISTER NOW