Team MeetingsStrengthen Relationships and Increase Productivity

Learning Objectives

1. Describe key roles involved in effective team meetings

2. Recognize the importance of setting ground rules and a consistent meeting agenda

3. Identify when team meetings are an effective method to accomplishing a goal

4. Define habits that lead to productive team meetings

What Is a Team Meeting?

Team meetings bring all members of the practice, such as the physician, nurse, medical assistant (MA), and office team members together to analyze the way work is currently being done and take steps to improve efficiency. Because all team members should be involved, you may have to send calls to voicemail during this time. In effective team meetings, each team member is encouraged to share ideas to improve the practice's workflow.

Ideas arising from team meetings vary in scope and scale. For example, team meetings at Boston Medical Center identified patient “lanes” at the front desk area as a mechanism to address specific types of patient needs. This simple solution alleviated stress for patients and the front desk team. At Bellin Health System, a team meeting brought together the extended care team to develop a care plan for one patient with chronic health issues that served as a model for helping other patients with similar needs. These examples demonstrate why it is imperative to involve all members of the practice.

1. Identify the Team

2. Meet Regularly and “On-the-Clock”

3. Agree on Ground Rules

4. Set a Consistent Meeting Agenda

5. Rotate Meeting Roles

6. Solve Problems as a Group

7. Record Action Items, Individuals Responsible, and Due Dates

8. Practice Good Meeting Skills

9. Have Some Fun!

10. Celebrate Your Successes

The team's composition may vary based on the practice's size or care setting. In one practice, the team might include 2 physicians and their medical assistants, nurses, and the clinic manager. In another practice, the team may include 1 physician, 2 nurses, and a receptionist who also handles the billing. Smaller practices may invite the lab or X-ray technicians to team meetings. In larger practices, other relevant team members, such as social workers and pharmacists, may be included.

Establish a regular meeting time and location. Meetings should be held away from the clinical area if they take place during patient care hours, and should be scheduled “on-the-clock”—time during which the practice team members are compensated, which may or may not be during regular clinic hours—to convey the message that meetings are part of the team's core workday. Many teams meet for one hour every 2 weeks. You may find that meeting first thing in the morning results in fewer distractions.

“Our care team meetings, where we talk about patient experience, health outcomes, and time spent on specific tasks, make the practice a more enjoyable place to work and has ultimately helped us recruit and retain staff.”

—Beth Averbeck, MD, HealthPartners Medical Group, Minneapolis, MN

To form a supportive and respectful environment for your team meeting, establish ground rules from the beginning. As a team, create your own set of ground rules to create buy-in on team meetings and strengthen teamwork. Signing a charter or statement of purpose can help the team connect with the ground rules and their commitment to the group.

Quiz Ref IDSome suggestions for ground rules are listed below:

1. Start on time, end on time: Come to the meeting on time and ready to work. End on time so team members grow to trust their time commitments.

2. Be present: Leave devices behind if possible. Those on call for patient care are exempted. Don't check your phone or your laptop during the meeting unless doing so adds to the topic at hand.

3. Stay on topic: If the discussion wanders, the meeting chair or another team member can say, “Let's take that offline,” or “That sounds like an issue to put in the ‘parking lot’ to talk about at another meeting.”

4. Focus on the issue, not the individual: The goal is to work together to improve the work, not to blame or incriminate individual people.

5. Step up or step back: Speak up if you've been quiet in the meeting; step back and let others speak if you've been speaking often. During their turn as meeting chair, team members may need some practice in drawing out quiet members. To encourage participation, you may say, “We haven't heard from everyone—Samuel, what do you think?” Another technique is for the chair to announce that the team will hear from everyone going in a clockwise direction, ensuring that all members are heard in an orderly process.

6. Give thanks: Thank each other for contributing during the meeting and afterward.

Many teams use an agenda template to set a consistent agenda for each meeting.

Common standing items (described in the Q&A that follows) include:

• Check-in

• Shout-out

• Check-back

• New business

• Education

• Debrief

Post the meeting agenda ahead of time, either online or on a bulletin board. Allow all team members to write in or submit agenda items. Next to each agenda item, write the name of the person responsible for leading the discussion and the approximate time allotted. Assigning a time for each item will help the meeting stay on schedule. If there are many items on the agenda, you may wish to prioritize them at the beginning of the meeting.

Quiz Ref IDAssign a different team member to the roles of chair, timekeeper, and recorder for each meeting. During one meeting, the receptionist might fill the role of meeting chair, while the nurse manager records the minutes as recorder. At another meeting, the medical assistant might lead the meeting, while the physician records the minutes. This approach can help build team culture, promote collaboration, and develop leadership skills.

Team meetings are a time for everyone to engage in problem-solving to make their collective work better, not a time for leadership to communicate new policies and procedures to the team. Updating team members on practice- or system-wide information may be better suited for the larger departmental team meeting.

Topics to discuss as a group include the “nuts and bolts” of running a practice. Consider brainstorming ways of optimizing workflows for the following tasks:

• Common clinical scenarios

• Pre-appointment questionnaire workflows

• Updating patients' medications lists

• Assigning roles and responsibilities for administering specific immunizations

• Housekeeping responsibilities

• Patient flow for procedures

• Post-care follow-up

Make sure that someone is recording minutes during each meeting on a standard form. Before concluding each meeting, identify action items, the individuals responsible for them, and their due dates. After the meeting post the minutes online or in an accessible place so team members can reference them in the future. At the next meeting, use the check-back to report each action item's status and continue to monitor progress.

Quiz Ref IDGood habits make meetings more productive. Some examples of good meeting habits include:

• Staying on task

• Focusing lengthy discussions by identifying important, but off-topic, items as “parking lot” issues to get back to later during the meeting or to address at another time

• Avoiding side conversations

• Making a point to respond constructively rather than negatively

• Maintaining respect and understanding for others' points of view

• Encouraging equal participation so that no one dominates the discussion

Occasionally, meetings may go astray despite your best efforts to keep them on track even when applying all of the good meeting skills outlined above. This may be the result of an individual who is negative, argumentative, or disrespectful of other team members. In those situations, you may find that a “praise in public, coach in private” approach can help address negative feedback or interactions, disrespect, or other issues encountered during the meeting. The following video is an example of how to coach in a constructive way.

It is important to have fun at team meetings. Promoting the team's shared purpose, respect, and friendship improves team culture and employee engagement. A bit of fun (eg, role-playing, games, or team-building exercises) can translate into significant improvements in reaching the group's mission.

Keep a running list of the team's accomplishments and periodically refer to it. Share stories about particularly meaningful patient interactions. Tell stories about inspiring patient encounters.

“During a team meeting, the physicians told one of our LPNs how much her pre-visit planning work helps them during patient visits. She realized how important the pre-visit planning process was to her team, and she quickly became the top performer.”

—Katie Holley, MHA, System Business Development and Planning Consultant, Fairview Health Services, Minneapolis, MN

Quiz Ref IDTeam meetings can help your practice efficiently and effectively solve problems, develop stronger bonds between team members, and provide better patient care. The strategies and tactics presented in this module will support your efforts to implement and conduct successful team meetings.

Journal Articles and Other Publications

• Godfrey M, Nelson EC, Batalden P, Trustees of Dartmouth College, Institute for Healthcare Improvement, and the Joint Commission. Clinical microsystems: the place where patients, families and clinical teams meet. Assessing, diagnosing and treating your long-term care facility. 2001. Updated October 16, 2017. Accessed February 15, 2021. http://clinicalmicrosystem.org/uploads/documents/long-term-care-workbook.pdf

  While this workbook focuses on long-term care, it offers several worksheets you may find useful for implementing team meetings in your practice, including a Meeting Notes template (p. 8), sample Staff Satisfaction Survey and Skills Assessment worksheet (pp. 18–20), and a practice improvement initiatives chart (p. 38).* Chase SM, Nutting PA, Crabtree BF. How to solve problems in your practice with a new meeting approach. Fam Pract Manag. 2010;17(2):31-34. https://www.aafp.org/fpm/2010/0300/p31.html

• Stewart EE, Johnson, BC. Huddles: Improve office efficiency in mere minutes. Fam Pract Manag. 2007;14(6):27-29. https://www.aafp.org/fpm/2007/0600/p27.pdf* Shenkel R. How to make your meetings more productive. Fam Pract Manag. 2003;10(7):59-60. https://www.aafp.org/fpm/2003/0700/p59.pdf

• Sinsky CA, Willard-Grace R, Schutzbank AM, Sinsky TA, Margolius D, Bodenheimer T. In search of joy in practice: a report of twenty-three high-functioning primary care practices. Ann Fam Med. 2013;11(3):272-278. doi:10.1370/afm.1531

• Sinsky CA, Sinsky TA, Althaus D, Tranel J, Thiltgen M. ‘Core teams': Nurse-physician partnerships provide patient-centered care at an Iowa practice. Health Aff (Millwood). 2010;29(5):966-968. doi:10.1377/hlthaff.2010.0356

• Lencioni PM. Overcoming the five dysfunctions of teams: A field guide for leaders, managers, and facilitators. 1st ed. Jossey-Bass; 2007. https://trove.nla.gov.au/work/7423423* Stout, S, Klucznick C, Chevalier A, et al. for the Cambridge Health Alliance. Cambridge Health Alliance model of team-based care implementation guide and toolkit. January 2012. Accessed February 15, 2021. http://www.safetynetmedicalhome.org/sites/default/files/CHA-Teams-Guide.pdf* Lind C, Redditt V, Satterstrom P, et al. for the Cambridge Health Alliance. Cambridge Health Alliance practice improvement team (PIT) development toolkit. September 2014. Accessed February 15, 2021. http://www.improvingprimarycare.org/sites/default/files/topics/Team-Step6-Cambridge-Practice%20Improvement%20Team-Toolkit.pdf

• Kreamer L, Rogelberg S. Leadership & professional development: evidence-based strategies to make team meetings more effective. J Hosp Med. 2020;15(4):236. doi:10.12788/jhm.3294

Videos and Webinars

• Best practice clinical innovation: Team huddle communications and pre-visit team planning. University of California Davis Health System. November 10, 2010. Accessed February 15, 2021. https://www.youtube.com/watch?v=VxdG2_nZ2fc