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Team MeetingsStrengthen Relationships and Increase Productivity

Learning Objectives:
At the end of this activity, you will be able to:
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.
0.5 Credit CME
How will this module help me?

  1. Identifies ten steps to help successfully conduct regular team meetings.

  2. Provides answers to common questions and concerns about team meetings.

  3. Outlines case reports describing how practices are successfully using team meetings.

  4. Shares team meeting implementation tools for you to use in your practice.

Introduction

What is a team meeting?

Team meetings bring all members of the practice, such as the physician, nurse, medical assistant (MA), and receptionist (you may have to put the phones on voicemail), together to analyze the way work is currently being done and take steps to improve efficiency. In effective team meetings, each team member is encouraged to share ideas to improve the practice's workflow.

Ten STEPS for effective team meetings

  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, who is responsible, and due dates.

  8. Practice good meeting skills.

  9. Have some fun!

  10. Celebrate your successes.

Step 1 Identify the team.

The composition of the team may vary based on the size of the practice or the setting where care is being provided. In one setting, the team might include two physicians and their MAs, nurses, and the clinic manager. In another setting, the team may be one physician, two 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 staff members, such as social workers and pharmacists, may be included.

Box Section Ref ID

Q&A

  • Should we include all the physicians and staff in our department?

    It depends. Yes, if you have a small team. No, if you have a large department. A team meeting with 4 to 12 people will be most productive. In a large team, it may be difficult for each team member to provide input and actively participate.

  • Should we include administrative leaders, IT, or compliance personnel on the team?

    Team meetings are problem-solving sessions. They are most effective when the standing team consists of the people directly doing the work and a manager who can connect with the larger organization. If the topic would benefit from an expert's contribution to the discussion, you can invite IT professionals, facilitators, or administrative leaders as needed.

Step 2 Meet regularly and “on-the-clock.”

Establish a regular meeting date and time during the work day, or “on-the-clock”, as the message that team meetings are part of the paid work day is important. Many teams meet for one hour every two weeks. You may find that meeting first thing in the morning results in fewer distractions. When possible, the meeting should occur “on-the-clock” and away from the clinical area to minimize interruptions.

“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
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Q&A

  • How can we meet when the phones keep ringing?

    Some practices meet before the clinic opens (but on-the-clock), whereas others turn off the phones during the meeting. Another option is to assign someone from another team to handle the phones so team members are not distracted. Each of these actions demonstrates the importance of team meetings to your practice.

  • We just instituted huddles before clinic sessions. How are team meetings different?

    Daily huddles are usually 5- to 10-minute discussions that serve to ensure team members are on the same page about the particular needs of the day. Issues that are identified in daily huddles that need further review can be added to the “parking lot” and discussed in further detail at the next team meeting, which typically occur weekly or bi-weekly. Team meetings are also an opportunity to improve workflows and strengthen team culture.

Step 3 Agree on ground rules.

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.

Some suggestions for ground rules are listed below:

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

  2. Be present: Leave devices behind. 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 clock wise direction, ensuring that all members are heard in an orderly process.

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

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Q&A

Step 4 Set a consistent meeting agenda.

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

Common standing items 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, place 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 opt to prioritize the items at the beginning of the meeting.

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Q&A

  • What is a check-in and what is its purpose in a team meeting?

    The check-in is a one- to two-minute opportunity for each team member to share something about their personal life. These few minutes can help establish a sense of community and allow people to set aside their worries. For example, a team member might share, “My roof is leaking and I've been calling around all morning,” or, “My child stayed home sick today and I'm a little distracted.” The check-in can also be a time for people to share positive events that may improve team building: “I found out my sister is going to have a baby!” Participation in the check-in is optional.

  • What is a shout-out and what is its purpose in a team meeting?

    More formally known as “appreciative observation,” a shout-out is a time where team members can share something that went well since they last met. This may include successful implementation of a new process or improvements in a particular patient's care. Stories that involve multiple team members are particularly meaningful. Such stories are powerful tools for team engagement and building team culture. Knowing that this time will always be part of the meeting agenda encourages team members to keep track of and report on successes.

  • What is a check-back?

    A check-back is the opportunity to revisit former agenda items or give updates on projects that were developed to solve problems discussed in previous team meetings.

  • What do we do when there are too many items on the agenda?

    It helps to spend one to two minutes at the beginning of the meeting setting priorities. The chair might say, “We have six new items on the agenda, what is your priority?” If time runs out, lower priority items can be moved to the next team meeting agenda. Assigning time limits—and sticking to them—can help the team efficiently move through a busy agenda.

    When an agenda item requires in-depth discussion, the chair can organize a team of volunteers to discuss the topic outside of the team meeting. This recognizes that the issue is beyond the scope of the meeting but is important to the team to resolve.

  • What is a debrief and what is its purpose in a team meeting?

    The debrief is a chance to immediately assess the meeting's effectiveness. The debrief focuses on promoting and encouraging the positive elements of the meeting with immediate feedback. At the close of the meeting, the chair may choose to ask, “Was there a portion of the meeting that was particularly meaningful or useful to you?” This approach promotes continual process improvement.

Step 5 Rotate meeting roles.

Assign 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 MA might lead the meeting and the physician records the minutes. This approach can help build team culture, promote collaboration, and develop leadership skills.

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Q&A

  • What does each role do in a team meeting?

    Quiz Ref IDThe chair helps organize the meeting and keeps the discussion on track by following the agenda as the meeting progresses. The timekeeper ensures that the discussion follows the allotted time per item so all agenda items are covered. The recorder takes notes and creates the minutes, capturing decisions, action items, and individual(s) responsible for each task.

  • The physicians are the owners and leaders in our practice. Can rotating the chair of the meeting work in our organization?

    Absolutely. While the physicians or other leaders will ultimately make the major financial and operational decisions, there are many issues at the practice level that are best worked out as a team. It takes time to break down the hierarchy in a practice and establish a level of comfort in speaking up. In the most effective team meetings, individuals “check their titles at the door,” to allow each team member to make important contributions. In a situation such as this, you should help staff understand that their roles are essential to the success of the team and the practice. This approach can help build team culture and confidence. Leaders that develop leaders can assure the success of the organization.1

  • What if some team members do not want to rotate in and run the meeting as chair?

    Some team members may not initially be comfortable with the leadership role as meeting chair, and it is worth investing time in their development. Managers can explain, “It's okay if you need help. Taking a turn as meeting chair is something that we all do as part of our jobs. We will mentor you in this rotating leadership role and are committed to your success.” Help them prepare by beginning mentorship right away and distributing the calendar with meeting dates and team member roles well in advance of the meeting.

  • How do we keep team meetings on track and focused?

    One of the responsibilities of the chair is to watch for wandering discussions and steer the group back to the topic by asking, “Should we be discussing this right now? Should the subject be taken offline from here?” or suggesting, “That sounds like an issue to put in the ‘parking lot' and talk about at another time. Let's make sure it's on the agenda for our next meeting.”

    When an agenda item requires in-depth discussion, the chair can organize a team of volunteers to discuss the topic outside of the team meeting. This recognizes that the issue is beyond the scope of the meeting but is important to the team to resolve.

Step 6 Solve problems as a group.

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 staff.

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Q&A

Step 7 Record action items, who is responsible, and due dates.

Record minutes from each meeting on a standard form and post online or in an accessible place so team members can reference it in the future. Before concluding each meeting, identify action items, who is responsible, and due dates. This information should be captured on the standard form. At the next meeting, use the check-back to report on the status of each action item and continue to monitor progress.

Step 8 Practice good meeting skills.

Good habits make meetings more productive. These 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.

Box Section Ref ID

Q&A

Step 9 Have some fun!

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 (e.g., role-playing, games, or team-building exercises) can translate into serious improvements in reaching the mission of the group.

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Q&A

  • Do you have any suggestions for fun activities to promote team cohesion?

    One leader reports that he often opens meetings with an icebreaker or team-building exercise, such as having each attendee:

    • Tell the team something about their name, such as its meaning or origin.

    • Share two truths and one lie about themselves; teammates guess which one is the lie.

    • Tell the person to their left something that they appreciate about that individual.

    Dedicate time at the beginning of a meeting to create a logo or motto for the team that captures the team's mission and purpose.

Step 10 Celebrate your successes.

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
Conclusion

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.

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AMA Pearls

Annual themes and meetings.

In addition to weekly meetings to discuss practical issues such as workflows and staffing, some practices have larger, quarterly or yearly meetings.

For example:

One practice at Martin's Point HealthCare in Bangor, Maine, holds a practice-wide retreat once a year.

At Southern Illinois University, there are quarterly “stand-down days” where all the physicians and team members from different specialties meet. There is an annual theme for these meetings. Past themes have included Diversity & Inclusion, Integrity & Accountability, Compassion & Respect, Collaboration & Partnership, and Continuous Improvement.

Glossary

on-the-clockon-the-clock: Time during which the practice team members are compensated for their time, which may or may not be during regular clinic hours.

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0.5 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;

0.5 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;

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0.5 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program;

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

Article Information

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this enduring material activity for a maximum of .50 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Target Audience: This activity is designed to meet the educational needs of practicing physicians, practice administrators, and allied health professionals.

*Disclaimers: Individuals below who are marked with an asterisk contributed towards Version 1 of this learning activity.

Statement of Competency: This activity is designed to address the following ABMS/ACGME competencies: practice-based learning and improvement, interpersonal and communications skills, professionalism, systems-based practice, interdisciplinary teamwork, quality improvement and informatics.

Planning Committee:

  • Christine A. Sinsky, MD, FACP, Vice President, Professional Satisfaction, American Medical Association*

  • Marie Brown, MD, MACP, Senior Physician Advisor, Professional Satisfaction and Practice Sustainability, American Medical Association & Associate Professor, Rush Medical College, Rush University Medical Center

  • Renee DuBois, MPH, Senior Practice Transformation Advisor, Professional Satisfaction and Practice Sustainability, American Medical Association

  • Brittany Thele, MS, Program Administrator, Professional Satisfaction and Practice Sustainability, American Medical Association

  • Julia McGannon, Segment Marketing Manager, Member Programs & CME Program Committee, American Medical Association

  • Rita LePard, CME Program Committee, American Medical Association*

  • Ellie Rajcevich, MPA, Practice Development Advisor, Professional Satisfaction and Practice Sustainability, American Medical Association*

  • Sam Reynolds, MBA, Director, Professional Satisfaction and Practice Sustainability, American Medical Association*

  • Krystal White, MBA, Program Administrator, Professional Satisfaction and Practice Sustainability, American Medical Association*

Content Reviewers:

  • J. James Rohack, MD, FACC, FACP, Senior Advisor and former President, American Medical Association

  • Renee DuBois, MPH, Senior Practice Transformation Advisor, Professional Satisfaction and Practice Sustainability, American Medical Association

  • Brittany Thele, MS, Program Administrator, Professional Satisfaction and Practice Sustainability, American Medical Association

  • Philip A. Bain, MD, FACP, Site Chief, Dean Health System, East Clinic-Internal Medicine*

  • Anton Kuzel, MD, MHPE, Professor and Chair, Department of Family Medicine and Population Health, Virginia Commonwealth University*

  • Jeffrey Panzer, MD, Family Practice Physician & Medical Director of QI, Oak Street Health*

  • Ellie Rajcevich, MPA, Practice Development Advisor, Professional Satisfaction and Practice Sustainability, American Medical Association*

  • Sam Reynolds, MBA, Director, Professional Satisfaction and Practice Sustainability, American Medical Association*

  • Andrew Schutzbank, MD, MPH, Vice President, Clinical Development, Iora Health*

  • Rachel Willard-Grace, MPH, Research Manager, Center for Excellence in Primary Care, Department of Family & Community Medicine, University of California, San Francisco*

About the AMA Professional Satisfaction and Practice Sustainability Group: The AMA Professional Satisfaction and Practice Sustainability group has been tasked with developing and promoting innovative strategies that create sustainable practices. Leveraging findings from the 2013 AMA/RAND Health study, “Factors affecting physician professional satisfaction and their implications for patient care, health systems and health policy,” and other research sources, the group developed a series of practice transformation strategies. Each has the potential to reduce or eliminate inefficiency in broader office-based physician practices and improve health outcomes, increase operational productivity and reduce health care costs.

Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships.

ABMS MOC Statement: Through the American Board of Medical Specialties (“ABMS”) ongoing commitment to increase access to practice relevant Maintenance of Certification (“MOC”) Activities, this activity has met the requirements as an MOC Part II CME Activity. Please review the ABMS Continuing Certification Directory to see what ABMS Member Boards have accepted this activity.

Renewal Date: February 22, 2016; May 23, 2019

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