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Team Meetings Case Report: Boston Medical Center

Internal medicine practice teams at Boston Medical Center meet every Friday morning from eight to nine. Some weeks individual practice teams of six to eight people (front desk staff, medical assistants, nurses, and clinicians) meet in their pods and work on specific projects, such as optimizing huddles, exam room stocking, or creating a wait-time notification board for the waiting area. Once a month, all six practice teams meet together for large group announcements and celebrations of success before separating into their pods for individual team breakout work.

Dr. Charlotte Wu, Director of the General Internal Medicine Primary Care Clinic, reports this meeting system “has allowed the multidisciplinary team members to get to know each other in a more personal way, which breaks down hierarchies and silos, and improves communication. It also helps move quality improvement projects forward, in part because they stem from the ground up. It gives each team member a voice. We've found that hot topics have engaged people on areas that they are particularly passionate about and help identify on-the-ground champions. Through integration of ideas from each team, these team meetings have helped us get buy-in and consensus on practice-wide workflows that could be standardized.”

Ashlyn Tate, one of the managers in the General Internal Medicine Primary Care Clinic, reports, “Team meetings make us feel like a special group of people, different from all the others, and helps us bond together in a way we didn't before. We learn more from each other, and all aspects of our lives, including our family lives, benefit from this experience. We learn what we can do to support each other with patients and what makes each of us tick.”

These meetings also give the team the time and space to troubleshoot issues together. For example, one issue was knowing which nurse was assigned to which role each day. After discussing the issue and possible solutions in the team meeting, the team decided to write the names and roles of the nurses on a white board in a common area. Having the clear communication helped the flow of the clinic and made the team more efficient.

Team meetings also provide the opportunity to educate each other on health items that are relevant for the current time, such as Ebola. Team members learned about the disease, how it is transmitted, and how to respond if a patient presents with symptoms.

At meetings, the team talks about how recent changes are working. For example, the front desk staff worked together to create specific lanes for certain patient needs at the front desk. This was a creative solution that was identified by the staff at a team meeting, and it helped alleviate stress that both patients and staff were experiencing.

Briana Dukas, who is also a practice manager in the clinic, said, “I have taken feedback discussed during team meetings back to my colleagues to address on a broader scale. With email or face-to-face conversations, I've communicated to my team how we are working to address those line-clogging issues. I think the team appreciates having a forum to discuss challenges we encounter in our practice.

“The other benefit to the meetings is that it gives all team members a chance to show why certain changes are necessary. It's not always obvious to the physician why the front desk does something a certain way, or vice versa. The team meetings are a chance to clear up some of that mystery.”

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