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Background <p>High-performing teams anchored by quality improvement and practice transformation skills strengthen primary care by improving patient outcomes. Effective team-based care may be particularly valuable in medically underserved communities (MUCs).</p> Objective <p>To evaluate the impact of a team-based training program that focused on quality improvement and practice transformation skills in community health centers (CHC) serving under-resourced communities across the Commonwealth of Massachusetts.</p> Design <p>The Advancing Teams Program was delivered to CHC teams over 6&#xa0;years (2016–2022). The evaluation used a mixed methods design to assess the program’s impact.</p> Participants <p>Forty-seven interdisciplinary teams from CHCs serving MUCs in Massachusetts. The 327 individual participants included administrative staff, clinicians, and trainees.</p> Approach <p>Evaluative data included participating CHC team and clinic demographics, pre-post evaluation of participants’ perceptions of practice transformation using the Qualis Health Patient-Centered Medical Home Assessment (PCMH-A), and qualitative analysis of team improvement projects to identify themes related to project aims, practice transformation skills, and patient outcomes.</p> Key Results <p>CHCs participating in the ATP program served under-resourced communities, with &gt; 65% serving high levels of Medicaid and uninsured patients. Pre-post PCMH-A analysis indicated significant improvements (<i>p</i> &lt; 0.05) in team members’ perceptions of leadership engagement, team-based care, evidence-based practices, patient-centered interactions, access, and care coordination. The largest improvement was seen in patient-centered interactions (+ 1.04, <i>p</i> = 0.001), with ATP participation strongly associated with improved perceptions of encouraging patients to expand their role in decision-making, health-related behavior change, and self-management. Positive change in perceived leadership engagement predicted greater improvement in clinic functioning (<i>β</i> = 0.68, <i>p</i> &lt; 0.001). Qualitative analysis showed that ATP teams successfully improved care in areas such as behavioral health, diabetes, substance abuse, and social determinants of health.</p> Conclusions <p>ATP is a promising approach to building primary care teams within under-resourced CHCs. Additional research should include evaluation of team quality and robust approaches to measuring improvement projects.</p> Graphical Abstract <p></p>

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Building Community Health Center Teams: Evaluating the Impact of Team Training

  • 期刊论文

  • 发表日期：

    2025年4月21日

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  • Young-Jin Sohn,
  • Hannah L. Schmitt,
  • Amie A. Pollack,
  • Erin E. Sullivan,
  • Lindsay S. Hunt,
  • Chenelle Norman,
  • Jennifer Azzara,
  • Julita Mir,
  • Louise Keogh Weed,
  • Amanda Frank,
  • Russell S. Phillips

摘要

Background

High-performing teams anchored by quality improvement and practice transformation skills strengthen primary care by improving patient outcomes. Effective team-based care may be particularly valuable in medically underserved communities (MUCs).

Objective

To evaluate the impact of a team-based training program that focused on quality improvement and practice transformation skills in community health centers (CHC) serving under-resourced communities across the Commonwealth of Massachusetts.

Design

The Advancing Teams Program was delivered to CHC teams over 6 years (2016–2022). The evaluation used a mixed methods design to assess the program’s impact.

Participants

Forty-seven interdisciplinary teams from CHCs serving MUCs in Massachusetts. The 327 individual participants included administrative staff, clinicians, and trainees.

Approach

Evaluative data included participating CHC team and clinic demographics, pre-post evaluation of participants’ perceptions of practice transformation using the Qualis Health Patient-Centered Medical Home Assessment (PCMH-A), and qualitative analysis of team improvement projects to identify themes related to project aims, practice transformation skills, and patient outcomes.

Key Results

CHCs participating in the ATP program served under-resourced communities, with > 65% serving high levels of Medicaid and uninsured patients. Pre-post PCMH-A analysis indicated significant improvements (p < 0.05) in team members’ perceptions of leadership engagement, team-based care, evidence-based practices, patient-centered interactions, access, and care coordination. The largest improvement was seen in patient-centered interactions (+ 1.04, p = 0.001), with ATP participation strongly associated with improved perceptions of encouraging patients to expand their role in decision-making, health-related behavior change, and self-management. Positive change in perceived leadership engagement predicted greater improvement in clinic functioning (β = 0.68, p < 0.001). Qualitative analysis showed that ATP teams successfully improved care in areas such as behavioral health, diabetes, substance abuse, and social determinants of health.

Conclusions

ATP is a promising approach to building primary care teams within under-resourced CHCs. Additional research should include evaluation of team quality and robust approaches to measuring improvement projects.

Graphical Abstract