Integrated Care Team Assessments
Many health care organizations have been implementing multi-disciplinary or integrated care teams in an effort to improve care coordination and boost care quality. Southcentral Foundation pioneered this in the medical home model nearly 25 years ago and has since published an Integrated Care Teams playbook and a Behavioral Health Integration playbook. Over the last few years, organizations have sought assessments of their integrated care teams from subject matter experts working in SCF’s Nuka System of Care.
SCF’s Integrated Care Teams (ICT) assessments have assisted organizations that are either looking to implement their own Integrated Care Teams, or that have already implemented them and are looking for feedback on how to optimize and improve them. ICT assessments can also include assessment of other service areas such as behavioral health depending on the needs of the organization. To perform an ICT assessment, SCF sends a team of subject matter experts to the location of the organization’s primary care clinic(s). This team will include members of SCF’s Integrated Care Teams, typically a primary care provider and a registered nurse case manager, who have director-level roles at SCF. Other team members may include other providers, improvement advisors, and/or members of SCF’s leadership, such as Vice Presidents.
For the assessment process, SCF’s consultants review documents, observe clinical workflow, and interview staff agreed upon ahead of time with the organization’s leadership. To gain a full understanding of the effectiveness of ICTs and the environment in which they operate, SCF does not limit its interviews to care team members. SCF speaks to employees ranging from top leadership to front-line administrative support staff.
After the assessment is completed, SCF provides a report to the organization detailing both the strengths observed by SCF’s consultants, as well as opportunities for improvement and associated recommendations. The topics covered can include not only the organization’s ICTs, but also a wide variety of other topics that impact ICT effectiveness such as leadership, communication, data collection and usage, referrals to other providers outside primary care, clinic operations, physical space, and more. SCF then discusses the report with organizational leadership in a debrief session.
SCF has received positive feedback on its ICT assessments from other organizations. When talking about an ICT assessment performed for them, a member of one organization stated “…when we talked about feedback after the consultants were here and did their visit, one of the things that I heard, almost from every location was the fact that they sat and listened to us and took what we said and gave feedback and we felt heard.” They also stated “when we got the feedback from the consultant report, we were really able to take a look at that and share that with our other leadership… [SCF] gave us recommendations on ways to hopefully streamline integrated care, and make it successful.”
For more information about SCF’s ICT assessments, SCF’s other consulting offerings, or any aspect of SCF’s Nuka System of Care, feel free to contact the SCF Learning Institute.
