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Effective teams include members representing three different kinds of expertise within the organization: system leadership, technical expertise, and day-to-day leadership. There may be one or more individuals on the team with each kind of expertise, or one individual may have expertise in more than one area, but all three areas should be represented in order to drive improvement successfully.
System Leadership
Teams need someone with enough authority in the organization to institute a change that has been suggested and to overcome barriers that arise. The team's system leader understands both the implications of the proposed change for various parts of the system and the more remote consequences such a change might trigger. It is important that this person have authority in all of the areas that are affected by the change. This person must have the authority to allocate the time and resources the team needs to achieve its aim.
Clinical Technical Expertise
A technical expert is someone who knows the subject intimately and who understands the processes of care. An expert on improvement methods can provide additional technical support by helping the team determine what to measure, assisting in design of simple, effective measurement tools, and providing guidance on collection, interpretation, and display of data.
Day-to-Day Leadership
A day-to-day leader is the driver of the project, assuring that tests are implemented and overseeing data collection. It is important that this person understands not only the details of the system, but also the various effects of making change(s) in the system. This person also needs to be able to work effectively with the physician champion(s).
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Example 1: Improving Care in Office Practices
Aim: We will improve care for all our patients with chronic disease by making improvements in our clinic that impact the six dimensions of quality, as outlined in the Institute of Medicine report, Crossing the Quality Chasm: A New Health System for the 21st Century. Team:
Team Leader: ____, MD, Medical Director for primary care clinics Technical Expert: ____, MD, Physician at downtown clinic Day-to-Day Leader: ____, RN, Manager of downtown primary care clinic Additional Team Members: Patient educator, medical assistant, clerk/scheduler, laboratory manager, quality expert
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Example 2: Improving Patient Safety
Aim: Reduce adverse drug events (ADEs) on all medical and surgical units by 75 percent within 11 months.
Team:
Team Leader: ___, MD, Chair, Pharmacy and Therapeutics Committee, Patient Safety Officer
Technical Expertise: ____, RPh, Director, Clinical Pharmacist
Day-to-Day Leadership: ____, RN, Manager, Medical/Surgical Nursing
Additional Team Members: Risk Manager, Quality Improvement Specialist, Staff Nurse, Staff Education, and Information Technology |
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Example 3: Improving Critical Care
Aim: Redesign the leadership and care systems of our Medical Intensive Care Unit (MICU) in order to reduce harm and improve outcomes for patients.
Team: Team Leader: ____, MD, Medical Director, Medical Intensive Care Unit (MICU)
Technical Expertise: ____, MD, Intensivist
Day-to-Day Leadership: ____, RN, MICU Manager
Additional Team Members: Respiratory Therapy, Quality Improvement Specialist, Staff Nurse, Clinical Pharmacist, Clinical Nurse Specialist
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