组建团队：它如何改变执业配置、规模和组成？
Establishing Teams: How Does It Change Practice Configuration, Size, and Composition?
作者信息
Chien Alyna T, Kyle Michael Anne, Peters Antoinette S, Nguyen Kevin H, Tendulkar Shalini A, Ryan Molly, Hacker Karen, Singer Sara J
机构信息
Department of Pediatrics, Harvard Medical School, and Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts (Dr Chien); Harvard Business School, Boston, Massachusetts (Ms Kyle); Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts (Ms Kyle and Mr Nguyen); Department of Population Medicine, Harvard Pilgrim Health Care Institute, and Harvard Medical School, Boston, Massachusetts (Dr Peters); Institute for Community Health, Malden, and Department for Community Health, Tufts University, Medford, Massachusetts (Dr Tendulkar); Harbor Health Services Inc, Dorchester, Massachusetts (Ms Ryan); Allegheny County Health Department, Pittsburgh, Pennsylvania (Dr Hacker); and Department of Medicine, Stanford School of Medicine, California (Dr Singer).
出版信息
J Ambul Care Manage. 2018 Apr/Jun;41(2):146-155. doi: 10.1097/JAC.0000000000000229.
Little is known about how practices reorganize when transitioning from traditional practice organization to team-based care. We compared practice-level (1) configuration as well as practice- and team-level (2) size and (3) composition, before and after establishing teams. We employed a pre-/poststudy using personnel lists of 1571 to 1711 staff (eg, job licenses, titles, and team assignment) and practice manager surveys. All personnel (physician and nonphysician) worked within 18 Massachusetts academic primary care practices participating in a 2-year learning collaborative aimed at establishing team-based care. We found that establishing team-based care can involve changing practice configurations and composition without substantially changing practice size.
对于医疗机构从传统的组织形式向团队式医疗转变时如何进行重组，我们知之甚少。我们比较了团队建立前后医疗机构层面（1）的结构，以及医疗机构和团队层面（2）的规模和（3）组成。我们采用了一项前后对照研究，使用了1571至1711名员工的人员名单（如职业执照、职位和团队分配）以及对医疗机构经理的调查。所有人员（医生和非医生）都在马萨诸塞州的18家学术性初级医疗诊所工作，这些诊所参与了一项为期两年的学习合作项目，旨在建立团队式医疗。我们发现，建立团队式医疗可能涉及改变医疗机构的结构和组成，而不会大幅改变医疗机构的规模。
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