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There Is No “I” in Teamwork in the Patient-Centered Medical Home: Defining Teamwork Competencies for Academic Practice

Leasure, Emily L. MD; Jones, Ronald R. MD; Meade, Lauren B. MD; Sanger, Marla I. RN, MBA; Thomas, Kris G. MD; Tilden, Virginia P. RN, PhD; Bowen, Judith L. MD; Warm, Eric J. MD

doi: 10.1097/ACM.0b013e31828b0289

Evidence suggests that teamwork is essential for safe, reliable practice. Creating health care teams able to function effectively in patient-centered medical homes (PCMHs), practices that organize care around the patient and demonstrate achievement of defined quality care standards, remains challenging. Preparing trainees for practice in interprofessional teams is particularly challenging in academic health centers where health professions curricula are largely siloed. Here, the authors review a well-delineated set of teamwork competencies that are important for high-functioning teams and suggest how these competencies might be useful for interprofessional team training and achievement of PCMH standards. The five competencies are (1) team leadership, the ability to coordinate team members’ activities, ensure appropriate task distribution, evaluate effectiveness, and inspire high-level performance, (2) mutual performance monitoring, the ability to develop a shared understanding among team members regarding intentions, roles, and responsibilities so as to accurately monitor one another’s performance for collective success, (3) backup behavior, the ability to anticipate the needs of other team members and shift responsibilities during times of variable workload, (4) adaptability, the capability of team members to adjust their strategy for completing tasks on the basis of feedback from the work environment, and (5) team orientation, the tendency to prioritize team goals over individual goals, encourage alternative perspectives, and show respect and regard for each team member. Relating each competency to a vignette from an academic primary care clinic, the authors describe potential strategies for improving teamwork learning and applying the teamwork competences to academic PCMH practices.

Dr. Leasure is assistant professor of medicine, University of Nebraska Medical Center, College of Medicine, Omaha, Nebraska.

Dr. Jones is associate director of medicine, Summa Health System, and associate professor of medicine, Northeast Ohio Medical University, Colleges of Medicine and Pharmacy, Rootstown, Ohio.

Dr. Meade is assistant professor of medicine and associate program director, Baystate Medical Center, College of Medicine, Springfield, Massachusetts.

Ms. Sanger is system quality program manager, Patient Engagement, Healthcare Improvement Division, PeaceHealth, Vancouver, Washington.

Dr. Thomas is associate professor of medicine and consultant, Division of Primary Care Internal Medicine, Mayo Clinic, College of Medicine, Rochester, Minnesota.

Dr. Tilden is dean and professor emerita, University of Nebraska Medical Center, College of Nursing, Omaha, Nebraska.

Dr. Bowen is professor of medicine, Oregon Health and Science University, Portland, Oregon, and Veterans Health Administration Office of Academic Affiliations, Washington, DC.

Dr. Warm is professor of medicine and program director of internal medicine, University of Cincinnati, College of Medicine, Cincinnati, Ohio.

Correspondence should be addressed to Dr. Leasure, 985185 Nebraska Medical Center, Omaha, NE 68198-5158; telephone: (402) 559-7545; fax: (402) 559-5588; e-mail:

© 2013 Association of American Medical Colleges