Suggestions to Help Better Coordinate Patient Care

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Suggestions to Help Better Coordinate Patient Care
Suggestions to Help Better Coordinate Patient Care

HealthDay News — The American Medical Association (AMA) recently described the elements of a team-based care model.

A new module from the AMA's STEPS Forward collection of practice improvement strategies details the individual elements of a team-based care model and describes how to bring these elements together.

According to the report, patients and team members should be prepared for patient visits ahead of time. Pre-visit planning includes reviewing notes from the previous visit, using a registry or visit-prep checklist, identifying whether further information is needed for the visit, and sending automated reminders to patients. The patient visit should follow a structure that optimizes team members and their expertise: The nurse or medical assistant should update the medical record, close care gaps, and obtain a history; they should continue to document the visit when the physician joins the appointment, and emphasize the plan of care and conduct motivational interviewing and education at the end of the visit. To assist with this, practices can expand rooming and discharge protocols, implement team documentation, use the annual visit to synchronize prescription renewals, and use the end of the visit to plan the next visit.

"Using this care model, the nurses or medical assistants become more knowledgeable about the treatment plan, can more effectively coordinate care between visits, and develop closer independent relationships with patients and their families," according to the article.


Parks T. How to Coordinate Patient Visits In a Team-Based Care Model. AMA Wire. Published March 22, 2016. Accessed March 30, 2016.

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