ArticleJournal of general internal medicine2014
Teamlet structure and early experiences of medical home implementation for veterans.
Article in Journal of general internal medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- Primary care micro-teams: an international systematic review of patient and healthcare professional perspectives.The British journal of general practice : the journal of the Royal College of General Practitioners · 2023Pooled it
- Teaming in Interdisciplinary Chronic Pain Management Interventions in Primary Care: a Systematic Review of Randomized Controlled Trials.Journal of general internal medicine · 2022Pooled it
- Impact of Primary Care Team Configuration on Access and Quality of Care.Journal of general internal medicine · 2025Observational
- Expanding Patient-Centered Medical Home Teams in Primary Care: Qualitative Evaluation of Implementation Experiences from a Multi-site Pilot Within the VA Healthcare System.Journal of general internal medicine · 2025Article
- Impact of primary care usual provider type and provider interdependence on outcomes for patients with diabetes: a cohort study.BMJ open quality · 2023Article
- The Association of Teamlets and Teams with Physician Burnout and Patient Outcomes.Journal of general internal medicine · 2023Observational
- Changes in Primary Care Quality Associated With Implementation of the Veterans Health Administration Preventive Health Inventory.JAMA network open · 2023Article
- Teaming up in primary care: Membership boundaries, interdependence, and coordination.JAAPA : official journal of the American Academy of Physician Assistants · 2022Article
- Care Practices to Promote Patient Engagement in VA Primary Care: Factors Associated With High Performance.Annals of family medicine · 2020Article
- Integrating Personalized Care Planning into Primary Care: a Multiple-Case Study of Early Adopting Patient-Centered Medical Homes.Journal of general internal medicine · 2020Article
- Balancing Unbalanced Lives: A Practical Framework for Personal and Organizational Change.Mayo Clinic proceedings. Innovations, quality & outcomes · 2019Review
- Primary care provider approaches to preventive health delivery: a qualitative study.Primary health care research & development · 2018Article
- Incorporating Guideline Adherence and Practice Implementation Issues into the Design of Decision Support for Beta-Blocker Titration for Heart Failure.Applied clinical informatics · 2018Article
- Barriers and facilitators to providing primary care-based weight management services in a patient centered medical home for Veterans: a qualitative study.BMC family practice · 2015Article
- Implications of the Patient-Centered Medical Home for Nursing Practice.The Journal of nursing administration · 2015Article
- Article
- Understanding Gender Sensitivity of the Health Care Workforce at the Veterans Health Administration.Women's health issues : official publication of the Jacobs Institute of Women's HealthArticle
- The influence of leadership facilitation on relational coordination among primary care team members of accountable care organizations.Health care management reviewArticle
- Factors associated with physician self-efficacy in mental illness management and team-based care.General hospital psychiatryArticle
- Challenges with Implementing a Patient-Centered Medical Home Model for Women Veterans.Women's health issues : official publication of the Jacobs Institute of Women's HealthArticle
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHigh functioning interdisciplinary primary care teams are a critical component of the patient-centered medical home. In 2010, the Veterans Administration (VA) implemented a medical home model termed the Patient Aligned Care Teams (PACT), with reorganization of staff into small teams ("teamlets") as a core feature.
objectiveTo examine the early experiences of primary care personnel as they assumed new roles through reorganization into teamlets.
designConvergent mixed methods study design involving semi-structured interviews and a survey; data were collected in 2011 and 2012.
participantsWe interviewed 41 frontline teamlet members (i.e., primary care physicians and staff) from three practices that were part of a PACT demonstration laboratory and examined clinician and staff survey data from 22 practices. MAIN MEASURES: Semi-structured interview guide and clinician and staff survey questions covering the following domains: teamlet formation and structure, within-teamlet communication, cross-coverage, role changes, teamlet training, impact on Veterans, and leadership facilitation and support. KEY
resultsRespondents had limited input into teamlet structure and indicated limited training on the PACT initiative. Guidelines delineating each teamlet member's roles and responsibilities were emphasized as important needs. Chronic understaffing also contributed to implementation challenges and territorial attitudes surfaced when cross-coverage was not clear. In addition, several core features of VA's medical home transformation were not fully implemented by teamlet members. Most also reported limited guidance and feedback from leadership. Despite these challenges, teamlet-based care was perceived to have a positive impact on Veterans' experiences of primary care and also resulted in improved communication among staff.
conclusionsThe PACT teamlet model holds much promise for improving primary care at the VA. However, more comprehensive training, improving the stability of teamlets, developing clear cross-coverage policies, and better defined teamlet member responsibilities are important areas in need of attention by VA leadership.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.