a learning culture. Teams work by planning forward, reflecting back, communicating clearly, and resolving conflict. Data and information are continuously analyzed so that problems can be identified early on; actions can be taken; and feedback can be provided to clinicians, employees, and leaders.

Joyce Lammert of the Virginia Mason Medical Center (VMMC) explores team-based learning and care through the experiences of VMMC. She highlights changes in medicine brought about by the digital age and changes in the patient-physician compact that give more authority to the patient. Lammert offers several recommendations for accelerating team-based care and driving centers of excellence, including a shift in medical schools’ teaching strategies to more of an interactive, team-based model; rapid process improvement workshops; and incorporation of routine learning collaboration in real practice settings.

Alice Bonner, formerly of the Massachusetts Department of Health (now Centers for Medicare & Medicaid Services), Craig Schneider of the Massachusetts Health Data Consortium, and Joel S. Weissman of Harvard Medical School address the importance of team-based care in the context of care transitions. They underscore the importance of interdisciplinary teams that are able to deliver safe, effective, culturally appropriate, and timely care within and across settings. Standardized procedures can improve the quality of care and reduce suboptimal outcomes and patient experiences, leading to more appropriate use of services and lower costs.


Allan S. Frankel, M.D., and Michael Leonard, M.D.
Pascal Metrics, Inc.

Across a variety of settings and industries, groups that effectively coordinate teamwork and improve science tend to achieve their goals (Mathieu et al., 2008). Since the Institute of Medicine (IOM) report To Err Is Human (1999) was published, the healthcare industry has learned a great deal about teamwork and improvement, but few in health care methodically combine the two in order to reap their full potential. Instead, teamwork and improvement are taught and applied separately. As a result, goals take longer to attain. Healthcare leaders have little in-depth knowledge of teamwork and improvement and therefore a limited ability to integrate the two concepts in order to improve practice. This paper explores the components of a continuous learning environment (Batalden and Splaine, 2002; Mohr and Batalden, 2002), positing that teamwork and improvement are essential—and inextricably linked—components of a successful learning environment.

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