Table 1 Components of Relational Team Development (RELATED) and Standard Practice Facilitation
RELATED | Standard Practice Facilitation | ||
|---|---|---|---|
PCP Clinical Supervision and Coaching (Coaching) | Practice Change Activity Team (PCAT) | ||
Description | Facilitator observes PCPs in 4+ visits with complex patients; facilitator uses clinical psychology and coaching techniques during 1-on-1 debriefs with PCPs. | Facilitator guides implementation of a practice change; in this process, maladaptive team dynamics are identified and addressed. | Facilitator guides implement-ation of a practice change and builds internal capacity for improvement activities. |
Participants | • PCPs • Patients whose visits are observed | • Clinic team (i.e., PCPs and staff representatives, leadership) • Patient representatives | • Clinic team (i.e., PCP and staff representatives, leadership) |
Implementation Factors | Distinguishing Features | ||
Mental Illness Management ⇒ Knowledge ⇒ Skills ⇒ Communciation | • Diagnostic and treatment feedback • Didactics tailored to individual knowledge gaps • Patient communication practice • Multicultural case discussion | • Tailored group didactics on mental illness • Communication practice | |
Practical ⇒ Quality improvement processes ⇒ Practice monitoring systems ⇒ Improvement Plans ⇒ Modified Workflows | • Use of interdisciplinary team and available mental health resources | Training: • Quality improvement methods • Measurement-Based Care (MBC) Facilitation: • Assess current system • Create improvement plan (for MBC) • Implement improvement plan (for MBC) • Evaluate/modify improvement plan targeting sustainability | |
Psyschosocial ⇒ Interpersonal relationships ⇒ Clinic Culture ⇒ Attitudes ⇒ Role change ⇒ Role clarity | Interpersonal focus on: • Emotional reactions • Self and other awareness • Attitudes towards team-based care • Experience of clinic culture | Team dynamics focus on: • Non-hierarchical communication and leadership behaviors • Creating mutually agreed upon processes • Role clarity • Psychological safety • Past practice change experiences | Group process emphasizing: • Role clarity • Communication workflows • Team-building activites |