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Over the next several weeks, we’ll be sharing blog posts from Quality Forum attendees on their experiences and favourite sessions. Our third recap is from physician Khati Hendry, who attended the workshop “You Had Me at Team-Based Care.” In this “unconference” style workshop, participants co-created the agenda and brainstormed solutions to the questions and problems raised. Read on to see what they came up with.

What happens when you go to a workshop and discover that the participants will invent their workshop and facilitate their own sessions, in the tradition of an “unconference” and “open space technology”? The agenda is generated by the participants, and whatever happens is the way it was meant to be.

In this case, people proposed ideas to talk about, we scattered around the room next to flip charts, and “voted with our feet” to go to different conversations. Below are the topics included in discussion, and key points from each:

  • How can people needing opioids for chronic pain avoid being stigmatized? If there is good communication, the patient and health providers know each other, and health providers pay attention to each patient’s story.
  • How can allied health providers be incorporated into teams when physicians work under fee-for-service? Fee-for-service makes it very difficult to solve this, as this doesn’t recognize work done by teams or time spent on quality improvement. Alternative payments schemes and salaries may help. Looking at successful models, it appears that new systems and sources of funding will be needed.
  • How can you get health providers in rural and remote areas to get more involved using IT to access care? The patients are keen to proceed, and less worried about privacy concerns than the health providers it seems. Getting students and allied health to use IT systems that communicate over a distance may help push the use faster. Seeing examples of how well this can work helps too.
  • What do the patients want to get out of team-based care and patient medical home settings? People value knowing and trusting the team members, getting more education resources, and getting a fulsome care plan.
  • How can we “un-hospitalize” people and get them cared for in the community? Many seem to fear care outside of the hospital, and there aren’t enough resources in the community. Listening closely to patient concerns and using navigators may be helpful as shifts are made out of the hospital setting.
  • How can a hospice successfully move to an oncology unit? This related to a particular local issue that threatens to fragment care, but reinforced the need for providers and patients to participate in plans when changes are undertaken.
  • How can community members be incorporated into patient care? Peer networks can be effective at times.
  • What will it take for physicians to participate in models of team-based care– in particular, what payment models would work best? To some extent, this will be a generational shift, and physicians are not only motivated by money. There are advantages to working in groups and sharing responsibilities. More options for payment other than just fee-for-service will be needed. Focusing on how to better organize care to serve the patients’ needs is a powerful way to make changes.

So—did the invention of our own workshop work? While I had expected more facilitation, the free-form workshop meant that some important concerns and questions were raised, some good discussion ensued, and we got a bit of a survey of what issues were out there. There was ample opportunity to learn from each other, and the knowledge came not from invited “experts”, but from the expertise of the participants.