DURHAM, NC – An estimated 40 million Americans are older people with serious illness and nearly one-third report report have duplicative tests and one-quarter receive conflicting medical recommendations. Better, more effective health care teams could resolve these issues and improve care for patients, according to a new study by Duke University and Durham Veterans Affair researchers.
The research, which appears in June issue of Health Affairs, examined the complex components of the health care system to determine a clear, evidence-based path forward to achieve high-quality team-based care for people with serious illness. This research will be presented, along with several other papers from Duke University faculty and staff, at a June 4 Health Affairs briefing on Community Care for High-Need Patients.
The Duke researchers argue for reconceptualization of the culture of teams to better meet the needs of people with serious illness. “Teams with more connections to each other, better information flow among each other and with the patient’s health record, and greater inclusion of a diversity of perspectives about care—especially those of patient and caregivers—provide high-quality care with better patient outcomes,” said lead author Courtney Van Houtven, PhD, a core faculty member of the Duke-Margolis Center for Health Policy, a research scientist in the Durham Veterans Affairs Health Care System’s Center of Innovation to Accelerate Discovery and Practice Transformation, and professor of population health sciences at Duke University School of Medicine.
In redesigning teams to care for patients living with serious illness, the researchers recommend specific components, including:
- Establishing connections: Team members caring for the same patient may never meet in person so purposefully establishing connections is critical
- Increasing information flow: Initiating a single document in a patient’s electronic health record that identifies all active medical and psychological issues, followed by referrals to appropriate services, is ideal for older people with serious illness
- Ensure a diversity of perspectives: Teams caring for people with serious illness are inherently interprofessional, which increases the likelihood of engaging diverse perspectives to interpret information and solve problems.
“Building a workforce to meet the demands of the growing population of aging people with serious illness requires a change in the culture of health care teams,” said Van Houtven.