Topic Significance & Study Purpose/Background/Rationale: New models of care delivery systems are necessary to provide for increasing complex patients in the ambulatory care setting. The purpose of designing and implementing a teambased care model is to promote patient focused care with an emphasis on improving patient satisfaction, employee satisfaction and retention while maintaining superior transplant outcomes. Development of a model for team-based care provides all members of the team with the opportunity to learn, teach, and coordinateworld-class patient care. The BMT program at the University of Kansas is projecting 370 transplants in 2015. Methods, Intervention, & Analysis: A multidisciplinary work group assigned physicians, nurse practitioners, nurse coordinators, pharmacists and patients into three teams. Team-centered work spaces were created to maximize collaboration and efficiency. A retrospective study assessing patient satisfaction, utilized a national patient survey to compare data pre and post-intervention. Results were collected a year prior to the intervention and data collection continues currently. Nursing satisfaction will be measured by comparing retrospective data from a pre-intervention 2014 national nursing survey to a post-intervention survey from 2015.The data collection review will include a retrospective analysis of nursing coordinator turnover rates for the last 5 years. Additional quality analysis are planned including a comparison of day 100 treatment mortality pre and post intervention to ensure our program continues to provide safe, high-quality care. Findings & Interpretation: Post-intervention provider rating has increased on average 6% and perceived patient wait times improved 10%. Patient satisfaction data is climbing upward and the clinic is experiencing all-time high patient satisfaction ratings in multiple areas including time spent with patient and same day response to medical questions. Due to the relative short observation period, further data reflecting nursing turnover and quality measures is maturing with an expected date of Winter 2015. Discussion & Implications: A significant portion of ambulatory care depends on the consistent collaboration of health care team members. This collaboration directly impacts patient satisfaction, quality of care, and allows nurses to maximize their capability and become integral team members. The model framework is intended to provide a roadmap for the consideration of other centers needing to meet the needs of continual growth and change within the complex ambulatory setting.
Winters, E. (2016). The Design and Implementation of a Team-Based Care Model in an Ambulatory BMT Clinic. Biology of Blood and Marrow Transplantation, 22(3), S461. https://doi.org/10.1016/j.bbmt.2015.11.1055