Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2010 Sep;25 Suppl 4(Suppl 4):S610-4.
doi: 10.1007/s11606-010-1390-1.

Using the Teamlet Model to improve chronic care in an academic primary care practice

Ellen H Chen  1 , David H Thom, Danielle M Hessler, La Phengrasamy, Hali Hammer, George Saba, Thomas Bodenheimer
Affiliations
Comparative Study

Using the Teamlet Model to improve chronic care in an academic primary care practice

Ellen H Chen et al. J Gen Intern Med. 2010 Sep.

Abstract

Background: Team care can improve management of chronic conditions, but implementing a team approach in an academic primary care clinic presents unique challenges.

Objectives: To implement and evaluate the Teamlet Model, which uses health coaches working with primary care physicians to improve care for patients with diabetes and/or hypertension in an academic practice.

Design: Process and outcome measures were compared before and during the intervention in patients seen with the Teamlet Model and in a comparison patient group.

Participants: First year family medicine residents, medical assistants, health workers, and adult patients with either type 2 diabetes or hypertension in a large public health clinic.

Intervention: Health coaches, in coordination with resident primary care physicians, met with patients before and after clinic visits and called patients between visits.

Measurements: Measurement of body mass index, assessment of smoking status, and formulation of a self-management plan prior to and during the intervention period for patients in the Teamlet Model group. Testing for LDL and HbA1C and the proportion of patients at goal for blood pressure, LDL, and HbA1C in the Teamlet Model and comparison groups in the year prior to and during implementation.

Results: Teamlet patients showed improvement in all measures, though improvement was significant only for smoking, BMI, and self-management plan documentation and testing for LDL (p = 0.02), with a trend towards significance for LDL at goal (p = 0.07). Teamlet patients showed a greater, but non-significant, increase in the proportion of patients tested for HbA1C and proportion reaching goal for blood pressure, HgbA1C, and LDL compared to the comparison group patients. The difference for blood pressure was marginally significant (p = 0.06). In contrast, patients in the comparison group were significantly more likely to have had testing for LDL (P = 0.001).

Conclusions: The Teamlet Model may improve chronic care in academic primary care practices.

PubMed Disclaimer

Conflict of interest statement

None disclosed.

References

    1. Bodenheimer T. Building Teams in Primary Care: 15 Case Studies. California HealthCare Foundation, July, 2007. www.chcf.org. Accessed April 22, 2010.
    1. Yarnall KS, Pollak KI, Ostbye T, Krause KM, Michener JL. Primary care: is there enough time for prevention? Am J Public Health. 2003;93:635–641. doi: 10.2105/AJPH.93.4.635. - DOI - PMC - PubMed
    1. Ostbye T, Yarnall KS, Krause KM, et al. Is there time for management of patients with chronic diseases in primary care? Ann Fam Med. 2005;3:209–214. doi: 10.1370/afm.310. - DOI - PMC - PubMed
    1. MacGregor K, Handley M, Wong S, et al. Behavior-change action plans in primary care: a feasibility study of clinicians. J Am Board Fam Med. 2006;19:215–223. doi: 10.3122/jabfm.19.3.215. - DOI - PubMed
    1. Sequist TD, von Glahn T, Li A, Rogers WH, Safran DG. Statewide evaluation of measuring physician delivery of self-management support in chronic disease care. J Gen Intern Med. 2009;24:939–945. doi: 10.1007/s11606-009-1033-6. - DOI - PMC - PubMed

Publication types

MeSH terms