Primary Health Care Teams

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Abstract
Three different implementations of team-based innovations at Kaiser Permanente describe increased use and changed roles of associate providers and improved communication and coordination among HCT staff. These descriptions emphasized integration of the practitioners (mid-level and physician providers) to allow physicians to see new patients, see more acute patients, practice “desk-top” medicine, or mentor mid-level practitioners. Further consideration of primary care as a microsystem (a team of health care professionals serving a defined panel of patients with information technology and the help of support staff, equipment, and a supportive environment) may be useful in fostering the continual improvement of primary care. Complexity theory and the development of “simple rules” for primary care may also assist in change efforts. Stories of innovation are valuable in sharing the success and challenges of primary care improvement.