Table 3.

Brainstorming Themes Regarding Team-Based Care Discussed at the 2016 Starfield Summit

Themes of Starfield Summit Participants' Discussion on Team-Based Care	Representative Statements Reflecting Themes
Good teams require the integration of primary care with services outside the structure of the traditional primary care clinic.	• We need Accountable Health Communities instead of Accountable Care Organizations.
	• We need to include community health workers and public health professionals to help address the social determinants of health.
	• We inadvertently stigmatize mental health issues every time we refer out of clinic.
Team-based care can act as a catalyst to joyful practice, but will require upfront and continuous investment to function successfully.	• We need to “Share the Care” with team members.
	• Teams can help prevent the death spiral of primary care via burnout
	• Team hygiene is critical: this requires coaching/leadership training.
Team-based care can increase the comprehensiveness of services available and are more likely to meet patients' needs.	• Teams are the antidote to the trend towards narrowing scope of practice within primary care.
	• Teams can facilitate communication with specialists and supportive services to improve comprehensive patient care.
Specialists should be valued members of teams and our system should promote communication between specialties and primary care.	• We ignore a large part of our health community when we don't partner with specialist colleagues.
	• Everything is about relationships and teams promote those stronger relationships.
	• We need to match the micro-culture of teams with the macro-culture of institutions.
Creating excellent teams starts with having the right people in medical school–those who can be excellent team members–and how we train them to be those members.	• We must stop training dehumanized cowboys.
	• We need to find and train individuals with substrate to be hybrids–the technologist and the humanist.
Changing current practices to achieve team-based care will be difficult.	• Where is the “UpToDate” for practice change?
	• Research is not enough to drive change. We need partnerships and alliances to fuel action.
The patient needs to be a part of the team in team-based care.	• Start each team meeting with a patient story.
	• We need to get out of the “safe” environment of our clinics and into the community to build partnerships with our patients.
	• We need to partner with patients for practice redesign–they have unprecedented power to advocate with us.
	• We need patient advocates with “lived experiences” to be on clinic boards and contribute to the betterment of the clinic and of the community.