Quality Improvement in Health Care Team-based care

The economies of team-based care

A good system enables many people to work effectively together towards a common goal. There are clear benefits to be derived from team-based care.

This is as true of general practice as it was for Ray Dalio in building up Bridgewater Associates, one of the world’s largest investment management firms. Here is what he has to say in his book, ‘Principles: Life and Work’.

“It would take me about 165 hours a week to achieve the level of excellence that I would be satisfied with.”

Can you imagine how long it would take us each day in general practice to deliver guideline-based care for each and every patient? Can you see why episodic care, that denies us the opportunity to plan for our patients, is inadequate? Treating the patient in front of us means that we must often focus on people’s most immediate and urgent needs. This robs us of the opportunity to practice holistic medicine, and fully engage our patients in other important aspects of their care such as preventative health.

Mr Dalio goes on to say, “That was obviously impossible. Since I wanted to delegate things as much as possible, I asked if the things I was doing could be done excellently by others, and if so, who were those others.

Everyone agreed that most of those areas could not adequately be delegated. I clearly hadn’t done a good enough job of finding and training others to whom I could delegate my responsibilities.

To me, the greatest success you can have is to orchestrate others to do things well without you. A step below that is doing things well yourself. And worst of all is doing things poorly yourself.”

Despite our amazing achievements, General Practice in Australia has not achieved this success. In fact, we are still struggling with doing things well ourselves. Even though we have one of the most effective and efficient primary care sectors in the world.

I challenge you all to take the next step #teambasedcare #trainanddelegate

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