Clinical trial NCT06011239: Family Teams: A Study to Promote Team Collaboration in Family Medicine Clinics
Official title: Family Teams: A Study to Promote Team Collaboration in Family Medicine Clinics
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Patient Care Team
Psychological Well-Being
Occupational Burnout
Keywords: family medicine
team function
burnout
compassion
Lead sponsor: University of Michigan
Sponsor class: OTHER
First posted: 2023-08-25
Enrollment: 400
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: NON_RANDOMIZED
Intervention model: SINGLE_GROUP
Intervention model description: The study will recruit all staff except the clinic managers at each of five family medicine clinics within our academic family medicine department.
Primary purpose: OTHER

Brief summary: This project includes an intervention in five Michigan Medicine family medicine clinics which is designed to improve staff collaboration across different job roles.

Detailed description: The primary intervention asks staff to meet with others in the same role and to consider the following questions:

* The Ask: When staff are busy or overwhelmed by work, what tasks can others do (people in each of these groups) to help make your job better or easier?
* The Offer: When people in other groups are busy or overwhelmed, what tasks can your group do to help make staff jobs better or easier?

After this information is collected, at an in-person meeting of all staff and faculty, the study team will divide everyone into groups by clinic and then by the four roles. The study team will hand out the idea list and ask participants to review the list, discuss whether there are new or additional ideas which should be added, and then prioritize staffs top five "asks" and top five "offers" for staff role.

Negotiation of asks/offers: The study team will hold 1-4 subsequent brief meetings at each clinic where staff are again sub-divided into four groups by role. Each group will review the asks from people in other roles and decide whether these are actions that staff can help with or whether there are barriers. The clinic champions will work with the groups to address barriers (which could include lack of information, lack of training, disagreements about need, etc). The ultimate goal will be for groups to come to consensus agreement on at least three ways staff can assist people in other roles. In some clinics this may be straightforward and require just one meeting. In other clinics, it may take several meetings.

Implementation: Once the asks and offers are finalized, it will be up to the physician champions to help promote these agreements at the clinic, follow up with staff and with the nursing, medical assistants, and clerical champions to ensure that people are following thru with commitments to help, and trouble shoot problems that come up.

Coordination with Leadership: a department leader will serve as the liaison between the clinic champions and members of leadership that oversee clinical functions. This leader meets regularly with these leadership groups and will help troubleshoot challenges to implementing the asks and offers which need higher-level approval or input.

Ongoing process improvement: Over time, the study team will send up to four brief, anonymous surveys to all staff asking whether the staff are indeed doing the things that staff committed to do and whether other role groups are following thru on the commitments. This provides an opportunity for people to identify and report problems. This data will be anonymously fed back to the physician champion that is tasked to troubleshoot and address the problems identified, working with the liaison as appropriate. This will likely require continuous process improvement and revisiting to ensure success.

Evaluation: The study team proposes to measure burnout and team centeredness using anonymous on-line surveys.

Brief surveys: At several points during the year, the investigators will send out brief surveys. These ask for the clinic and job role and then ask participant to rate how much effort they have made to help others, how much effort others have made to help them, and if there are open-ended comment about what is or is not working. This information will be used to improve the intervention at each clinic.

Qualitative interviews regarding clinic culture will also be conducted with the project champions at each clinic who are helping to implement the project.

This study is Institutional review board (IRB) exempt and will have a waiver of documentation of informed consent with survey completion representing consent.

Eligibility criteria: Inclusion Criteria:

* Staff in the roles of medical assistant, nurse, clerical staff, or clinician (physician, nurse practitioner, and physician assistant)
* Must work in one of five family medicine clinics at the University of Michigan.

Exclusion Criteria:

* administrative clinic director at each site (managerial)
* Staff outside of the above roles such as a dietician, social worker, pharmacist

Primary outcomes:
measure: Team Development measure
timeFrame: Months 0, 12, 18
measure: Team Compassion Behavior survey
timeFrame: Months 0, 12, 18
measure: Burnout
timeFrame: Months 0, 12, 18
measure: Satisfaction with Intervention
timeFrame: Months 0, 12, 18
measure: Participation Effort
timeFrame: Months 0, 12, 18
Secondary outcomes:
Other outcomes:
measure: Clinic Culture
timeFrame: 1 month
Locations:
city: Ann Arbor
country: United States
facility: University of Michigan-Domino Farms
state: Michigan
city: Ann Arbor
country: United States
facility: University of Michigan- Briarwood
state: Michigan
city: Chelsea
country: United States
facility: Uniiversity of Michigan- Chelsea
state: Michigan
city: Dexter
country: United States
facility: University of Michigan-Dexter
state: Michigan
city: Ypsilanti
country: United States
facility: University of Michigan-Ypsilanti
state: Michigan
Study officials:
affiliation: University of Michigan
name: Katherine Gold, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Stock R, Mahoney E, Carney PA. Measuring team development in clinical care settings. Fam Med. 2013 Nov-Dec;45(10):691-700.
citation: Wee EXM, Fehr R. Compassion during difficult times: Team compassion behavior, suffering, supervisory dependence, and employee voice during COVID-19. J Appl Psychol. 2021 Dec;106(12):1805-1820. doi: 10.1037/apl0001001.
citation: Pommier E, Neff KD, Toth-Kiraly I. The Development and Validation of the Compassion Scale. Assessment. 2020 Jan;27(1):21-39. doi: 10.1177/1073191119874108. Epub 2019 Sep 13.
citation: Linzer M, McLoughlin C, Poplau S, Goelz E, Brown R, Sinsky C; AMA-Hennepin Health System (HHS) burnout reduction writing team. The Mini Z Worklife and Burnout Reduction Instrument: Psychometrics and Clinical Implications. J Gen Intern Med. 2022 Aug;37(11):2876-2878. doi: 10.1007/s11606-021-07278-3. Epub 2022 Jan 19. No abstract available.