Rounds Preview: Developing True Team Medicine

The team concept extends to acute hospital care, as well, Pearl says. His group realized it needed a specific team of physicians, nurses, and technicians to handle sepsis, which is the No. 1 killer of patients in the hospital, Pearl says. "You need a full sepsis team 24/7, able to respond to the emergency room immediately because the treatment is very complex and somewhat dangerous, but the result of doing it in the most timely fashion is you save the lives of a significant number of patients." 

The early signs of sepsis can be difficult to diagnose, particularly with young people, Pearl says. "You need to have the expertise to draw appropriate laboratory tests, to provide high fluid administration and placement of central lines, and to provide intense treatment on a consistent basis for patients who at that moment don't look particularly sick, but you know they will be in 24–48 hours. To do that well requires a team of individuals with a broad skill set—physicians and nurses and other individuals who come to an emergency room, see a patient, and begin the treatment—because if you just let everyone do it who doesn't do it often enough, it's too late and the results are not as good as they could be."

The business model for most of healthcare today does not support team care. Typical fee-for-service reimbursement discriminates against the type of coordination that team-based care often requires, Halvorson says. But once the reimbursement plates have finally shifted and necessary tools are put in place, team medicine can have enormous power, he says.

"The business model has to support team care by paying for all the pieces," Halvorson says. "And then if you have the right computer system, the right care registry, and you've got the right set of caregivers, the combination of all those pieces is magical. It creates the energy and the synergy that you need to make a difference in the lives of those patients."

This article appears in the May 2012 issue of HealthLeaders magazine.

Reprint HLR0512-10