Team-Based Care Isn’t Controversial


The Future of Nursing, in particular, has created considerable controversy regarding whether APRNs should be licensed to practice independently in primary care settings. The hot-button issues that are part of that controversy, such as practice independence, competition, and restraint of trade, are not germane to the present discussion on cardiovascular team-based care. Issues that are germane to cardiovascular team-based care, such as interdependency, cooperation, autonomy, efficiency, and effectiveness, however, are not controversial. (read the 2015 ACC Health Policy Statement on Cardiovascular Team-Based Care)

The Institute of Medicine, in collaboration with the Robert Wood Johnson Foundation, published a report entitled The Future of Nursing: Leading Change, Advancing Health in 2010, which the ACC's Health Policy Statement mentions as generating "considerable controversy between nursing organizations and physician organizations."

TEAM-BASED CARE ISN't CONTROVERSIALThe statement suggests that arguments over practice independence have no relevance to the well-substantiated argument in favor team-based care, but it's easy to see how those lines get blurred. Professionals feel threatened when scope-of-practice barriers are taken down for professionals with a different educational knowledge-base.

The issue? These fears can be very influential in maintaining state regulatory barriers to team-based care.

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ACC Endorses Team-Based Care, Adds Advanced Practice Practitioners

The American College of Cardiology released a health policy statement endorsing team-based care and outlining the inclusion of advanced-practice practitioners.

The ACC’s strategic plan is aligned with the triple aim of improved care, improved population health, and lower costs per capita. The traditional understanding of quality, access, and cost is that you cannot improve one component without diminishing the others. With cardiovascular team-based care, it is possible to achieve the triple aim of improving quality, access, and cost simultaneously to also improve cardiovascular health. (read the statement)

The statement lists the advantages of several different models for team-based care, from the traditional care model to health clinics and a population health framework. These include reduced readmissions, reduced hospitalizations, reliable use of evidence-based therapies, consistent documentation of education, improved patient safety, efficient use of workforce, and improved access and care coordination.

The statement stresses the importance of inter-professional education in facilitating team-based care:

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