Example of Barriers

Toolkit for Implementing the Chronic Care Model in an Academic Environment

The Hoxworth internal medicine-pediatric team at the University of Cincinnati Academic Health Center identified several barriers to effective teamwork after conducting a Team Health Audit, including lack of staff and poorly defined roles and processes.

University of Cincinnati Barriers

After completing a Team Health Audit, the University of Cincinnati Academic Health Center identified these barriers to successful team functioning:

• Understaffing.
• Undefined roles.
• Lack of nursing leadership.
• Inefficient processes.
• Burnout and low morale.
• Resistance to change
• Resistance to more work being added to the existing workload.

To overcome these barriers, the internal medicine-pediatrics team worked with a Six Sigma blackbelt from Health Alliance's Corporate Training and Development Department and initiated a 9-month team development project to:

• Hire or develop an onsite nursing leader.
• Clearly redefine team roles and responsibilities.
• Develop effective practices and team competencies.
• Provide leadership coaching for physician and nursing directors.
• Implement guidelines for how team members treat one another.

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