Toolkit for Implementing the Chronic Care Model in an Academic Environment

Example of Barriers

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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Page last reviewed October 2014
Page originally created January 2008
Internet Citation: Example of Barriers. Content last reviewed October 2014. Agency for Healthcare Research and Quality, Rockville, MD.