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<h1>Toolkit for Implementing the Chronic Care Model in an Academic Environment</h1>
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<h2>Example of Barriers</h2>
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<h3>Table of Contents</h3>
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<ul>
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<li><a href="/prevention/curriculum/chroniccaremodel/index.html">Toolkit for Implementing the Chronic Care Model in an Academic Environment</a></li>
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<li><a href="/prevention/curriculum/chroniccaremodel/chronicack.html">Acknowledgments</a></li>
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<li><a href="/prevention/curriculum/chroniccaremodel/chroniccare1.html">1. Engaging Leadership</a></li>
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<li><a href="/prevention/curriculum/chroniccaremodel/chroniccare2.html">2. Harnessing the Academic Culture</a></li> <li><a href="/prevention/curriculum/chroniccaremodel/chroniccare3.html">3. Implementing the Chronic Care Model into Practice</a></li><li>
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<a href="/prevention/curriculum/chroniccaremodel/chroniccare4.html">4. Health Professions Education for Chronic Care</a></li> <li> <a href="/prevention/curriculum/chroniccaremodel/chronicgloss.html">Glossary</a></li> </ul>
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<div class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><p>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.</p>
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<h3>University of Cincinnati Barriers</h3>
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<p>After completing a Team Health Audit, the University of Cincinnati Academic Health Center identified these barriers to successful team functioning:</p>
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<ul><li>Understaffing.</li>
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<li>Undefined roles.</li>
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<li>Lack of nursing leadership.</li>
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<li>Inefficient processes.</li>
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<li>Burnout and low morale.</li>
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<li>Resistance to change</li>
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<li>Resistance to more work being added to the existing workload.</li>
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</ul><p>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:</p>
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<ul><li>Hire or develop an onsite nursing leader.</li>
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<li>Clearly redefine team roles and responsibilities.</li>
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<li>Develop effective practices and team competencies.</li>
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<li>Provide leadership coaching for physician and nursing directors.</li>
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<li>Implement guidelines for how team members treat one another.</li>
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</ul><p><a href="/prevention/curriculum/chroniccaremodel/chronic2a.html">Return to Document</a></p>
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<div id="created-reviewed-citation" class="pad-bottom-sections">
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<div id="page-reviewed" class="body-copy-italic">Page last reviewed October 2014</div>
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<div id="page-created" class="body-copy-italic">Page originally created January 2008</div>
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<p>
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<span class="citation-hdr">Internet Citation:</span> Example of Barriers. Content last reviewed October 2014. Agency for Healthcare Research and Quality, Rockville, MD.<br>
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<span class="citation-url">https://archive.ahrq.gov/prevention/curriculum/chroniccaremodel/chronic2a2.html</span>
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