Care Teams and Workforce Guide

About the Guide

This guide offers a practical, tested approach to building and supporting team-based care, starting with the intentional identification of a core team of people who together can provide care for most of the patient needs on their panel. Centering the cultivation of continuous healing relationships between patients, families and their care teams, the guide then shows how to build out the expanded care team to assure the functions of high performing primary care are in place. Finally, the guide offers a map for how different care team roles can help to support those functions, including licensure and full-time equivalent (FTE) considerations.

Phmi Care Teams Exec Summary Cover

Suggested Citation and Acknowledgements

Recommended citation: Population Health Management Initiative. Jeanene Smith, Catherine Knox, Katie Coleman, and Elise Pomerance. Care Teams Implementation Guide. In: Coleman K and Singer A, editors. Building the Foundation Implementation Guide Series. 1st ed. Oakland, CA: Kaiser Permanente, Health Management Associates, and Pyramid Communications; 2023.

Acknowledgments: This document was created by the Population Health Management Initiative (PHMI), a California partnership of the Department of Health Care Services, Kaiser Permanente and Community Health Centers. We gratefully acknowledge the contributions of these partners and the Regional Associations of California along with the many other academic, health plan and consulting partners who shared their expertise and insights freely as we co-designed the initiative and created these guides.

Individual reviewers and content contributors to the first edition of the Building the Foundation Implementation Guide Series: Jennifer Sayles and Elise Pomerance (KP PHMI); Palav Barbaria, Yoshi Laing, David Tian, Jeff Norris and Karen Mark (DHCS); Allie Budenz and Cindy Keltner (CPCA); Jeanene Smith, Catherine Knox, Nancy Kamp, Ethan Norris, Leslie Brooks and MaryEllen Mathis (Health Management Associates); Anne Tillery, Sarah Starr, Karis Cady, Candace Jackson, Josh Daniel and Denise Rhiner (Pyramid Communications); and Veenu Aulakh.

With additional contributions from: Pyramid Design Team and Kaiser Permanente PHMI team.