Team-based care

Updated: April 19, 2024

Access a team of health care providers to support quality care

BC is working to increase people’s access to primary care by introducing a team-based care approach to primary care. This is being done through patient medical homes (PMHs) in family practices, primary care networks (PCNs) in the community, Urgent and Primary Care Centres (UPCCs) across BC, and the Nurse in Practice Program.

Within a team-based model of care, multiple health care providers from different professional backgrounds work together and with patients/clients, families, caregivers, and communities to deliver comprehensive health services across care settings. Effective teamwork is a critical enabler of safe, high quality care and supports a patient's ongoing relationship with their primary care provider (a family physician or nurse practitioner). Teams broaden availability and accessibility of clinical supports for patients and for family doctors.

Teams are organized locally through various partnerships of doctors, PMHs, PCNs, divisions of family practice, health authorities, community partners, and the Ministry of Health, and are based on the needs of patients in a community or a practice.

By implementing team-based care, physicians and practice teams can:

• Provide preventive care, disease management and counselling, and arrange for follow-up services in the community.
• Increase support for patients with complex and/or chronic health conditions. 
• Work to their strengths, and support and rely on each other to give patients the best care. 
• Collectively increase a community’s capacity to attach patients to a primary care provider.

For patients

Patients get timely access to continuous, comprehensive care, and appropriate supports to support their health needs and prevent unnecessary ER visits.

For doctors

With the added support and expertise of a team, physicians can:

• Focus more of their time on difficult diagnoses, medical care, and strengthening patient relationships. 
• Reduce the burden of caring for patients alone, which can help prevent burnout. 
• Feel more at ease when they know their patients are well cared for and getting comprehensive support. 
• Increase the efficiency of a practice and streamline processes to maximize time and capacity.
• Improve the satisfaction of family doctors, staff and partners.

Team-based care models aim to attract new doctors to family practice to further reduce pressures on existing family physicians and communities.

Get involved

Opportunities for family doctors to work with teams are increasing as new models of care evolve in BC communities. Family doctors can:

• Use their EMR data (panel management) to understand their patients’ needs and arrange for appropriate team-based support to serve those needs.
• Work with other physicians and the local division of family practice to influence emerging, local team-based care models - including through PCNs. 
• Create an interdisciplinary team in practice or through the community as supports become available.

For more information about team-based care, please contact the FPSC.