TEAM Framework

The Innovation Support Unit (ISU) developed the Team-based care Evaluation and Adoption Model (TEAM) Framework1 to aid in coordinating primary and community care evaluation planning. The TEAM Framework includes a 10-dimension Evaluation Model (Figure 1), incorporating the key concepts of team-based care (TBC), and an Adoption Model (Figure 2) to support both formative evaluation within projects and summative evaluation over time.

The Evaluation Model is positioned on the backdrop of the WHO’s partnership pentagon,2 to acknowledge the stakeholders involved in TBC projects, and includes 10 key dimensions for team-based care evaluation: Relationship Centred Care, Patient Experience, Provider Experience, Team Function, Quality of Care Process, Capacity & Access, Team-Based Primary and Community Care (TBPCC) Foundations, Governance & Accountability, Health of the Population, and Healthcare Costs.

Diagram of the TEAM Framework.  The pentagon shape has the following dimensions on the outermost layer: Health of the Population, Healthcare Costs, Team-Based Primary and Community Care Foundations, and Governance and Accountability.  The middle layer includes dimensions of Team Function, Capacity and Access, and Quality of Care.  The centre of the diagram includes the final three dimensions of Patient Experience, Provider Experience, and in the very middle is Relationship Centred Care.

Figure 1: Evaluation Model

The Adoption Model highlights that evaluation needs to be considered over time. When planning an evaluation, one needs to consider how the evolution of indicators change over time across the dimensions of the Evaluation Model; from measuring baseline and early intention to change, through to observable behaviour and, finally, long-term outcomes. It incorporates the EPIS (Exploration, Preparation, Implementation and Sustainment) implementation framework3 to highlight the importance of considering at what stage of adoption a team is at when planning and implementing evaluation and quality improvement efforts.

The ISU is currently reviewing tools and metrics to build a toolkit of evaluation resources that can be used for provincial consistency and adapted to meet the needs of communities looking to evaluate TBC.

Diagram shows the Adoption Model which includes overlapping waves of adoption over time starting with Baseline into Engagement, then Early Behaviour Change leading into Systematized Behaviours, leading to Early Indicators and finally Outcomes.  Overlayed is the EPIS framework.

Figure 2: Team Framework’s Adoption Model

Additional Resources

  • Download this page as a shareable PDF here.
  • Listen to the TeamUp! webinar and podcast discussion of the TEAM Framework here.

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  1. Fletcher SC, et al. Team-based care Evaluation and Adoption Model (TEAM) Framework. Canadian Family Physician, 2021. Available here
  2. Framework for action on interprofessional education and collaborative practice. World Health Organization; 2010.
  3. Moullin JC, et al. Systematic review of the Exploration, Preparation, Implementation, Sustainment (EPIS) framework. Implementation Science, 2019.

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