5 Principles of High-Performing Healthcare Teams

Many value-based payment models that are gaining traction in healthcare are built on the premise that team-based care improves outcomes. But does it?

The evidence suggests it does.

  • For example, a 2015 review of 52 studies of team-based care for hypertension found that teams achieved controlled blood pressure in 12 percent more patients that routine care did.
  • In another study, researchers found that a novel team-based model that includes more proactive coaching, planning and healthcare screening improved patients’ self-management of hypertension and diabetes.
  • A multi-disciplinary team-care approach also was shown to improve survival outcomes in high-risk neuroblastoma patients.

And the list goes on.

There is evidence that multi-disciplinary team-based care is associated with better performance on traditional measures of health care quality – such as emergency department utilization and hospital readmissions – and different studies have concluded that optimizing team-based care is cost-effective intervention.


The link between team-based care and positive health outcomes is important from an overall societal standpoint, but also because it’s important when care is implemented for patients with complex care needs.

Think in terms of the typical Medicare patient who visits two primary care clinicians and five subspecialty care clinicians per year, not to mention other health care professionals such as those who provide diagnostic, pharmacy and other services. Managing that care requires seamless care collaboration and transitions, which team-based care can best handle.


If teams are a critical component of health care and are critical to improving outcomes, are there principles that can be used to create and maintain high-performing teams?

Here are 5 Key Principles:


The team establishes shared goals that can be clearly articulated, understood and supported by all members.


Clear expectations for each team member’s functions, responsibilities, and accountabilities to optimized team efficiency and effectiveness are articulated and performed.

MUTUAL TRUST (Psychological Safety)

Team members trust one another and feel safe enough within the team to admit a mistake, ask a question, offer new data, or try a new skill without fear of embarrassment or punishment.


The team prioritizes and continuously refines its communications skills and has consistent channels for efficient, bi-directional communication


Reliable and ongoing assessment of team structure, function, and performance that is provided as actionable feedback to all members to improve performance occurs.

Smith, C. D., C. Balatbat, S. Corbridge, A. L. Dopp, J. Fried, R. Harter, S. Landefeld, C. Martin, F. Opelka, L. Sandy, L. Sato, and C. Sinsky. 2018. Implementing optimal team-based care to reduce clinician burnout. NAM Perspectives. Discussion Paper, National Academy of Medicine, Washington, DC. https://nam.edu/implementing-optimal-team-based-care-to-reduce-clinician-burnout. doi: 10.31478/201809c