Thank you. We have nothing to disclose for this talk. Over the past several years, specifically during the COVID-19 pandemic, clinician well-being has gained increased attention as one of the five major pillars of healthcare delivery known as the quintuple aim. As a practicing sports medicine surgeon and the director of clinician well-being at my organization, it's my job to promote a culture of wellness, personal resilience, and efficiency of practice for all clinicians. Efficiency of practice specifically has been shown to be a major source of frustration for clinicians nationwide. A recent discussion paper from the National Academy of Medicine in 2018 strategically and thoroughly outlined the concept of team-based care models as it relates to clinician burnout. Several advantages of team-based care have been extensively studied, however, its effect on clinician burnout and clinical efficiency has yet to be fully understood. Our goal with this project was to compare two distinct care team models. The first one is a nested care team model where the same clinicians and the same team members practice at the same site full time. The second model is a rotating care team model where clinicians rotate between various sites and work with different team members depending on the site that they're at. Our hypothesis is that a nested care team model would be advantageous regarding professional fulfillment, burnout, team development, and clinical efficiency. Team members from both models consisted of physicians, physician assistants, athletic trainers, medical assistants, and CAS technicians. Assessments included the Professional Fulfillment Index, the Mini-Z, a team development measure, and objective EMR data which were obtained at two time points seven months apart for all team members. Regarding the Professional Fulfillment Index, results from both time points indicated that nested care team members scored more favorably on each metric with differences in professional fulfillment and overall burnout being significantly different. Regarding the Mini-Z, nested care team members scored significantly better on all metrics including supportive work environment, practice efficiency, and total scores at both time points. Regarding team development, the nested care team members demonstrated higher scores at both time points although these values were only significantly different between the two models at the first time point. Regarding EMR use, nested care team members demonstrated better efficiency on all metrics with significant differences noted for time in in-basket per day and time for clinical review per patient. In conclusion, we have shown that a nested care team model in an academic pediatric sports medicine clinic demonstrated greater professional fulfillment, decreased burnout, greater team development, and increased EMR efficiency when compared to a rotating care team model. Limitations include small sample size, lack of generalizability to non-pediatric or non-academic centers, lack of correlation to clinical and patient reported outcomes, and potential biases due to differences between clinician team leads. Despite these limitations, clinicians and administrators should work together in collaboration to consider nested care team models to enhance efficiency of practice when striving for professional fulfillment for all clinicians. Thank you.

sports medicine surgeon

clinician well-being

team-based care models

clinician burnout

nested care team model