United States: Primary Care Functions

The Cambridge Health Alliance in the United States has undergone numerous innovative reforms to align with a patient-centered model of care. These reforms have been translated into an Implementation Guide and Toolkit. The Cambridge Health Alliance has a comprehensively staffed team including a primary care provider; registered nurse; a medical assistant, medical receptionist, and/or licensed practice nurse; planned care coordinator; clinical pharmacist; registered dietician; and social worker.1 Although the relevant cadres will differ between countries, the Implementation Guide provides an example of how to map existing cadres to roles and responsibilities within the context of a care team. Multidisciplinary teams at the Cambridge Health Alliance meet for ten-minute huddles at least once a day to review the flow of the day and plan for patient care. This also provides an opportunity for the team to address how they can support each other throughout the day and plan for any anticipated problems.  This practice could be valuable for a team of any size; ensuring protected time to discuss workload, challenges, and delegation can help build team trust and understanding of team roles.


  1. Stout S, Klucznik C, Chevalier A, Wheeler R, Azzara J, Gray L, et al. Cambridge Health Alliance Model of Team-Based Care Implementation Guide and Toolkit [Internet]. Cambridge; Available from: https://www.integration.samhsa.gov/workforce/team-members/Cambridge_Health_Alliance_Team-Based_Care_Toolkit.pdf