**Published in Progress in Community Health Partnerships (PCHP) 17.4. All rights reserved.**
ABSTRACT
Background: Team-based care is fundamental to providing high-quality health care for patients. However, moving from a traditional, hierarchical way of providing care to team-based care is challenging and involves systematic and sustained process changes.
Objectives: To describe the implementation and evaluation of a partnership between academics, clinic, and community to improve team-based care in primary care practices serving vulnerable populations utilizing a structured change package and implementation support.
Methods: The partners 1) created a 6-strategy structured change package, 2) designed implementation support and 3) evaluated implementation using an assessment scale at baseline and every 6 months.
Results: Practices improved in all care-team functions from May 2015 to August 2018, with the most improvement seen in population management, planned care and empanelment.
Conclusions: Academic-community partnerships can use evidence-based practice supports to measurably improve team-based care in primary care practices serving vulnerable populations.