A nonprofit health care organization serving nearly 60,000 Alaska Native and American Indian people implemented an innovative method of providing primary care that is built around the needs of the patient and a team-based method of care delivery. Each Integrated Care Team (ICT) was made of a Provider, RN Case Manager, Administrative Support person and a Certified Medical Assistant. The organization realized that the ICT’s ability to work interdependently was the key to success—that by building better relationships with each other and their patients, the quality of care would also improve.
The charge was twofold:
- Maximize the effectiveness of Integrated Care Teams, and
- Teach a cadre of Providers and Nurses a strengths-based relational model of coaching so they could mentor both their teams and other ICT’s.
The challenge was in meeting all the criteria: It had to teach teams in a method that was “easy to understand, practical and immediately applicable.” Also, teams could not be out of clinic and away from patients for more than 90 minutes. Finally, the program had to support the organization’s core competencies: Communication & Teamwork, Improvement & Innovation, Organization Care & Relationships, and Workforce Development Skills & Abilities.
The organization chose 5 Dynamics to address these needs, and our methodology was included as a cornerstone of teaching teams to work together effectively. Each ICT member completed the 5 Dynamics Starting Point assessment, received a one-on-one debrief of his or her individual results, and then the team came together for a team debrief, with a focus on the team’s collaboration styles and insights on strategies to support good teaming for their specific team makeup.
With a time-to-value of 93 minutes—3 minutes to complete the assessment and 90 minutes of training—teams began implementing the 5 Dynamics methodology.
Two pilot programs were developed and delivered to teach mentors a strengths-based relational coaching model. The first included clinical teams and administrative managers in the medical services division of the organization. The first pilot was so successful that a second pilot was expanded to also include non-clinical managers.
5 Dynamics played a feature role—the 5 Dynamics Project Completion Cycle was used to teach the coaching model; the mentors found it easy and intuitive to understand and apply. Having 5 Dynamics as the foundation for both team effectiveness and the coaching model had the added benefit of shortening the learning curve of the mentors significantly.
Feedback from the initial pilot programs was so positive that the organization decided that every ICT in the medical services division would complete 5 Dynamics and receive the individual and team debrief; now 5 Dynamics is a prerequisite for anyone working on a clinical team.
The results of the pilots also demonstrated that the model of coaching provided a practical, strengths-based methodology that is universally applicable; consequently, the coaching methodology is now being rolled out organization-wide to all leaders and others who ‘coach’ as part of their job (e.g., improvement advisors). In addition, 5 Dynamics is being integrated into other initiatives in which team collaboration is essential.
5 Dynamics has provided the ICTs with greater self-awareness and a better appreciation of differences in working styles; as a result, an immediate impact in teambuilding has been seen through increased trust and quality interpersonal interactions. Managers are now learning to mentor their direct reports using a strengths-based model of development.
Ultimately, it is the patients who receive the greatest benefit: a high-functioning
Integrated Care Team provides for better care and organization service.
By focusing on the organization, taking a systems approach, and providing easy-to-implement methodologies like 5 Dynamics, the organization was honored with the Malcolm Baldrige Award.
“A health care system owned and managed by Alaska’s Native people has achieved astonishing
results in improving the health of its enrollees while cutting the costs of treating them.”
—The New York Times
“This is organizational vision and leadership at its very best… to achieve
whole population health excellence for your organization-owners.”
—Dave Ford, Former CEO, CareOregon
“I think it’s the leading example of health care redesign in the nation, maybe the world.”
—Don Berwick, Former Administrator, Centers for Medicare and Medicaid Services