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:
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.
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.
has provided the ICTs with greater self-awareness and a better
appreciation of differences in working styles; as a result, an immediate
impact in team building 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.
“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