Most Health Centers don’t have to convince their employees that the work matters.
The people who work in community health understand the mission. They care about their patients, their communities, and the difference their work can make.
So why can it still be difficult to build a care team that works the way everyone hopes it will?
Often, the issue isn’t the people. It’s the way the work is organized.
In our work with one Health Center, we surveyed employees about their experience within the organization.
About 95% said they felt they contributed to the Health Center’s mission every day.
That’s a strong foundation. It tells us that the people doing the work believe in what they are doing.
But some of the other responses told a different story. Nearly 48% felt the organization was not functionally organized, and more than 40% felt there was a lack of efficiency.
Those numbers point to something we see fairly often.
People can be completely committed to the mission and still find themselves working within systems that make it harder to do their jobs well.
A provider may spend part of a visit trying to track down information that could have been gathered beforehand. A medical assistant may know that a patient is overdue for something but not have a consistent process for making sure it gets addressed. A care coordinator may only become involved after a patient’s needs have become more complicated.
Everyone is working hard.
But working hard and working well as a team aren’t always the same thing.
For a care team to reach its potential, the organization has to look at the work itself, not just the people doing it.
Healthcare is naturally divided into roles. Providers have their responsibilities. Nurses have theirs. Medical assistants have theirs. Care coordinators, behavioral health and dental professionals all have theirs. The problem is that those roles can become silos.
A provider may think of a patient as “my patient,” with other members of the team stepping in only when they’re asked to. This usually isn’t intentional, but rather how the workflow has developed over time.
But patients don’t experience their care as a collection of job descriptions. They experience the whole thing.
If information isn’t shared, the patient feels it. If a follow-up doesn’t happen, the patient feels it. If they have to explain the same situation to several different people, they feel that too.
A stronger care team starts with a different understanding: the patient is the responsibility of the team as a whole.
This doesn’t negate the importance of individuals. Providers, CMAs and care coordinators still have their own specific skills and responsibilities. Instead, it means everyone understands how their part of the work contributes to the patient’s overall care.
That shift from “my patient” to “our patient” may sound small, but it can change the way the team works together.
Another issue is whether people are being used in the way they were trained to work.
Take the Medical Assistant. MAs do a tremendous amount of important work around the patient visit. But in some organizations, much of their role remains focused on the basic tasks surrounding the encounter.
With the right protocols and training, an MA can do more. They can help with pre-visit planning, identify gaps in preventive care, review information in the EHR, and help prepare the team before the patient arrives.
That doesn’t necessarily mean giving the MA more work. It means looking at the work differently and deciding who is best positioned to do it.
The same question applies to every member of the team.
Are providers spending time on tasks that could appropriately be handled by someone else? Are care coordinators involved early enough to make a difference? Are behavioral health resources being brought into care when they’re needed rather than after a problem has escalated?
When the answer is no, the solution isn’t always to hire more people.
Sometimes the organization needs to make better use of the people it already has.
Today’s Health Centers have a powerful resource that wasn’t so readily available in the past: the information already sitting in the EHR.
We know a great deal about our patients.
We know who is overdue for a screening, where a patient was referred for additional care and diagnosis, who has missed follow-up, and which patients may need additional support managing a chronic condition. The question is whether we’re using that information to act.
A traditional workflow often starts when the patient walks through the door. The team finds out what is needed during the visit and responds.
A more proactive workflow starts earlier.
If the team knows a patient is overdue for a screening, that can be addressed before the appointment. If someone needs follow-up, the team can have a plan for reaching them. If a patient is struggling to manage a chronic condition, the right member of the team can become involved sooner.
This isn’t about creating another layer of work.
It’s about using information the organization already has to organize the work more effectively.
That shift from reacting to anticipating patients’ needs is one of the most important changes a care team can make.
A robust care team model also requires a shift away from assessing patient needs one individual patient at a time.
Population health methodologies give organizations a way to identify patterns across their patient population and decide where proactive outreach or care management could make the biggest difference.
Instead of waiting for every patient to come through the door to be assessed, the team uses all of the appropriate tools to identify patient needs and prepare for them.
That is a fundamentally different way of thinking about care that takes care teams beyond the gains in efficiency and effectiveness achieved through collaboration alone to the higher order benefits that come from strategically optimizing their deployment of Health Center resources.
Of course, changing the workflow doesn’t automatically change the way people work.
If a provider has always been responsible for something, asking another team member to take it on can take some adjustment. If an MA has always waited for instructions, being expected to take a more proactive role requires clarity and support.
This is why care team development is about people as much as process.
Teams need to be open to change. They need to understand what their colleagues can contribute and when they themselves should step in before they’re asked to. And they need enough flexibility in the organization’s culture to try something, see what happens, and make adjustments.
Maybe you agree it’s time for a change, but don’t know where to start.
That’s where we’ll go next.
In our next blog, we’ll look at how organizations can assess their current care team workflows and develop more effective ones that harness the full potential of the care team model
Because a strong mission matters. But people also need a system that helps them deliver on it.
