Strategic re-Design of Team-based Patient-focused Healthcare Services

Despite evidence that patient-centered medical care can increase the patient's quality of care by emphasizing preventive medicine, and improved communication and coordination among providers, widespread implementation of patient-centered medical homes (PCMH) remains marginalized by our healthcare system. Regardless of advocacy for an organizing framework to effect major improvements in the quality of our healthcare system, it remains a fragmented, hierarchical, silo-oriented, medical practice model that does not support utilization, coordination, continuity and communication across healthcare settings. This paper proposes that the PCMH model is an organizational innovation that promotes a transformational vision of improved partnerships and coordinated patient-centered care. We suggest that the PCMH is an innovative healthcare organization model of the future, committed to building a more economical and clinically-aligned relationship that promotes quality and efficient patient care. The delivery of healthcare services must be strategically redesigned around patient-provider teams and the larger care community that includes family and local neighborhoods. These stakeholders need to collaborate toward achieving improved population health and well-being. An alternative team-based approach and a system-wide change model are proposed for leading healthcare organizations through the white water of large-scale transformation. It is a transformation process predicated on strong leadership able to align an organization toward a vision of patient-centered care, creating a collaborative culture committed to health goal achievement. The PCMH necessitates transitioning from an adversarial to a collaborative culture. It requires that participants within healthcare organizations learn new skills and behaviors to achieve the anticipated quality and efficiency improvements through partnership.