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>> My role in CPC is dual.
I'm a practitioner.
I have an office-based practice, and my practice is CPC focused,
and, also I'm a medical director for a physician group.
I think the difference is really seeing the role of a leader
and how leaders can implement change,
and then measuring the change at the practice level.
And so one of the things I've seen at the practice level is
that I can tell you my day-to-day functions have
changed significantly since began participating in CPC.
When I have a diabetic patient who comes into my office
and their A1c is 11 and they need to be placed on insulin,
I run, I grab my care coordinator.
We spent time with the educational process.
I get that patient home safely with the information
and knowledge about how to administer insulin,
and these are things that would have taken me weeks
to do before CPC occurred, and so I see the value of this
at the clinic site, side, which then reinforces the things
that we've done
on the administrative side in a leadership role.
So I think it's been really wonderful to be able to be,
have a foot in each, each camp around, around CPC.
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Setting the stage for, for team building is really a group
process, and so I think from a leadership perspective,
you have to bring in all of your key leaders and everyone has
to be on the same page, and I think what one of the things,
first things we did was really build infrastructure
around group meetings and bringing all
of our leaders together on a regular basis
to understand our goals and to understand
where we're trying to, where we're trying to go with that,
with our value-based programs, but I think the other part
of that is, is, is the knowledge and, and the mission,
and then implementation, and so one of the things we've done
which has been very valuable to our organization was
to build a LEAN process and bring LEAN training in and,
and really spend a lot of time with our,
with our leadership understanding what LEAN Six
Sigma and LEAN processes look like.
We've done training, and we've trained about 150 employees now
on LEAN Six Sigma training and, and then we begin the process
of implementing that across the organizations, so,
so I think it's not just understanding the goals
but it's how do you implement those goals,
and I think I'm bringing infrastructure
like that has been really valuable to our organization.
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We know as a health care system
that we can't implement transformation
and leave it only isolated to our office-based clinics,
and so we, we have a wonderful leadership structure
within Hillcrest Healthcare System, the CEO of our system,
the CMO of our health care system have all been supportive
and, and really integral to our success, and,
and one of the values that we've had is that because we've got
such a good relationship across the leadership
and the health care system, they've been able to understand
where we're going and, and support that,
but also build our expertise and bring our expertise into that,
into the hospital systems, and,
and really from that perspective,
understand how we change at the hospital level as well,
and so they've embraced some of the,
some of the cultural changes we've had because of CPC,
and then they've integrated those cultural changes into some
of the cultural changes at the hospital level,
so we built our work, our work from outpatient setting back
to the inpatient setting, but, but we couldn't have done
that without the support of our leadership.
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The challenges that we deal with are the same challenges
that every organization does, it's the resistance to change,
and I think, you know, we've really spent a lot
of time understanding change management
and understanding what change management looks like, and,
and I think not being frustrated
because change doesn't happen fast enough.
I think that's some
of the biggest barriers we've dealt with.
We take our physician leaders who embrace these programs
and we really, we engage them, and we make them leaders,
and our practices where we've struggled,
we've put more resources in, in their laps, and we,
we do everything we can to show them the value of providing,
you know, some of these additional resources
to our high-risk patients, and so I think the biggest issue,
I think, has always been that cultural transformation,
and for every organization that's a struggle,
but I think it's understanding the importance of walking
into a headwind and knowing that you have to continue to persist
and that you can't back down when you feel pressure.
You just have to continue to move forward,
and I think with that in mind, I think we've gotten past a lot
of the barriers that, that we didn't anticipate having
when we first began this transformation.
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Alignment is a real challenge,
and I think every health care system struggles
with the same thing.
You know, what is it that you can do to,
to align not only the physicians but the staff
and the management, and I think our initial alignment was
really, this is the right thing to do,
and I think our providers understood
that this was the right thing to do,
but it didn't always motivate all the behaviors we wanted
to motivate, so then we really began to look
at compensation models,
and I think that compensation is another way
of creating a really motivating alignment, and so we began
to align physician compensation with our quality metrics
and with our patient experience metrics like a lot
of other organizations do,
but we felt that wasn't really enough,
and so we've also aligned our executives compensation
and the alignment is really almost exactly the same.
They are aligned with quality and with patient experience
as well, and so between all those alignments,
you really begin to see the push towards how do we,
how do we change a system in a way that,
that we can see individual benefit but, group benefit
as well, and I think one of the things that we've seen
as a result of the alignment is
that our metrics have improved substantially.
We've been able to see a substantial change
in really the attitude of our executive leadership as well
because they've begun to ask the questions they weren't
asking before.
Why are our blood pressure controls not improving
any better?
Why are we not doing better job at colon cancer screening?
Because now they're interested in the outcomes and,
and because of that alignment I think the system is,
is really better prepared for value-based care
than it has been in the past.
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