PARTNERING FOR TRANSFORMATION: A MENU OF MANY POINTS OF ENTRY FOR YOUR DEPARTMENT

Sharon Hull; Amanda Weidner; James Lloyd Michener; The ADFM Healthcare Delivery Transformation Committee: Al Tallia, MD, MPH (Committee Chair); Chelley Alexander; Sean Bryan; Valerie Gilchrist; Laurel Giobbie; Sharon Hull; Michael Jeremiah; J. Lloyd Michener; Robert Pallay; Michael Rabovsky; Linda Speer; Lisa Tavallali; Ardis Davis; Amanda Weidner

doi:10.1370/afm.1873

Healthcare delivery transformation is happening at many different levels but these myriad activities all share one thing in common: they are impacted heavily by the old adage, “all politics are local.” Recognizing that there are many points of entry to transformation, at many different system levels, the ADFM Healthcare Delivery Transformation Committee (HCDT) developed a graphic (Figure 1) to help understand how to engage with this healthcare delivery transformation process depending on the local context.

Figure 1

Departmental points of entry.

AAMC = Association of American Medical Colleges; CDC = Centers for Disease Control and Prevention; CMMI = Center for Medicare and Medicaid Innovation; NCQA = National Committee for Quality Assurance; NQF = National Quality Forum; QI = quality improvement; PCMH = Patient-centered medical home.

The graphic illustrates where the health system and community/population health interact and where within this overlap individual patient care takes place. This illustration is based loosely on a model put forth by the World Health Organization as a framework for people-centered integrated health services delivery.¹

In addition to showing how elements of care models overlap, the graphic lists a series of resources for each component of the illustration, providing a literal menu to those interested in finding ways to partner for transformation. For example, leaders of a Department of Family Medicine may be interested in considering ways to partner with community or population health entities in their local environment and could look at the “Practical Playbook” for some examples of other systems and institutions that have successfully partnered with local community and public health organizations. ADFM’s HCDT Committee updates this menu of resources periodically; the color version of the graphic with the menu of resources hyperlinked for easy access is available at: http://www.adfm.org/Members/PrimaryCareCommunicationToolkit.

The complexity of healthcare system change leads us to be like the proverbial “blind man and the elephant” in that we sometimes can identify the part we are dealing with, but are not as successful in recognizing the larger “beast.” The graphic is designed to help with this challenge. Chairs, Administrators, Division Chiefs and other senior leaders in Departments of Family Medicine are best positioned to understand the local politics and to guide Departments in selecting entry points that will likely have the greatest impact and intended outcome.

We will continue to evolve this graphic through our work over the year to help Departments of Family Medicine and other organizations understand how they can partner and envision a different future within their own local reality.