Table 5

Strategies That Increase Practice Buy-in to PCMH by Creating Team Environment Encouraging Ownership, Accountability, Support, and Confidence

Strategy	Exemplary Qualitative Data
Have a work flow of defined, overlapping, and flexible roles and responsibilities within an incremental transformation plan	“Everyone just falls right in the flow…if there’s something that’s on one person more, we’ll try to spread it out and say ‘maybe you can have this person do this so you’re not so overworked with doing a certain task.’ Whatever it is that we have to do for the patients. So we just spread out the work.”
Create an open environment where everyone’s input is sought and respected	“Staff is encouraged to share their buy-in or lack of, their ideas, so conflict to us is probably not viewed as conflict, more of a negotiation. Sometimes, I think I know everything, but I don’t. Staff will ground me and say ‘that’s not going to work,’ and I think I speak for the providers when I say they are open…to the ideas of everybody.”
Foster a culture of creativity and innovation	“It’s not like someone is coming in and imposing a program on us. We’re designing our own program. We’re seeing what works for us. We’re experimenting with different ways of doing things…being willing to experiment and not have anything written in stone…if it doesn’t work, onto the next one.”