Organizational Success Factors
1. Ongoing focus on meeting patient needs and preferences. Patient centricity was a core tenet of the primary
care redesign. The team did signficant research into patient
preferences to optimize how best to meet their needs.
Research drove decisions around clinic hours, percentages of provider templates reserved for same-day/next-day
access, and channels for patients to communicate with the
2. Engaging front-line staff and providers. Recognizing
that the front-line teams are closest to daily operations,
the transformation team engaged them directly in both
assessments of current-state and future-state design that
informed the redesign effort. This approach yielded multiple benefits: capturing a realistic assessment of the current
state; testing the validity of the redesign; and supporting
change management efforts.
3. Engaging leadership. Active and sustained commitment
to planning, execution, and change management is critical
to transformational care redesign. The primary care leadership team met weekly throughout the assessment, design,
and implementation of transformation strategies to discuss
the process, remove barriers, and determine key messages
and appropriate mode and timing to share messages.
4. New primary care practice organizational structure
and governance. Organizations require innovative lead-
ers in the right roles to drive change and achieve and
maintain performance. To support the long-term goals for
primary care, the executive team designed and imple-
mented a new organizational structure for primary care
that elevated physician and administrative dyad leader-
ship within the clinics. In addition, they created regional
dyad director-level leaders, as well as functional dyad
director-level leaders, to oversee quality and patient
experience/access. The new directors comprised the
Primary Care Leadership Council, which met biweekly to
understand performance and support progress toward the
goals. Between meetings, the dyad partners worked with
clinics to support implementation of the new initiatives.
5. New performance dashboards. Effective dashboards help
leaders, providers, and front-line staff understand their
current performance and their progress toward measurable goals. The HealthEast team designed and deployed
a new set of performance dashboards with meaningful
metrics, targets, and drill-down capabilities that were
shared monthly with primary care and site leadership to
understand performance as it relates to the care team, the
contact center, and patient access.
6. Training for clinic-based leadership. New leaders must not
only be empowered to lead but also must have the skills
and tools necessary to effectively function in their roles. As
part of the practice re-organization, the Primary Care Leadership Council defined the competencies and skills required
of the new clinic-level dyad leadership teams. Shortly
after moving into their new roles, the dyad leaders underwent training on performance measurement and practice
management. The curriculum was designed to align with
defined competencies and the new dashboard.
7. Deliberate change management process. Executing a
change of this size required ongoing engagement of and
communication with physicians and clinic leadership. The
primary care leadership team and Chartis developed and
executed a deliberate change management plan to support
communication and risk mitigation.
HealthEast (now a part of Fairview Health Services) has a significant presence in the eastern Twin Cities, Minnesota, market. Clockwise from top
left: The Gallery Professional Building in St. Paul; HealthEast Clinic and Specialty Center — Maplewood; St. John’s Hospital; HealthEast Clinic —
Woodwinds; HealthEast Clinic — Stillwater; and St. Joseph’s Hospital.