PCMH: Devilishly Angelic

I heard a story on a webinar the other day. A very experienced healthcare practice coach (practice coach = somebody who helps guide practices through changes such as quality improvement processes and PCMH work) said how, during the span of her work, providers had likened her to an angel and a devil. The provider who likened her to a devil said something to the effect of, ‘When we know she’s coming to visit, we know that change is ahead and it’s going to be hard’. The provider who likened her to an angel said something like, ‘When we know she’s coming to visit, we can expect she will bring us new knowledge and resources that will help us get where we want to be and deliver better patient care’.

Though nobody has put such a fine point on it, I can really relate to this story. I feel that sometimes in my role of guide/coach that I am like an angel and a devil – often at the same time – and that the whole PCMH transformation process is both devilish and angelic, at the same time. Thus is the nature of change, especially when you believe that the result will be for the good.

Here is a good example of how PCMH transformation process itself can be devilishly angelic.

A practice in our PCMH Learning Collaborative recently fully implemented team-based care, a big change for them. The change included rearranging furniture and phone lines, explaining changes to patients, and – most importantly – putting people into color-coded teams with a new modus operandi. Understandably, this presented some real challenges and people were feeling stressed.

But they were dedicated and committed to the change, for good.

I was honored to facilitate a team-building activity for them to help. In the process, I got to hear some wonderful stories about the positive impact the new arrangement was having. In one story, a referral coordinator talked about now being able to spend more time connecting patients to community resources and was proud of recently securing care for a high-risk pregnant mom.

The devil may have been in the details of this momentous practice change, but it meant that a care team member got the chance to be that mom’s angel that day. For me, folks, this is what it’s all about.