Posted by: knightbird | April 26, 2012

Exceptional Performance

I had the pleasure of attending the Annual Community Health Aide (CHA) forum here in Anchorage yesterday. One of our CHA’s was selected as this years “Shining Star,” the most prestigious award for the CHA group, which has over 400 members.

In fact, we have had one of our staff awarded a “Shining Star” or a “Rising Star” for the past three years. I was very proud of our staff and thought about why we have been so successful with awards. I believe I know the answer—teamwork. When we started a Lean transformation in our health care system, our providers were a team supportive of their own interests. One interest was time off. Another interest was pay. As with all providers, they were interested in their patients. However, I did hear reports that providers were upset if they saw more patients per day than other providers in the clinic. And rarely did the providers travel to our Villages to work directly with the CHA’s. That all changed in one epochal event when all of the providers quit after I started trying to introduce Lean.

In one year we went from having 6 mid-level providers to one MD and one Physicians Assistant. Both of our new providers committed to traveling to each Village once a month. The Physician assumed responsibility for Clinical Direction and began to provide regular training and oversight for the CHA’s. Our PA also worked with our CHA’s to provide oversight and training.

And we also started working as a team on a regional basis. Instead of being willing to work only in their home community, our CHA’s began regional work assisting in other communities. Since we have such a large overcapacity of providers, this regional focus helped with reducing the need for bringing in itinerant providers. We could also provide more variety in the type of patient contacts each provider experiences. Each provider also began selecting specialty areas to expand their skills to. One provider chose diabetes care, another smoking cessation and a third chronic disease self-management.

Our turnover is also falling. With good benefits, great training and regional expanded responsibilities, our CHA’s are challenged and excited about their responsibility. We are proud of our CHA team, and rightfully so. Now the rest of the state is recognizing their good work and the leadership they provide to the rest of the state.

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