On Team and IHI
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By Janice John, PA-C, MHS, Chief PA, Cambridge Health Alliance, Primary Care

AAPA MARKETING - MD ANDERSONTeam is such a simple concept, yet it can be so difficult to develop teams that not only contribute to the triple aim (population health, patient experience of care, and cost-effective care) but also the quadruple aim (the fourth aim being provider wellness… or joy in the workplace). Knowing the statistics about burnout, and resilience and the difficulties around team development, it gave me great joy to be able to go with part of my team to present at the Institute for Health Care Improvement’s 17th Annual Summit on Improving Patient Care in the Office Practice and Community.  We presented “Relational Team-Based Care” that we believe is the foundation for the quadruple aim.

The focus of IHI has been helping organizations move toward the quadruple aim.  This year, IHI deepened to conversation to talk about how social justice is at the heart of everything that we do, which, as a safety net PA for many years resonated with my core.

The opportunity to present with our team – our referral coordinator, team nurse, medical director, and operations supervisor – was rewarding on a number of levels.  A retrospective look at our transformation journey revealed a unique view of our foundation.  The journey has not always been an easy one – like many places going through transformation we have had significant turnover.  Upon reflection, we realized that a large number of people who have ‘left’ had moved on to leadership positions or other growth opportunities.   At the time, we felt a sense of loss because they were part of the family, but this allowed us to feel joy in knowing that part of transformation is directly tied to development.  And, in many ways, providing pathways for growth for many of our staff is also a form of social justice and removing barriers to wellness.

In addition to presenting, the learning and community at IHI led to two of the richest days of CME learning I have experienced in 15 years of practice.  I believe that we are continuously growing but that our growth should not be limited to medical knowledge as growth in each core competency is equally important.  While I was able to attend many different sessions throughout the conference, two continue to impact me. The most powerful session I attended was a learning lab “Personal Mastery for Transformational Leadership” by Neil Baker.  I learned – or relearned – how important culture is in the process of change.  I also took home lessons on empathic listening that are critical for every human interaction – leadership, patient relationships, parenting, etc.

The last session that I attended before flying home was a talk given by another astounding team of PA-CMO Kevin Heidrick from Yuma Washington and the Chief of Social Work for their organization on “Pathways to Population Management in Safety Net Organizations”.  The room was filled with ‘my people’, social reformers from across the country.  As a PA who has observed the various hierarchies and how they can affect our profession, I was heartened by this humble yet bold representative of our profession.  I was reminded of the youth of our profession, and also reminded that staying true to our core of team-based care and excellence in care will continue to carry our profession forward.

Not surprisingly, the rooms were filled with early adapters.  It was powerful to share and learn from both failures and successes.   Having dinners with teams from Australia and realizing the peer mentorship is not bound by geography or culture reinforced my belief that learning from each other is one of the best pathways to growth.  My hope is to see many more PAs integrated into much of the rich learning that is available at places like IHI, and Robert Wood Johnson.  We are a young profession and our growth will be tied to our linkages in places leading transformation of our health care systems.

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