Coastal Medical, an accountable care organization (ACO) in Rhode Island, ranks third in the nation for quality among 333 Medicare Shared Savings ACOs. Chief Operating Officer Meryl Moss explains why she believes teamwork is helping her ACO thrive. She will be faculty for IHI’s Population Management Executive Development Program. Coastal Medical is also a member of the IHI Leadership Alliance.
People often ask me about the secret to Coastal Medical’s success in improving population health.
How did we reach the top 1 percent for quality among ACOs? How did we reduce unnecessary emergency room and urgent care visits? How did we so quickly develop, pilot, and scale up new programs for high-risk primary care patients?
The answer is both simple and challenging.
One of the major reasons for Coastal Medical’s success in population health is our tradition of developing and empowering teams at all levels of our organization. This may sound straightforward, but it hasn’t been easy.
The Challenges of Teamwork
Effective teamwork requires special skills. Team members need to know how to collaborate, cooperate, and truly share the work. They must put the needs of the patients above their own need for personal recognition. They need to let go of their own egos and immerse themselves in the goals of the team and the organization.
Teamwork can also be difficult because many of us have learned to idolize the individual. We train to be experts. Transitioning from expert to team member is a journey.
Most organizations promote, praise, or reward employees because of their knowledge and expertise. We often reward them as “shining stars.” Why should they give up individual accolades to become one of many?
What if being a high achiever is the basis of their self-worth?
The Rewards of Shared Achievement
Even individual achievers can find teamwork rewarding. Why? Because high-functioning teams always achieve more than any individual could on their own.
High-functioning teams can get great results because a team has collective brainpower — no matter how smart we are on our own. Individuals have different strengths. One person is creative. Another person is organized. Someone else is good at visualizing future goals.
Team members don’t just bring different talents — they can also have distinct roles. For example, a team could consist of physicians, medical assistants, and managers. These individuals bring very different perspectives. The office manager, concerned about how the office runs, thinks about day-to-day efficiency. The medical assistant thinks about practical clinical operations. Physicians take a medical approach.
All are valid and important.
How Teamwork Improves Quality at Coastal
For example, consider a critical juncture we reached recently at Coastal.
Our leadership team had been trying to determine how to meet our quality targets without overburdening the offices and the physicians. Our management team invited a broad group of stakeholders to weigh in on the problems and help determine a solution.
Medical assistants sat side-by-side with physicians and corporate staff. The group recommended standardizing some quality processes, redirecting some to medical assistants, and performing some at the corporate level. Drawing from their day-to-day work experience, these individuals came up with thoughtful and workable ideas.
Coastal Medical’s patients are reaping the rewards of effective teamwork. Coastal is third out of 333 Medicare Shared Savings ACOs for quality in the nation. In addition, we have met the goals of all 142 quality metrics — without overburdening staff.
I believe that we owe our progress to the solutions our teams develop. They are richer and more thoughtful than anything any one person could create alone.
You may also be interested in:
Share the Work, Share the Wealth: Lessons from Coastal Medical’s ACO Journey
Healthcare Executive - ACOs: A Step in the Right Direction
IHI White Paper - A Guide to Measuring the Triple Aim: Population Health, Experience of Care, and Per Capita Cost