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Message from Leadership: Keeping Caregivers Informed with Strategic Decision Making

Published August 25, 2014

By Tom Brennan, Chief Strategy Officer

Strategic decisions can start in any number of ways. Some are intentional through our annual strategic planning cycle or the budget process. Some are opportunities come out of the blue and represent a significant potential benefit to the organization. Others still are a reaction to changing environmental challenges that may place the organization at risk. Whatever the source, they all require thoughtful deliberation and consideration for the future of Providence, as well as the effect on both patients and caregivers.

So, how does leadership keep patients and caregivers at the heart of those decisions? Each strategic decision goes through a process of idea development, exploration of impact, evaluation of alternatives, and approval of a plan. Some ideas are small, while others have significant financial or market impact that require a high degree of confidentiality. For all strategic decisions, the process starts with a limited number of people asking the question “what if?” We then begin to ask the question of “how would we?” with more people becoming involved to add more information. From there, we ask the question “should we?” which puts one idea against another to determine the relative benefits to the organization as a whole. If approved, we then create action plans, or “who will?” with assignments to bring the idea to the market.

Let me describe a recent decision and what was involved: An example of an intentional strategic change would be the creation of our Providence Medical Building Monroe. For many years we served residents in east Snohomish County through Providence Medical Group and a limited number of hospital based services (x-ray, pharmacy, lab, etc) in a building near the Valley General Hospital campus. This clinic came to Providence over 20 years ago as an acquisition of a local primary care clinic. Over the years, the clinic grew and it became clear that the facility would no longer meet the needs of patients or caregivers, including things like an Electronic Medical Record, integrated advanced imaging, and the expanding specialty services of Providence Medical Group. In addition, the facility was inefficient in space adjacencies that reduced caregiver productivity as well as having an atmosphere that did not represent our brand aspirations for the patient experience.

Our PMG leaders wanted to dramatically change the experience for patients by bringing more resources to the facility, changing work processes to eliminate waste and patient wait times, and take advantage of the integrated PMG & PRMCE Epic medical record system. So that's what we did.

We tested the idea with a small group of people to see if the market would support a larger facility and more resources. When it appeared it would, we began to engage more leaders in financial modeling, understanding referral patterns, the demographic trends of the greater market, and location options. This smaller group recommended a new location to build that would place the new facility in heart of the retail visibility zone of Monroe. A business case was presented to our System leadership to share this concept and seek feedback from experts throughout Providence to make our concept and approach stronger. This feedback was reviewed by the team and refined. A business plan was then developed and reviewed by an expanded team of PMG and PRMCE leaders to be able to commit to growth and expense expectations. With the support of the local leadership, we presented the Monroe clinic for approval by the System office due to its overall financial impact. Many members of the Northwest Region and PMG leadership team presented the plan and received approval.

Once approved, several work teams and additional experts worked together to create processes and engaged numerous caregivers to hear what was important to them. We created new designs to modify things both big and small like decreasing the cost of imaging services for patients to the locations of the desks in exam rooms to allow caregivers and patients to better communicate. We brought in new technology called Versus that created a visual map of the clinic and requires each patient to have a tracking badge with their room number on it with them at all times. By doing this, we can track where each patient is, monitor how long they have been waiting and overall, provide a better experience for them. All of this helps improve communication and reduce wait times for patients. Other areas we were able to engage caregivers was through the picking of the color scheme and the artwork on the walls, some artwork is even from a Providence caregiver.

We welcomed input from over 150 individuals from all over Providence to help with idea development, final design and execution. We developed communication tools from team reports and informed Providence staff about the new building through staff meeting updates and web tracking tools so every caregiver could follow along in our journey. We told patients about our plans through home mailing materials, clinic signage, and ultimately, Open House extravaganza where over 2,000 local residents came out to see their new clinic. The Providence Medical Building Monroe is a terrific example of how we can turn a strategic goal of serving our community better into a specific idea, then a plan, and then a reality.