What is a Patient Centered Medical Home? Dive in and find out!
Don’t Leave Me Clueless About a PCMH!
What’s a patient centered medical (or health) home? Well, Google it and you get 1,600,000 hits within 0.13 second, but ask a primary care audience of smart people just trying to do the best they can for their patients and 95% of them will say: “Honestly – I’ve heard the phrase a lot, but I can’t tell you what it is.” The Patient Centered Medical Home (PCMH) has to be one of the worst communicated public policy initiatives in history. And this is really frustrating to many of you in safety-net primary care organizations.
Well if that question can baffle the respondent, how about this question: “If your PCMH was a sound, what sound would most symbolize the PCMH to your community?” And that’s just one of about 30 plus questions that gets asked and answered by participants in a Coleman Associates’ Patient Centered Health (Medical) Home Deep Dive – which is an all-day breathless immersion in not only bringing the concept to comprehensible life for all participants but exploring its potential as well.
The Patient Centered Health Home Deep Dive is an all-day breathless immersion that brings the concept to life and explores its potential.
The PCMH Deep Dive can be conducted at a state level with all levels of participants, or within an individual health center with all staff. But the best forum is at an association level – because it allows broad participation while ensuring that almost all participants work in a delivery setting. The Deep Dive runs from 9:00-3:30. It is based on a fusion of two concepts:
- The Deep Dive technique developed by the design firm IDEO in Palo Alto, California, and used to foster innovation and creativity.
- A Kinetic, Focus-Group Technique that converts participants from “conference attendees” to active designers of the Patient Centered Medical Home.
And both of these techniques are fun, engaging, inspiring, and energizing. Put them both together and it’s akin to nuclear powered creativity. Participants leave the Deep Dive largely focused on creating a PCMH at their place of work. When asked what they liked best about the Deep Dive, participants comment:
- “Collaborative. Brought in insights from many different perspectives. Fun, and outside the box. A good start to thinking creatively about the PCHH.”
- “Very energetic!”
- “I really like the Coleman approach. There was a lot of interaction.”
- “Entertaining engagement. Inspiring, can do. Told us how to do it! Inspire, engage, activate.”
- “High energy enthusiasm. The concept of ‘it’s not all that complicated,’ what can we do, think and act way-y-y-y outside the box, in fact – get rid of the box. I loved all of it and want more!!!”
- “Entertaining and educational. Moved quickly, fun, covered topic, address questions – GREAT JOB!!”
And by “immersion” we mean up to your eyeballs all day in this innovative setting. There’s only one 20 minute break – and that’s to get your lunch. Otherwise, no breaks. Group huddles run about 15 minutes followed by an exploratory facilitation. Then you’re back at it again after the groups are changed up. You never work with just people you’re already familiar with. You never work with the same group of people more than once. And for each huddle session, let’s say there are six groups, there will be up to four different questions being addressed by the groups simultaneously – not just a single question addressed by all groups. So the “content” – largely the product of the group work – is rich and gains in richness throughout the day.
In addition to the groups, there’s another group called Skunkworks – i.e., “where the crazies live,” where we attempt to concentrate the most out-of-the-box thinkers. To them we assign our most gnarly questions – “Describe a clinically difficult patient and then describe – in detail – the care that patient receives over the course of a year from YOUR PCMH.”
So the Deep Dive explodes with ideas, concepts, insights, and revelations continually and constantly throughout the day. You’d have to be dead to not be turned on by this! And did we mention the “homework?” It always involves a reading (this year our favorite has been Atul Gawande’s “HotSpotting”) as well as bringing to the “Deep Dive” your drawing of a PCMH – something that symbolically conveys what that means to you. And then we paper the walls of the session room with this stuff – and some of it is amazing! Oh, and you have to bring your toothpaste… but we’ll let you wonder about this and not spoil the surprise for those of you who take advantage of this Coleman Associates program.
You have to be dead to not get turned on by this!
Yes, we are aware that NCQA, in particular, has all kinds of requirements for certification as a PCMC, but – frankly – they lack heart and soul, which makes them very difficult for the members of our work force – from physicians to front deskers – to relate to. It’s like taking a group of people and carefully explaining all the rules of basketball, then throwing them on the court and expecting them to be successful. Sure, the rules are important – but by themselves they do not tell you how to play the game, how to succeed or, more importantly, why you should care.
So we at Coleman Associates just couldn’t take it anymore. We know the frustration out there is palpable, and we believe in the Patient Centered Medical Home, so we created a program that brings it into colorful relief for all the folks in our organizations.
Oh, and to conclude: how do participants respond when asked “If your PCMH was a sound, which sound would it be?” Well, there are many variations on the theme, but the theme goes something like: “The sounds of nature, in particular a bubbling brook, or gentle ocean waves, or a delicate fountain, etc.”
In other words: beautiful, peaceful, soothing sounds. (Does this sound like your clinic, LOL?). And beauty is an important aspect of health care delivery that is almost always missing. Except – if you want to see a great example of beauty and health care entwined – visit the Mayo Clinic in Rochester, Minnesota. Is it an art museum? Or is it one of the premier health care delivery organizations in America? Gladly, it’s both.
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