Highlights | Unifying our Ambulatory Care clinics
- To improve collaboration, 125 UW Medicine Ambulatory Care clinics standardized common tasks to ensure patients get the care they need.
- The clinics used pilot programs to test different ways to solve each problem.
- In the process, they laid the foundation for cultural change across Ambulatory Care.
When associate administrators JoAnne McDaniels and Kassie Hollman began work to improve standardization at UW Medicine’s Ambulatory Care clinics, they found themselves at a crossroads. Between the two of them, they oversee 2,200 employees at 125 clinics and quickly discovered that each clinic operated a little differently from the next. Creating a system that could help them better collaborate and streamline services — while still preserving the unique role each clinic plays — was a big task.
Because ambulatory care exchanges referrals with so many other teams within the hospital system, standardizing operations became a critical goal to ensure patients get the care they need when they need it.
Spurred by Mission Forward, McDaniels and Hollman brought their teams of doctors, nurses, clinic administrators, managers, front-line lead staff, finance and technology specialists, and shared services together for monthly meetings.
“It took us a minute to figure out where we wanted to focus,” Hollman says. “There’s always something you want to improve, but what do we want to focus on for everyone? And how do we do this together?”
Even though McDaniels oversaw ambulatory care for UW Medical Center and Hollman handled Harborview Medical Center, they quickly found alignment on what they wanted to accomplish: Improve access for patients, make staffing more consistent and reduce variability between clinics.
But these were lofty goals with dozens of potential solutions, and each clinic managed its workflows differently.
“The question was, how do we choose the best path forward?” says McDaniels.
Collaborating for a solution
For some of the answers, they looked to colleagues like Chesna Briceno, the interim associate administrator for Primary Care. Briceno oversees around 535 employees, around 200 providers and 17 clinics that are physically separate from the larger hospitals. Because they have smaller teams, Briceno says they don’t experience as many of the hiccups as the other ambulatory care clinics. And in some cases, like InBasket coordination for patient messages, they had already figured out good solutions that they could share with McDaniels and Hollman. Those suggestions became the foundation for at least one pilot program.
“Across the board, we took bits and pieces from everyone and implemented a hybrid of what we heard,” says McDaniels.
By June 2024, they’d finished some of the pilot programs and are now beginning to roll them out in more than 100 ambulatory clinics across UW Medicine.
The central support team
To manage the expanding slate of pilot programs, Briceno, Hollman and McDaniels looked to Jenny Brackett, associate administrator of ambulatory access and business operations. She oversees a newly reformed central administration team.
“The ambulatory access and business operations team is a central support team that works closely with operational leaders. Many of the Mission Forward projects have moved to our team to carry forward and expand across ambulatory,” Brackett says.
In addition to managing the pilot programs as they expand into all the clinics, Brackett’s team also handles a range of responsibilities, including improving patient access and supporting patients through the Contact Center.
“Since COVID-19, UW Medicine has gotten better and better at operating as a cohesive system. Mission Forward is a critical forum to drive that continued collaboration and continue achieving shared goals across our organization,” Brackett says.
A cultural shift
“Cultural change is hard. It takes a while, especially for an organization that’s as large as we are,” Hollman says. “We’re not going to flip on a dime, but Mission Forward gave us a framework to do this work. These initiatives aren’t fading away; now we’re making them part of our book of business.”
Hollman and McDaniels say that simply the process of building these systems led to a notable change in UW Medicine’s approach to ambulatory care.
“Now our work culture feels more collegial. It feels like you’re not alone. You’re not trying to do something in your silo,” McDaniels says. “We don’t initiate any changes at UW Medical Center without checking in with Harborview. That wasn’t ingrained before. Now, it’s very natural.”
Editor’s note: Updated on Oct. 10 with the number of employees, providers and clinics that Chesna Briceno oversees in primary care.
