Tag Archives: patient centered medical home

Portland VA Healthcare Team Building: Patients Included

It was nice to drive past Portland on my way to work today, to the Red Lion Inn in Vancouver, Washington, on the Columbia River. Our Primary Care team from the Portland VA Medical Center enjoyed a rare day off campus, together, for Team Building Training. Our team – several residents included – joined care teams from satellite clinics (in Hillsboro, West Linn, Bend, East Portland & Vancouver).

Referred to as Patient Centered Medical Home elsewhere, VA calls this PACT or Patient Aligned Care Teams. In my few years at Portland VA, I’ve experienced welcome, palpable shifts towards working on a Team.

Highlights were from VA patients. These adept patient advocates stood front & center and shared their Patient Voice. Patients Included!

Scott Silva and Priscilla Thompson


Priscilla Thompson, retired from the Navy as an Aviation Electronic Technician, said ‘patients do OK if they’re healthy but if things go south, it’s another story.’ She shared her story about a doctor calling on a Sunday night, concerned and instructing her to go to the hospital. Confronted with a difficult new diagnosis, she learned about her condition as well as the VA. A patient advocate on Portland VA committees, Priscilla gave recommendations to help patients be active members of the Team.

    * Let me know the reason for this appointment or test;
    * Let me share information before a visit (so the PCP knows..)
    * Hand out that detailed After Visit Summary (it tells me what to do..)
    * Let me see all my record information (get back to MyHealtheVet Pilot..)
    * Know all about VA information & resources (help me get what I need..)
    * Have staff available to answer questions (a human when I need one..)
    * Let me get VA services in my community (make it convenient for me..)

Scott Silva is a VA patient and an employee — with a hugely valuable perspective from all ‘sides’. After serving as a Special Operations Medic, he is working as a Telehealth Coordinator. We talked at break about what’s coming down the pike: more and better remote services for hard-to-reach Veterans, delivered by a variety of staff, including specialists.

Sessions were expertly lead by Lisa Mazzia and Lori DeLeeuw from VHA National Center for Patient Safety. Brief talks and exercises had everyone focused on important things: how we communicate (or don’t), work as a team, make assumptions, respond to issues. When asked, What characteristic make a great Team? answers came quickly and repeated across the room: effective communication, great listening, be flexible, knowing each other and our roles, focus on patients, feeling content, know the mission. A list was dubbed Portland VA’s Dream Team.

It’s still early in this PACT journey, and today felt like we’re gaining traction and meaning. Skill-building is good for us team members, and we need to keep the pedal to the metal. We can’t do this without our #1 stakeholders, so lets make sure we =always= have Patients Included.

Patient Included Logo is from Lucien Engelen’s Patient Included Act – attend only conferences that include patients.

What do patients really, really, really want? The answer is the destination for patient-centered care.

The 2011 Planetree Conference just wrapped in Nashville, Tennessee. It was the best motivational conference I’ve ever attended. Who knew?

I was one of 500 staff from the Veterans Health Administration. This great participation came about by the Patient Centered Care and Cultural Transformation Office (PCCCT). This new – and major – VHA office was created this year, with Dr. Tracy Gaudet as its Director. Tracy is an Ob/Gyn, a best-selling author and national speaker (hello! She was on Oprah and NPR). She created the Center for Integrative Medicine at Duke University. More in a minute.

Some highlights from the plenary speaker lineup:

Azure Antoinette, poet, artist and youth literary advocate opened the first night. I wasn’t able to capture her moving and lovely words, but here are a few, paraphrased –

There is something to be said about patient centered care
Something angelic about role models and champions…
This revolution of patient-centered must have happened three times over.
I must have missed it.
The healthcare revolution won’t be televised.

A huge treat was listening to Ben Zander, speaker, author of the Art of Possibility (with his wife Rosamund) and conductor of the Boston Philharmonic. He engaged us in wonderful ways, starting by discussing with the audience (only 1,400 people) why so many people sit in back rows. He asked people take empty seats in the front – and they did. For 90 minutes, he spoke about how people are molded by boundaries that humans set for themselves. He energized the crowd with laughter, stories, singing (we sang Happy Birthday repeatedly until it became a cause), and dreams about the “art of possibility”. He told us that in his job as a leader – or any leader – is

“to remind people what the rhythm of transformation is.”

He also stated, “if people don’t do what you want, you can apologize to them for not engaging them enough.” What a very different kind of viewpoint for patient engagement!

Tim Sanders talked about a new kind of leadership, where people give and get much more in return…by sharing knowledge, sharing networks, and having compassion. He spoke about leadership and improvement as love. Loved it.

Dr. Tracy Gaudet, recently named as a top woman in healthcare, was fitting as the last plenary speaker. Randy Carter, Planetree Senior VP, introduced her by noting that Tracy is one of the most quotable people he knows, always asking the most critical questions.

Tracy asked us, What is Patient-Centered Care? Is it better customer service? Is it open access to clinics and services? Is it treating people with respect? Treating people as human beings rather than a body part? Is it about patient preferences? Yes, it is all of these. Yet, if these are fully accomplished, Tracy presses, will we have achieved patient-centered care? No. We have to have a clear destination — where people drive their own health and care. And Tracy tells us to reach that destination, we have to answer (and provide): what do patients really, really, really want?

The speakers at #Planetree11 were remarkable not only because they are passionate and visionary, but because they told stories, created emotional connections and helped make patient-centered care palpable. They engaged us and made us believe in ourselves. Believe that we can be more, together – to achieve great things for patients and all of us.

This is how patients should be approached, to have them dream and believe and open up the art of possibility – for their health and their lives.

I really could use a dose of this EVERY SINGLE DAY.

(Oh, note to Planetree: bring in more patient advocates as speakers.)

VA eHealth University Charts Future – More Shared Information with Patients

It was an exciting week for attendees of the VA’s eHealth University in Las Vegas. “VeHU“, as it’s called, is an unparalleled chance for VA professionals to rally around electronic records – with demonstrations, hands-on training, deep dives and up-to-date talks.

Transforming care delivery was a theme, with informatics solutions all around. I joined a panel on use of health IT for Patient-Centered Medical Home. I talked about patient-facing information and Participatory Care. My portion of the session’s slides:

I also participated on 3 classes on secure messaging. We focused on improved patient access, efficiencies in communicating online (for patients and professionals alike), and how messages between visits lets providers know more about patients. I’ve talked before here how messages bring more context and an emotional connection..

Speaking of connections, VeHU planners hit it out of the park for the closing plenary. Stories, videos and a performance by the 4 Troops, a young veteran quartet with lovely voices and beautiful songs. Transformation can happen when people make emotional connections. How can we do this on a regular basis, not just at a once per year conference??