Gawande

Tom Harburg, MD, is the physician in charge at Division Medical Office in the Northwest. He co-sponsors two primary care teams in the medical office along with the medical office manager and their labor partners. “Doctors can’t be cowboys anymore,” says Dr. Harburg, referring to physician Atul Gawande’s New Yorker article “Cowboys and Pit Crews.” Harburg agrees with Gawande that doctors need to work in a team environment and that, as Gawande wrote, “places that function most like a system are most successful…(where) diverse people actually work together to direct their specialized capabilities toward a common goal for patients.” Dr. Harburg talked with LMP communications consultant Jennifer Gladwell about being a sponsor and the value of having the physician involved in the team.

Q. What is your role as a sponsor?

A. As the medical director of the clinic, I work with the medical office manager and labor partners to help sponsor the teams. We help facilitate leadership. I think the strength of the unit-based teams lies with the grassroots approach. The ideas come from the front line. My role is to help build awareness and alignment to the goals of the organization and ensure that our approach is member-centric.

Q. What’s the biggest barrier you see?

A. The measurement is the biggest barrier. We have to be able to measure our performance to see if what we’re doing has any effect on our patients.

Q. How do huddles improve the work of the team?

The true benefit of the huddles is communication. There’s a social aspect to in-person huddles that allows you to address issues that pop up. It also facilitates learning and disseminating information—like the first day of a new protocol, you can remind folks at the huddles. I also think it’s a morale builder. Huddles foster good camaraderie. We only have two huddles per week at the clinic, but we have been doing huddles for three years. We’ve changed the time of the huddles based on the clinic hours, and now we’re going back to mornings.