Shift Focus for Texas Children’s Pediatric Associates (TCPA)

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Message Shift Focus Expansion isn’t just about being in more places. And Texas Children’s Pediatric Associates (TCPA), the nation’s largest pediatric primary-care group practice, knows this. As TCPA continued to grow, the organization sought a new strategy that would unify its broad network of locations, enhance the patient experience, and differentiate its brand. TCPA believed an outside perspective would catalyze its imperative for change—and it asked IDEO to provide one. The joint creative team spoke directly with families, physicians, and staff to identify and understand their needs. Their input suggested that a next-generation practice would make pediatric care more convenient for parents; address the needs of maturing adolescents; streamline complex managed-care contracts and payer negotiations; accommodate the “tidal wave” of part-time physicians; ensure TCPA’s practices were not competing internally; and one-up the competition, online and off. With all this and more in mind, the creative team launched a prototype. It then solicited organization-wide feedback and conducted additional research. The final strategy, “TCPA – Grow With Us,” aimed to enhance the patient experience and serve as a platform for organizational change. The plan included a co-created set of brand values, a new framework for encouraging experimentation, and creative staffing models (and career paths) based on work/life balance needs. TCPA and IDEO also reconfigured the organization’s practice space to help create a unique TCPA experience. The design changes included an open, hospitable reception area (to replace the traditional opaque wall with a hole) that would be easy for staff to monitor; a blended Quiet and Active waiting room (instead of Sick and Well) – the latter featuring an interactive photo game and place to “plug and play”; smaller “porch” waiting areas outside exam rooms to stage patients and manage people flow; and magnetic whiteboards (for kids and doctors), retractable exam-table stairs, and dividing/privacy curtains in exam rooms. In addition, private offices and workspaces were transformed into shared work areas to support team-building among staff. In May 2008, TCPA debuted all elements of the next-generation model at its new Cinco Ranch practice (near Houston). Rollout at additional locations is planned throughout 2009. So far, the concept has been well received by physicians and patients. Most notably, the strategy has created a cultural shift within the organization, from “physician-driven to patient-centered,” and encouraged additional change. “Your team got us out of the box and gave us the faith to try things we wouldn’t have done on our own,” said Ayse McCracken, the then president of TCPA. Meanwhile, Cinco Ranch was one of the only sites out of 42 in the highly competitive region to outperform projections in TCPA’s first quarter. It beat expectations by 20 percent. http://www.ideo.com/work/shift-focus-for-tcpa

Expansion isn’t just about being in more places. And Texas Children’s Pediatric Associates (TCPA), the nation’s largest pediatric primary-care group practice, knows this. As TCPA continued to grow, the organization sought a new strategy that would unify its broad network of locations, enhance the patient experience, and differentiate its brand.

TCPA believed an outside perspective would catalyze its imperative for change—and it asked IDEO to provide one. The joint creative team spoke directly with families, physicians, and staff to identify and understand their needs. Their input suggested that a next-generation practice would make pediatric care more convenient for parents; address the needs of maturing adolescents; streamline complex managed-care contracts and payer negotiations; accommodate the “tidal wave” of part-time physicians; ensure TCPA’s practices were not competing internally; and one-up the competition, online and off.

With all this and more in mind, the creative team launched a prototype. It then solicited organization-wide feedback and conducted additional research. The final strategy, “TCPA – Grow With Us,” aimed to enhance the patient experience and serve as a platform for organizational change. The plan included a co-created set of brand values, a new framework for encouraging experimentation, and creative staffing models (and career paths) based on work/life balance needs.

TCPA and IDEO also reconfigured the organization’s practice space to help create a unique TCPA experience. The design changes included an open, hospitable reception area (to replace the traditional opaque wall with a hole) that would be easy for staff to monitor; a blended Quiet and Active waiting room (instead of Sick and Well) – the latter featuring an interactive photo game and place to “plug and play”; smaller “porch” waiting areas outside exam rooms to stage patients and manage people flow; and magnetic whiteboards (for kids and doctors), retractable exam-table stairs, and dividing/privacy curtains in exam rooms. In addition, private offices and workspaces were transformed into shared work areas to support team-building among staff.

In May 2008, TCPA debuted all elements of the next-generation model at its new Cinco Ranch practice (near Houston). Rollout at additional locations is planned throughout 2009. So far, the concept has been well received by physicians and patients. Most notably, the strategy has created a cultural shift within the organization, from “physician-driven to patient-centered,” and encouraged additional change. “Your team got us out of the box and gave us the faith to try things we wouldn’t have done on our own,” said Ayse McCracken, the then president of TCPA. Meanwhile, Cinco Ranch was one of the only sites out of 42 in the highly competitive region to outperform projections in TCPA’s first quarter. It beat expectations by 20 percent.