Creating a Shared Vision Case Study: Stillwater Medical Group

In 2008, Stillwater Medical Group, a multispecialty clinic in Stillwater, Minn. joined with the local community hospital to form an integrated health system. System leadership was looking to communicate a cohesive vision and mission for the new organization. Patient-centered care was identified as a core value around which the mission and vision could be focused.

The system leadership developed a program to explore the fundamental elements of patient-centered care using an interactive process with leaders, the community and the employees at all levels of the organization.

This process allowed leaders to listen to what was important to the people providing and receiving care and to reflect back the important concepts that would be necessary to be patient centered. One of the central elements of patient-centered care is shared decision-making. Prior to the integration, the clinic had already begun some small quality improvement pilot projects involving shared decision-making, and clinic leadership saw an opportunity to expand on this work because of the alignment of the mission and vision of the system with the clinic’s quality improvement goals. The leaders of the system provided clear vocal support for the value of this work and the projects that supported its implementation. The shared decision-making message resonated with staff because it was consistent with what was important to them and because their experiences in the pilots were positive for both patients and health care teams.

The environment at the clinic allowed a gradual expansion of shared decision-making projects into other areas. Spread occurred as opportunities were identified that aligned with the ongoing clinic quality improvement work which was a part of regular clinic operations. This approach helped to keep the work on shared decision making from being thought of as a separate project. Instead, the work was carefully integrated into the everyday work processes. The outcome was patient centered change that was supported, consistent and sustainable.