Hospitals in pursuit of excellence

Customer-owned Model of Care at Southcentral Foundation

Southcentral Foundation
Anchorage, AK
150 beds

A nonprofit health care organization owned by the Alaska Native people. SCF and the Alaska Native Tribal Health Consortium jointly own the Alaska Native Medical Center.

The Problem 
Fragmented care, poor patient satisfaction, and high staff turnover. Alaska Native leaders decided to create a customer-owned system of care built on the values of Alaska Native people.

The Solution
Southcentral Foundation moved from the Indian Health Service to a customer-owned “Nuka System of Care” built around the value of shared responsibility. All aspects of the care system are designed by the customer-owners. The board of directors and 54 percent of the workforce are made up of customer-owners. In addition, surveys and focus groups are utilized to listen to customer-owners and feedback is incorporated into care delivery.

Multidisciplinary ‘Integrated Care Teams’ consist of a primary care provider, a certified medical assistant, a full-time nurse, a case manager, an administrative assistant providing care coordination support and a behaviorist. Customer-owners chose their primary care provider and develop a relationship with their chosen integrated care team. Southcentral Foundation removes barriers to care by giving customer-owners access to their team’s direct phone numbers and encouraging email communication. Medical concerns that cannot be handled by telephone or e-mail are addressed in a same-day appointment with an appropriate member of the Integrated Care Team.

Staffing is a key contributor to the system’s success. Southcentral Foundation conducts group interviews and uses behavioral interviewing techniques. New hires have an extensive orientation and onboarding process that includes information about the customer-owner philosophy of care and the culture of the Alaska Native people. Front-desk staff receive additional training and participate in a six-month mentoring process. All employees are trained in quality improvement. Clinical staff work in teams and are encouraged to work to their highest skill level.

Lessons Learned
Staff were initially uncomfortable with the shifting of responsibilities created by encouraging the clini-cal team to work to the top of its level. Carefully screening and matching new employees with the right team, making sure that employees are trained in their new roles and providing them with appropriate supervision are all important factors in a successful transition.

Contact Information
Jennifer Ambarian
Director of Process Improvement
(907) 729-4370
jambarian@southcentralfoundation.com

This case study was originally featured in the HPOE guide: "Engaging Health Care Users: A Framework for Healthy Individuals and Communities," published January, 2013.