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Clients and
case studies

Samples of our work and client results:

Client list:

California Academy of Family Physicians 
American Academy of Family Physicians
Lumetra Healthcare Solutions
NorthBay Healthcare 
Healthcentric Advisors

South Cascades Alliance
Gastroenterology of the Rockies 
St. John’s Health Systems 
The Children’s Hospital 
Eisenhower Medical Center
Health TeamWorks 
Rockford Health System

Kaiser Permanente 
Independent Health Plan 
Baltimore Medical Systems 
Denver Health 
Moses Cone & Wesley Long Community Foundation

The Pediatrics Center
Spruce Street Internal Medicine 
Estes Park Family Clinic 
California Rural Indian Health Board 
Astra Merck 
Eastman Kodak Health Sciences Division 
Physician’s Computer Network

We've provided consultation, training, and clinical operational improvement assistance, some of which are now recognized as national best practices. We've helped to positively change the working culture of medical groups and assisted with putting teams in place to sustain desired change. Our best results are always built on first listening to understand our clients, from desired details to project vision.

Case studies:
Case Study 01




Healthcentric Advisors of Rhode Island needed help providing support to medical home practices participating in an initiative to reduce unnecessary hospital readmissions and emergency department visits. Additional requirements included training and mentoring practice coaches, and provide content for physician and staff learning sessions.




A complex project which required a broad range of skills from advising project leaders to on-site facilitation of clinical operations improvement and training of practice coaches – all within a tight budget. The majority of provider operations were focused on longstanding payment incentives to boost office visit volumes. However, rising per member, per month payments to participating practices was shifting incentives from volume-based care to improved diabetes care.


Solution & Results


We conducted site visits and assisted with improving clinical workflows, access, EHR utilization, group medical appointments, and optimizing practice revenues. To reduce unnecessary hospital re-admissions and ED visits, we helped guide development of nurse care manager roles and training of physicians and staff on proven medical neighborhood strategies for post-hospital visit planning and patient support. Our customized redesign boot camp provided coaches with the hands-on skills needed to address the specific improvement issues facing physician practices.


A local learning community of participating physicians and staff was facilitated to share best practices and clinical outcomes data. Access to 24/7 learning about local and national best practices was put in place with BRIEF VIDEOS OF SITE VISITS. We also recruited assistance from local physician thought leaders to forward the project's goals. 


97% of attendees said they would recommend to colleagues the training program we conducted on the cultural and operational transformation required for successful medical homes. 98% of attendees were prompted to make changes in their practices.

Case Study 02




TransforMED, an affiliate of the American Academy of Family Physicians embarked on a project to transform Family Medicine practices to a new model of care. The TransforMED leadership contacted us to train facilitators and help Family Physicians redesign their clinical operations.




The project required development and implementation of training for a groundbreaking national project to redesign clinical operations. An important consideration when planning was that some of the facilitators had no prior experience in healthcare.


Solution & Results


We designed and delivered a 2-day training using highly interactive learning scenarios to build problem-solving skills with national practice improvement facilitators. Visual tools helped simplify complex office practice workflows. Subject matter included how-tos for improving chronic illness care, workflows, patient access, and group visits with simple financial modeling. Attendees gained a new ease in effectively guiding improvement. We were subsequently invited to conduct how-to workshops for the 36 participating medical groups on managing culture and operational change as well as optimizing the use of EHRs. The project has become a model for Patient Centered Medical Homes nationally.

Case Study 03




Baltimore Medical Systems (BMS) wanted to improve patient access and clinical operations, including patient flow and efficiency to reduce no-shows within an urban community health center network.




Inefficiencies and high no-show rates were negatively impacting revenues as well as creating long waits for visits for a high-need and under-served patient population. Limited community health center budgets were a major factor.


Solution & Results


We helped BMS to improve patient access by 25% and revenues increased by 20%. We redesigned inefficient workflows, enabling patients to get access care on the day that they called, and identified metrics with which to measure success. We facilitated discussions to constructively deal with the resistance of some physicians and staff to change. A customized skills training was conducted for physicians and staff on how to use redesign concepts to improve access. We also advised BMS's CEO and COO on how to leverage national best practices to sustain the desired changes as well as common costly pitfalls to avoid.


Following the successes of the initial health center, the project was rolled out at an additional three sites.

Case Study 04




A regional group practice network requested our assistance to improve patient centered care and build "a culture in which patient satisfaction is number one."




Lack of existing structure and process to ensure high level of patient satisfaction, and a lack of physician and staff awareness of how to manage the patient service experience. Existing processes were provider and staff centric rather than patient focused, with little patient self-management skill building.


Solution and results


We facilitated the development of a physician led improvement team that met regularly, identified patient satisfaction goals and metrics as well as a process to rapidly test desired changes. A curriculum was developed and training conducted for physicians and staff to design and manage the patient service experience as well as service recovery. Inefficiencies and duplication of tasks which often frustrated patients were identified and eliminated. Physician specific patient satisfaction surveys were designed and implemented and the results posted in common areas. Patient self-management skills were facilitated via self-care tools on the practice website. We also facilitated the sometimes-difficult dialogues with staff resistant to the changes required to delight patients.


Patient and family comfort issues were addressed such as providing warm blankets routinely to patients undergoing procedures rather than only when requested, and a refreshment area for family members was added. Scheduling redundancies, background rock music at one site and the pervasive smell of antiseptics were also addressed. An organizational customer service vision was developed with physician leaders. As a result, patient satisfaction scores increased over 10%.

Case Study 05
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