ABSTRACT
This chapter describes the groups who represent the human qualities of sociotechnical systems, and examines constraints on what’s possible within the intervention context. It focuses on the building blocks for driving change in high-performing healthcare systems: engaged leadership, data-driven value improvement workgroups, clear provider–patient relationships through empanelment and attribution, team-based care and care management and patient engagement. The organization of people into highly functioning interdisciplinary workgroups, with well-defined roles and responsibilities, is a necessary precondition for sustained value improvement efforts. Organizational hierarchies and governance structures for leadership and decision-making may need to evolve as semi-autonomous projects are formed to meet the unique demands of specific quality measures. A successful governance structure that is both scalable and flexible receives vision and goals from an executive committee, is guided by a steering committee, has a program manager for day-to-day administration, and has workgroups for specific measures. A steering committee exercises its responsibility to triage, prioritize, and make decisions during weekly oversight meetings.
