It started with an unexpected result on my CTA scan – two arterial blockages that required further investigation. The radiologist’s report said it was at least 70% blocked and possibly 90%. With rural healthcare being what it is in the Lake Tahoe region, I had to wait 5 months to get the scan scheduled after discovering I had AFib in late June. My depression deepened, and my anxiety soared at just the idea of having to get the care I needed and how long it would take.
For a week, I held it inside until finally breaking down when I learned that my primary doctor didn’t even read the report after I sent it to him requesting a referral for an angiogram. I knew that if we got it right away, I might avoid a heart attack and be out for weeks instead of months. Ultimately, I felt compelled to share my sorrow and frustration on Facebook, seeking emotional support.
Luckily, I have built a network of amazing humans over years of giving, connecting, and building community, one of whom is Kym McNicholas, the founder of the Global PAD Association. After experiencing a healthcare nightmare with her father, she built an independent foundation to ensure more people didn’t suffer as she and her father had. She sent me a DM offering her support and pledged that she would ensure I would be ok. That she would personally make sure I was ok.
She not only gave me emotional support and more information than I could ever get from my doctors, but she became my advocate. She helped me arrange an angiogram with one of the doctors in her network within a week, and I am now on the other side of this nightmare, looking back and looking at the bigger picture beyond my own fear.
This moment wasn’t just a personal medical revelation; it was an awakening to a fundamental truth about navigating the US for-profit healthcare system: no one should face it alone. This realization led me to imagine a more structured approach to Healthcare Advocacy Teams. It also birthed the concept of Heart Flow, an approach to health advocacy that transforms individual healthcare journeys into collaborative missions.
The Wake-Up Call
Despite their mission to heal and support, healthcare systems, particularly in the US, can often feel like Byzantine structures where patients become lost in the complexity of specialties, procedures, and medical jargon. While ‘care’ is literally in the name, it often isn’t in the patient experience. My journey through cardiac diagnostics and intervention revealed not just the state of my arteries but also the critical importance of having a coordinated team approach to healthcare and the vital role that an advocate such as Kym could play.
That’s where she and the Global PAD Association filled a critical care gap for me and many others. They provide high-touch advocacy to assist patients in navigating complex healthcare systems and expediting timely, effective life and limb-saving care around the world.
PAD stands for Peripheral Artery Disease, which is more prevalent and deadlier than breast cancer, prostate cancer, and colon cancer combined. It refers to poor circulation, primarily in the legs, experienced by three in five heart attack sufferers. Most may not even realize it until a heart attack, stroke, or amputation becomes imminent. Many physicians too quickly misdiagnose complaints of leg pain, leg cramps, neuropathy, and sleepy legs as simply old age or diabetic neuropathy.
Kym and her foundation have now helped people like myself worldwide get the critical care they need, which the system and individual doctors would not provide without her wisdom, advocacy, and network.
The traditional patient care model often places the burden of coordination, understanding, and decision-making solely on the patient’s shoulders. This burden can become overwhelming in moments of health crisis or chronic condition management. The solution lies not in trying to become a superhuman patient who can juggle all these responsibilities alone, but in building and nurturing a Health Advocacy Team, or what I’ve been calling a HAT.
Applying the Team Flow Model to Healthcare
As conceptualized by Dr Jef van den Hout, team flow provides an ideal framework for healthcare advocacy. I never imagined how personal it would become when I founded the Team Flow Institute to advance his work and empower teams to work better together. When applied to healthcare, this model can be used to create a new framework that ensures no vital information, decision, or opportunity for care improvement falls through the cracks.
What follows is my initial draft of a framework for Healthcare Advocacy Teams, which I am now calling Heart Flow, to provide the guiding principles for their success.
Building a Healthcare Advocacy Team
The “Heart” of Heart Flow.
At the heart of every successful HAT lies the intrinsic motivational force of a shared vision: the specific optimal health outcome for the patient. This collective ambition is the organizing principle of the Team Flow model. It transcends individual roles and responsibilities, creating a unified purpose that drives every team member’s actions and decisions. In practice, this means everyone – from the patient to the primary care physician to family caregivers – aligns their efforts toward clearly defined health goals and outcomes.
Critical to the success of the HAT is a common understanding that requires every member to have access to the same information. Healthcare is complex, with each specialist speaking their own technical language. A successful HAT bridges these different languages and systems, ensuring that medical information is translated into actionable insights that all team members can understand and act upon. This shared understanding extends to treatment plans, medication schedules, lifestyle modifications, and recovery milestones.
The Six Pillars of Heart Flow (and the team flow model itself)
1. Open Communication
Communication in healthcare must be more than just open – it needs to be strategic and effective. A well-functioning HAT establishes clear channels and protocols for sharing information, raising concerns, and making decisions. This might include regular team meetings, shared digital platforms for tracking progress, and designated points of contact for different aspects of care.
2. Psychological Safety
Psychological safety within a HAT enables all members to voice concerns, ask questions, and challenge assumptions without fear of dismissal or ridicule. This is particularly crucial in healthcare, where small details can have significant implications. Where patient advocacy often requires speaking up against established routines or practices. Where graceful persistence is necessary to get timely responses and avoid unnecessary confusion and anxiety.
3. Ambitious Team Objectives
Ambitious objectives elevate healthcare beyond standard protocols to pursue optimal outcomes. A well-functioning HAT establishes challenging yet achievable goals that unite members in pushing past conventional boundaries while maintaining medical prudence. This might include accelerating diagnostic timelines, developing comprehensive treatment plans, or creating innovative support systems that enhance patient care. When team members collectively commit to these elevated goals, routine healthcare transforms into mission-driven care delivery.
4. Aligned Personal and Team Goals
The sustainable success of an HAT depends on the harmony between individual members’ motivations and collective patient outcomes. This alignment manifests uniquely for each team member while contributing to the overall mission, and their collective ambition is manifested. A physician’s commitment to clinical excellence aligns with innovative treatment approaches while advocates balance emotional investment with evidence-based care decisions. When personal aspirations serve team goals, it creates a powerful synergy that elevates the entire healthcare experience AND outcomes.
5. High Skill Integration
Each member of an HAT brings unique strengths to the table. The primary care physician provides medical oversight, specialists contribute deep expertise in their areas, advocates offer system navigation skills, and family members bring intimate knowledge of the patient’s daily life and preferences. The magic happens when these diverse skills are recognized, respected, and integrated seamlessly.
6. Mutual Commitment
The success of a HAT depends on each member’s dedication to their role and responsibilities. This commitment extends beyond professional obligations to a genuine investment in the patient’s well-being and the team’s success. Ongoing fulfillment of promises made leads to a sense of progress, which leads to deeper trust, faster progress, and improved health outcomes.
Building Your Health Advocacy Team
Trust forms the bedrock of effective healthcare advocacy. It manifests in multiple directions: the patient’s trust in their medical team, the doctors’ trust in patient-reported symptoms and concerns, and the advocates’ trust in medical expertise and patient preferences. Building this trust requires time, transparency, and consistent demonstration of competence and care. But as the end of the cold war taught us, trusting does not exclude verifying. The advocate also serves the important role of asking questions and seeking alternative perspectives.
My experience with Kym as my advocate inspired the genesis of Heart Flow and raising the prevalence of Healthcare Advocacy Teams. A phrase which only shows 9 results in a Google search.
I am publishing this today, seeking your comments, insights, additions, and suggestions for improvement. It is only the beginning of what I hope will become a broader conversation and a more standard approach to saving more lives and easing the pain and suffering created by the very system that is supposed to care for our lives.
Core Team Members and Their Roles
1. The Patient
At the center of the HAT lies the patient – not as a passive recipient of care, but as an active participant in health decisions. The patient’s role includes:
– Clearly communicating symptoms and concerns
– Participating in treatment decisions
– Following agreed-upon treatment plans
– Providing feedback on care effectiveness
– Maintaining personal health records
Most importantly, the patient must take personal responsibility for enacting the team’s recommendations.
2. The Lead Advocate
A family member, professional patient advocate, or dedicated healthcare navigator might fill this crucial role. It could eventually become a profession of its own. Their responsibilities encompass:
– Coordinating communication between team members
– Maintaining comprehensive records
– Scheduling and tracking appointments
– Ensuring follow-through on treatment plans
– Acting as the patient’s voice when needed
3. The Primary Physician
As the medical team leader, the primary physician:
– Oversees the overall treatment strategy
– Coordinates with specialists
– Manages medication interactions
– Provides continuity of care
– Makes referrals as needed
4. Specialty Teams
Depending on the patient’s condition, various specialists join the team:
– Providing expertise in their specific areas
– Conducting specialized tests and procedures
– Recommending targeted treatments
– Contributing to the overall treatment plan
– Collaborating with other team members
5 The Front Office Staff
As the operational backbone of great patient backbones, the front office staff:
– Manages schedules, appointments, and patient flow.
– Handles communication between patients, physicians, and the HAT.
– Processes insurance, billing, and medical records.
– Provides essential administrative support to the entire team.
– Ensures seamless information flow and practice operations.
Implementing Team Flow Principles
1. Establishing Communication Protocols
– Regular team meetings (virtual or in-person)
– Shared digital platforms for information exchange
– Clear emergency communication procedures
– Designated points of contact for different concerns
– Documentation standards for all team members
2. Creating Psychological Safety
– Encouraging questions from all team members
– Validating concerns and observations
– Establishing non-judgmental feedback mechanisms
– Celebrating team successes
– Learning from mistakes without blame
3. Integrating Skills
– Mapping team member strengths and expertise
– Creating clear roles and responsibilities
– Establishing handoff procedures between team members
– Regular skill-sharing sessions
– Cross-training where appropriate
4. Building Mutual Trust
– Consistent follow-through on commitments
– Transparent decision-making processes
– Regular check-ins and updates
– Acknowledgment of team member contributions
– Open discussion of challenges and solutions
Maintaining Team Effectiveness
Regular Assessment and Adjustment
The effectiveness of a HAT should be regularly evaluated through:
– Patient outcome metrics
– Communication effectiveness measures
– Team satisfaction surveys
– Process efficiency assessments
– Resource utilization reviews
Continuous Improvement
Teams should establish mechanisms for:
– Incorporating new team members
– Updating protocols based on experience
– Adapting to changing patient needs
– Enhancing communication systems
– Strengthening team relationships
The Impact of Heart Flow
When properly implemented, the Heart Flow approach transforms healthcare experiences by:
– Reducing medical errors through multiple checkpoints
– Improving treatment adherence through better support
– Enhancing patient satisfaction and outcomes
– Decreasing stress on individual team members
– Creating more sustainable care systems
Conclusion: A Call to Action
The journey through healthcare challenges doesn’t have to be a solitary one. By adopting the Heart Flow approach and building a strong Health Advocacy Team, patients can transform their healthcare experience from one of isolation and confusion to one of supported, coordinated care.
The power of team flow in healthcare advocacy lies not just in team members’ individual strengths but in the synergies created when these strengths are appropriately coordinated and directed. Whether you’re facing a new diagnosis, managing a chronic condition, or simply wanting to optimize your healthcare experience, consider building your own HAT using the principles outlined here.
Remember: in healthcare, as in life, we are stronger together. The path to optimal health outcomes isn’t found in trying to do it alone but in building and nurturing a team that can support, advocate, and care collectively.
Question: Is this worthy of further pursuit? Add your thoughts and share it with others who may benefit or may contribute to strengthening it with us.
