Background and Theory Overview: Academic practices and departments face increasing pressure to meet the Triple Aim of care experience, population health, and affordability. Although care, education, and research are conceived as mutually reinforcing, they often present challenges in practice as the missions are experienced as separate or competing. This paper presents a longitudinal case example from a large family medicine department that has harmonized its academic missions so that each complement and enhances the others, without any single mission dominating or negating the others. The goal was to highlight an example of harmonizing missions that builds a foundation for a learning health system, potentially improving faculty well-being.
What is New: The existing literature lacks specific examples and strategies for achieving a goal where missions positively reinforce each other and improve faculty well-being. The faculty within the Department of Family Medicine and Community Health at the University of Minnesota Medical School created a shared vision of harmonized missions across the operation. Instead of establishing a centralized project management plan, the department was led as a complex adaptive system. This system employed three elements: a belief in a "good enough vision," like a 2013 vision that described sections of a jazz band playing the same music, not separate bands playing their own songs, which provided a shared language from which faculty oriented themselves and engaged. They created a harmonization group that looked for opportunities to balance priorities and harmonize on projects. Lastly, they applied simple rules for harmonizing missions, such as translating innovations that spontaneously arise in any mission area to all mission areas, designing projects as tri-mission efforts from the start, using harmonization when dealing with crises, thinking "harmonize" when groups become distant, and giving department performance feedback across missions, not in isolation.
Results: Since the start of the project, the department's academic missions have increasingly been experienced as mutually beneficial rather than as parallel and competing priorities, with significant expansion of scholarly output across all faculty. Though not originally intended to improve faculty vitality, enthusiastic partnerships appeared to amplify excitement and participation.
Why It Matters: Harmonization is an example of creating a learning, adaptive health system within an academic department that has the potential to additionally improve clinician well-being. The paper presents concrete examples of cultural and operational strategies that institutions can implement to better integrate their missions and support faculty careers over the long term.
Harmonizing the Tripartite Mission in Academic Family Medicine: A Longitudinal Case Example
C.J. Peek, PhD, et al
Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota
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