• Sasha Morduchowicz, Jonathan S Lee, Lei Choi, Coleen Kivlahan, Dan Null, Susan Smith, and Mitchell D Feldman.
• Faculty Practice Operations & Ambulatory Services, University of California, San Francisco, San Francisco, CA, USA.
• J Gen Intern Med. 2020 Dec 1; 35 (12): 3650-3655.

AbstractThis Perspective presents a case study of multidimensional clinical transformation in an academic general internal medicine practice. In the face of increasing internal and external pressures, health systems and individual medical practices have pursued multiple strategies to improve quality, patient experience, and efficiency, while reducing staff and provider stress and burnout. We describe a Lean-informed approach that emphasizes the importance of organizational alignment in goals, evidence-based problem solving, and leadership behaviors to support a culture of continuous improvement. Our aim in this Perspective is to provide a real-world example of a feasible process for the planning, preparation, and execution of effective transformation, and to present lessons that may be useful to other academic health center practices seeking to develop innovative models to achieve the quadruple aim.

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