Episode 140: Teamwork That Transforms - Practical Steps to Improve Access & Sustainability

Welcome to the Sustainable Clinical Medicine Podcast!

In this episode, Dr. Sarah Smith sits down with Dr. Marcia Kashani, a nurse and experienced healthcare improvement advisor, to explore practical strategies for making your clinical day more efficient, effective, and—most importantly—sustainable. Drawing on years of experience facilitating primary care transformation and team-based initiatives, Dr. Kashani shares stories of real-world success: from leveraging the strengths of every team member, to optimizing clinic workflows, and even reimagining how tasks get delegated to maximize value for both clinicians and patients.

If you’ve ever felt overwhelmed by a never-ending list of tasks, long wait times for appointments, or the challenge of figuring out what you can hand off—and to whom—this is an episode you won’t want to miss. Dr. Smith and Dr. Kashani offer actionable insights into improving access, reducing unnecessary physician workload, and embracing change as a path to better care and a better work-life balance. Whether you’re part of a large clinic or running a small practice, you’ll find inspiration and hope for positive change right here. Tune in and take one step closer to reclaiming time for your patients—and yourself!

Here are 3 key takeaways from this episode:

1. Empower Your Team: Distinguish between physician, nurse, and administrative tasks. When tasks are thoughtfully delegated—like patient screening calls or form-filling—clinicians can reclaim time for patient care and improve office efficiency.
2. Reduce Unnecessary Visits: Examine return visit rates and consider whether clinical follow-ups always require physician attention. Thoughtful use of nurses, pharmacists, and even patients’ support networks can safely reduce visit volumes and waiting times.
3. Leverage Process Improvement: Document and map out workflows to highlight inefficiencies, duplications, and points of delay (like EMR optimization or referral processing). Even simple changes—like consistently titling scanned documents—deliver significant time savings for clinicians.

Meet Dr. Marcia Kashani:

Marcia has over 40 years of front-line nursing and progressive leadership experience in primary care, community care and acute care. Notable accomplishments include involvement in the business planning and governance of multiple Primary Care Networks in the Edmonton Zone.

In 2005 her focus turned to Quality Improvement and System Redesign where she became the first non-physician AIM faculty, participating in several AIM collaboratives.  She completed the Improvement Advisor Program through the Institute of Healthcare Improvement and continued as a facilitator for the program.

Most recently, Marcia has been a project manager with the Edmonton Zone Primary Care Networks team and North Zone Primary Care Business Unit, including work with Transitions of Care, Specialty Access and Referral teams, and assisting Practice Facilitators with improvement initiatives.

You can find Dr. Marcia Kashani on:

• LinkedIn: https://www.linkedin.com/in/marcia-kashani-44898638/

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