Implement Techniques to Improve Quality

With a focus on improving the use of health care services, refining the outcomes for patients, and reducing errors, we are integrating many quality improvement techniques into the doctors’ offices and hospitals.

How can my practice improve morale, patient care, and reduce costs?

Regardless of the type of industry a person is in, every workplace can find ways to become more efficient. Think about your own practice. Is staff wasting time looking for bandages and then losing time with the patient? Are all of your diabetic patients receiving the proper tests? Through AF4Q – South Central PA's Planned Care Collaborative, coaches from the local business community are helping practices:

  • Become more efficient.
  • Improve staff and provider morale.
  • Implement problem-solving techniques.
  • Reduce costs.
  • Improve patient care.

What is the process?

The collaborative brings together family medicine, internal medicine, and specialty practices with local business coaches to focus on key performance measures provided by our leaders. Trained to help reduce waste and provide guidance on improving patient-centered, self-management techniques, the coaches work with practices for one year.

The practices receive a specific number of hours of the coaches' time each week, participate in monthly phone calls, and attend face-to-face meetings with the other participating providers to discuss successes and struggles.

What are the benefits?

  • It brings an outside perspective
    to practices.
  • It provides access to process-improvement tools.
  • Coaches can watch and see how the practice operates day to day to determine the areas that need to be altered.
  • It's a step-by-step procedure for implementing change with little to no interruption to the practice.
  • It teaches the staff that they have the knowledge and power to make a change that will improve their performance.
  • It allows for more patient interactions to improve care.
  • Providers are able to receive Maintenance of Certification and CME credit for collaborative meetings.

Are practices finding it helpful?

Learn how the collaborative is working for area practices by reading articles from the Quality 4orum newsletter!

How can you get involved?

Practices are encouraged to contact Rush Gross at 851-6859 to participate.

How can my practice become a certified Patient-Centered Medical Home?

The Patient-Centered Medical Home (PCMH) is an approach to health care that is receiving accolades from the medical community and insurance companies. Through PCMH patients receive accessible, continuous, comprehensive and integrated care from their primary care provider. The care is typically coordinated by their primary care provider and their care team.

This approach emphasizes the importance of each person having a personal medical provider who leads a team of health coaches to coordinate all of their medical care. The goal is to reduce fragmentation in the health care system, improve communication and improve health care quality.

Why does it exist?

There are two trends that are helping to build momentum around the medical home model.

  • A growing shortage of primary care clinicians due to adverse practice conditions.
  • The increasing prevalence of chronic conditions among the U.S. population.1

As U.S. baby boomers age, it is expected that the burden of chronic conditions, such as diabetes, heart disease, and high blood pressure, will increase and put even more strain on our already limited health care resources. Furthermore, Americans currently receive only about 50 percent of all recommended preventative and chronic health care, which has spurred a nationwide discussion on how best to improve health care quality.

What are its critical features?

  • Personal physician
  • Physician-directed medical practice
  • Whole person orientation
  • Coordinated and integrated care
  • Quality and safety
  • Enhanced access to care
  • Payment to support the PCMH

In addition to the major professional medical organizations listed above, more than 100 large employers and other health care consumers have joined an organization called the Patient-Centered Primary Care Collaborative to help develop and advance the Patient-Centered Medical Home with the belief that it will improve the health of patients and the viability of the health care system.2

The concept is supported by the American Academy of Pediatrics, the American Academy of Family Physicians (AAFP), the American College of Physicians and the American Osteopathic Association.

How can you become a PCMH?

Through the Planned Care Collaborative, practices can work towards becoming a Patient-Centered Medical Home. A lot of the tools offered in this collaborative help practices achieve this goal. Once the practice completes the third level, the documentation of their work is submitted to the National Committee for Quality Assurance, who then determines if they are certified.

In order for the patient-centered model to work, the entire medical community needs to come together to make this a reality. Contact us for more details.

1The Deloitte Center for Health Solutions 2008, The Medical Home: Disruptive Innovation for a New Primary Care Model

2Patient-Centered Primary Care Collaborative

How can we avoid poor transitions for patients?

Part of improving quality care is ensuring that the transition of a patient from one setting to another is done in the most efficient manner. Poor transition can lead to misunderstandings, miscommunication and even death. With a strong focus on Transitions of Care, we are collaborating with hospitals, doctors' offices, and skilled nursing facilities to produce well-organized transitions, so we can be one step closer to reducing unnecessary hospitalizations and readmissions. Some of the techniques being used include:

Transforming Care at the Bedside

Transforming Care at the Bedside, also known as TCAB, is being implemented in medical and surgical units of York and Adams counties' hospitals. Through TCAB, hospitals are aiming to:

  • Improve the quality of patient care and patient service,
  • Provide more effective care teams,
  • Improve staff satisfaction
    and retention, and
  • Be more efficient at the
    bedside in medical and
    surgical units.

To meet these goals, some nursing staff are implementing bedside reporting. Instead of discussing the patient's health outside of the room, the nurses coming on and going off their shift talk about the patient's status in front of the patient. This helps start the nurse-patient relationship, and allows the patient and family to witness the teamwork. It results in having a more confident patient and family, and provides the patient the ability to be engaged in their care.

SBAR(T)

Because technology is always changing, hospitals, assisted living facilities, and primary care are using different technology, as well as different formats for forms, and often times the information isn't user-friendly. SBAR (Situation, Background, Assessment, Recommendation) is a technique used throughout the world by hospitals and care facilities to help open the communication between all health care providers, and we are working to integrate it into the South Central PA region.

By using SBAR, the focus is on communicating about the current situation as well as the patient's background, and then making recommendations from a full assessment. It provides expectations for what should be communicated, and how to do so with each member of the health care team. Everyone understands what's expected, and the patients are receiving high quality care.

However, we are also taking SBAR a step farther by adding another letter to the acronym – the letter T. SBART incorporates Teach-Back into the communication process – which in the end ensures everyone has the same understanding as it involves repeating back what the person thinks he’s heard. This provides clarity and continuity of care.

How can I connect with other practices?

It's important to share best practices and to work together to improve the quality of care. But, as doctors and nurses, your time outside the hospital or practice is limited. We help eliminate the gap between practices by holding bi-monthly Physician Clinician Learning Network meetings that focus on pertinent topics for physicians and their staff. You'll be able to:

  • Network with other physicians, nursing staff and other medical staff.
  • Learn best practices in evidence based medicine.
  • Participate in forums to
    share ideas about quality care.
  • Hear from reputable guest speakers.
  • Work collectively to
    improve health care!

To receive the electronic invitation for our next meeting, contact Joyce Ortiz at jortiz@wellspan.org.

And, don’t forget to check our What’s Happening Calendar!