Health Care Practices & Business Leaders Come Together for Quality Improvement

Every day, doctors, nurses, receptionists – everyone in the medical practices are trying to meet the high demand of patients, while providing good quality care. But sometimes care isn’t at its best because of limited time and resources. So, isn’t there a better way?

Through Aligning Forces for Quality – South Central PA, an initiative called the Planned Care Collaborative is applying a more aggressive approach for improving quality care for patients in Adams & York counties.

By bringing family medicine, internal medicine, and specialty practices together with local business coaches, doctors’ offices are becoming more efficient, improving morale, implementing problem-solving techniques, reducing costs, and improving patient care.

Each of the eight practices involved in the collaborative has made a one-year commitment to focus on improving patient care for individuals between the ages of 18 and 75 with diabetes. Aligning Forces for Quality – South Central PA provided a list of key performance measures that the practices are striving to achieve. With these goals and measures in mind, the practices work with coaches from the business community who are trained to help reduce waste and provide guidance on moving forward with patient-centered, self-management techniques.

The practices receive four hours of the coaches’ time each week, participate in monthly phone calls, and attend five face-to-face meetings to discuss successes and struggles with the other doctors’ offices. “The scheduled phone calls and meetings help reduce the silo effect between practices. By bringing them together at a set time, they can clearly share what their achievements are and what they are doing to improve their processes,” stated Rush Gross, Planned Care Coordinator for Aligning Forces for Quality.

“It’s a commitment for any medical practice and its staff, but it’s well worth it because of everything you gain,” stated Dr. Shawn Moyer, MD of Pinchot Family Medicine.

The coaches bring an outside perspective and access to process-improvement tools. They are able to watch and see how the practice operates day to day, and then determine the areas that need to be altered. In the end, it helps the practices become more efficient. 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, and allows for more patient interactions to improve diabetic care. In the end, it will drive health care costs down and reduce the number of repeat patients. It’s designed to change the culture of the practice and sustain the efforts over a long period of time.

According to Gross, all of the participating practices have seen improvements, and the patients are benefiting from the collaborative. One of the biggest process improvements is the increased percentage of completed eye exams. Many times practices have no idea if patients see their eye doctor, so this is a big deal. In addition, there are improvements in Blood Pressure and A1C levels for diabetic patients.

“Our coach showed us ways to improve the way we enter patients’ data into the electronic medical records. His new method assures us that we’re capturing all the information needed for patients with diabetes. He’s also helped us save 30 minutes a day by restructuring the way we stock our items.  As a solo practice physician, it’s helped reduce my day-to-day stress because I know things are happening the way they’re supposed to. And, I have even more time for patients,” stated Dr. Moyer.

 “In one case, the staff was asked what prevents them from providing good care. After each person had time to voice his or her opinions on paper, the answers were categorized into things that don’t cost money, items that do cost money, and things that are time related. By using this technique, the coach helped guide the entire staff to determine what they could do to fix these issues. In the end, the practice saved time and money,” stated Dr. Karen Jones, Aligning Forces for Quality Physician Champion.  

Dr. Jones also indicated, “It’s really opened up the dialogue for referrals. Doctors are asking each other questions, and making sure the information is being documented in one place.”

“As doctors, we all want to provide excellent care, and believe we are with individual visits. But, sometimes methods used within the practice can be altered to help the entire team provide excellent care all the way around. The collaborative has helped us look at all aspects of the practice, and focus on care for the entire population – not just the individual visit. In addition, we are fixing the way we document things and better using our time,” stated Dr. Ann Ramage, MD and Site Director for Yorktown Family Medicine.

Dr. Ramage also noted, “By participating, we’ve set aside time to collaborate with other physicians, which sometimes doesn’t happen because of our schedules. It’s an opportunity to solve problems, and adopt some techniques that are working for other practices.”

The Planned Care Collaborative is seeking 15 more practices to become involved. Practices will need to commit to the collaborative from May 1, 2011 to April 30, 2012. To improve the quality of care that patients receive, change must occur, and a collaborative like the Planned Care Collaborative is helping practices to achieve this important goal. For more information about the Planned Care Collaborative, or to become involved in this year’s program, contact Rush Gross at 717-851-6859 or rgross3@wellspan.org .

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