Planned Care Collaborative Graduates Its First Eight Practices

In the January/February edition of Quality 4orum, AF4Q – South Central PA highlighted the progress of the practices involved with the initiative, Planned Care Collaborative.This month, we’re pleased to announce that the eight local practices from York and Adams counties completed their one-year commitment to the Planned Care Collaborative.

The participating practices included: Pinchot Family Medicine, Brockie Internal Medicine, Gettysburg Adult Medicine, East Berlin Family Medicine, Yorktowne Family Medicine, WellSpan Endocrinology, WellSpan Lung, Sleep and Critical Care, and York Hospital Community Health Center.

One year ago, each of the eight practices agreed to focus on improving patient care for individuals between the ages of 18 and 75 with diabetes or pulmonary nodules in the case of lung, sleep and critical care. AF4Q – South Central PA, in partnership with PA IPIP (Improving Performance in Practice), provided a list of key performance measures that the practices strived to achieve. With these goals and measures in mind, the practices worked 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.

Rush Gross, Planned Care Coordinator for Aligning Forces for Quality and Stacy Ropp, Practice Support Specialist for WellSpan Medical Group were two of the leaders assisting the practices through this initiative. According to each of them, the practices exceeded their expectations.

“When making any kind of change, it takes time and patience. In one year, these practices accomplished great results; determined what worked and what didn’t work for their practices; and made a significant impact on their patients,” stated Gross.

“Across the board, improvements were made with their processes as well as tests provided to patients with diabetes. We saw an increase in the number of monofilament tests given as well as improvements with Blood Pressure and A1C levels for diabetic patients,” stated Ropp.

Not only did the progress with monofilament tests affect the practices’ internal process, but it greatly impacted the patients. Without these tests, providers wouldn’t know if diabetic patients are losing sensation in their feet, and a loss of sensation could lead to amputation.

One practice focused on improving the coordination of care, specifically with those patients who needed a retinal eye exam. A retinal exam is usually completed by an ophthalmologist, and prior to the practice’s participation in the collaborative, there was no follow up to ensure the patient had the referred eye exam. Through this initiative, the practice changed their tracking system to make sure they received the results from the referred practice. In addition, the practice’s staff was educated about the importance of retinal exams, and how they differ from regular eye exams.

The York Hospital Community Health Center focused their efforts on increasing the number of patients receiving monofilament tests, blood sugar and cholesterol testing, discussions of smoking cessation, microalbumin tests (screening test for kidney failure) and achieving good blood sugar and cholesterol control. Over the course of the year, the Center was able to increase the number of smoking cessation discussions by 503 patients, and the number of monofilament tests by 288 patients. 

As an integral component of the collaborative, the practices also work towards becoming a Patient-Centered Medical Home. A lot of the tools offered during the collaborative help practices achieve this goal. According to the National Committee for Quality Assurance, the Patient-Centered Medical Home is “a set of standards for a health care setting that facilitates partnerships between individual patients, and their physicians, and when appropriate, the patient’s family. Care is facilitated by registries, information technology, health information exchange and other means to assure that patients get the indicated care when and where they need and want it in a culturally and linguistically appropriate manner.”

By working in a collaborative environment, the practices learned new ways to eliminate waste, techniques for saving time, and most importantly how to improve the care given to their patients. The practices walked away with plans to carry on their achievements, and they have the opportunity to come back together at least three times in the coming year to share their progress.

“The practices and coaches recognize it can be a big culture change for some. It may be harder for some to keep going, so it’s important as with anything you do, to have the support available,” stated Ropp.

Now, as the second round [8 practices] is beginning their one-year commitment in May the leaders are looking forward to implementing new tools, such as Action item Logs for the group.

“With the key performance measures we provide, we want better care and experiences for the patients. If we can address the issues, we’ll be able to give better service to patients by applying clinicians’ suggestions to process improvements,” stated Gross.

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