HomeWhat's New Salina Residency Practice Recaps a Successful First Year of PCMH Transformation

Salina Residency Practice Recaps a Successful First Year of PCMH Transformation

02/05/2010

By Elaine Skoch, RN, MN, EMBA, CNAA and Ana Jensen, PhD

One year ago, Salina Health Education Foundation (Salina Family HealthCare Center and the Smoky Hill Family Medicine Residency Program) launched their medical home transformation initiative with the help of TransforMED. On January 21st and 22nd, 2010 the board of directors, the leadership team and staff took time to review their efforts over the past year to integrate patient-centered medical home (PCMH) concepts and processes into the practice.

The two day meeting began with a review of accomplishments across all aspects of the PCMH model with the board of directors for the center. The board showed strong support for the center’s leadership team about the work they have been doing and the plans for 2010. 

Day two included in depth discussions with the leadership team and planning for work to be accomplished in 2010. There was unanimous agreement that one of the major accomplishments in the past year was the development of what they identified as the "Four Team Concept." The leadership, residents and staff of the organization determined that they could provide better access to care and improve the continuity of care with some realignment of the clinic staff and including residents.  After studying the situation and informing patients of the desire to make the change to improve access and continuity, the practice created four teams that each included a staff physician, a resident from each class year, a physician's assistant and a representative from the nursing staff. Roles were redefined for staff members to include nurses as the point of contact for patient phone calls on their respective teams, as well as for managing refills and preventive services ordering.

The overwhelming response from everyone (including the patients) is that the "Four Teams" change has been a huge success. In implementing these changes the members of this organization truly began to understand the connectedness of the goals for each module of TransforMED's patient-centered model of care to each other and the impact that change in one area of the organization has on other parts of the organization. Patients have become immersed in the concept, as well. Now when they call in to the clinic they identify themselves as members of a specific care team: "I'm on the blue team."

Robert Freelove, MD

Another significant change in the organization was the alignment of two separate organizations (Salina Family HealthCare Center and the Smoky Hill Family Medicine Residency Program) under one leader for both. Dr. Rob Freelove was appointed to the CEO position of the Salina Family HealthCare Center and remains in his position as the Smoky Hill Family Medicine Residency Director.  This re-organization effort places greater emphasis on the interdependence of the residency program and the health center (FQHC) with each other. The success of one group is truly related to the other.

Changes were also identified in several other areas throughout the organization to improve services to the patient population. Examples of some of the services include:

• the opening of an opthomology clinic for dilated eye exams for diabetics
• increased in-house lab and colposcopy capabilities
• the creation of a referral coordinator position
• improved services related to the medication assistance program and review and refinement of the screening process for services

Other changes "behind the scene" included:

• the development of scheduling templates to optimize continuity and acces
• implementation of tracking processes for clinical measures and indicators
• a server upgrade
• and adjustments to EHR care templates to improve the tracking of health maintenance care for patients.

In addition, the clinic was able to reduce costs by scheduling hearing challenged patients on a particular day when sign language services could be made available for those patients.

In relaying the summary of these accomplishments to the entire group of providers and staff, Dr. Freelove expressed his sincere appreciation for the participation that everyone had demonstrated over the past year. As he was sharing his information, it became apparent in the group's reaction that the concepts of the medical home that had been shared in the PCMH orientation a year before became real because they were applied to the processes and accomplishments of the organization. Dr. Freelove’s ability to call out staff by name and affirm to others present what people had contributed was extremely powerful.

The day ended with members of the leadership team sharing the vision and focus for the work to be addressed in coming year with the entire staff. Everyone was encouraged to participate and become part of a team to advance one of the PCMH areas chosen as a point of focus. 

About TransforMED

The Leawood, Kan.-based TransforMED LLC is a wholly-owned subsidiary of the American Academy of Family Physicians. Established in 2005, TransforMED provides ongoing consultation and support to physicians looking to transform their practices to a new model of care that is based on the concept of a patient-centered medical home. TransforMED is an active member of primary care communities and recognizes and supports the unique value that primary care offers to patients and the health care system. TransforMED shares and supports the idealism and altruism of primary care physicians and the strong commitment to their communities and patients through continuing patient relationships and independent decision making. TransforMED offers practices both products and services, including consultation and advice on implementing the patient centered medical home model. To learn more about TransforMED, visit www.transformed.com.