Transforming How We Deliver Care
by David Gilchrist, MD
Education Director and Interim Medical Director
Hahnemann Family Health Center has been involved in an innovative redesign of how we deliver care utilizing the principles of the Patient Centered Medical Home (PCMH) model for the past three years. The faculty, residents and staff are involved in this transformation at every level of change. The prospect of change is not something most people look forward to, but this has provided an opportunity for our team to work more as a cohesive unit and deliver excellent patient care. It has also allowed us to think about the way we work and redesign this in a more efficient manner with the help of the front line staff doing the work every day.
While it is always nice to hear how someplace wants to change and do a better job, how does this really happen? As a health center, we are looking at our patient registries to see if patients are receiving the care they need (colonoscopy for colorectal cancer screening, A1C's for diabetics at least twice per year, etc) and if they have their chronic disease care optimized (all patients with persistent asthma are on controller meds, diabetics have an A1C of under 7, etc).
One of our front desk staff created a pilot for how we get women eligible for mammogram a same day appointment immediately following their appointment without the provider being involved in the process at all. Our nursing staff has taken the lead on educating patients on overdue health care services. Providers are reaching out to patients with chronic disease not optimally controlled. We are giving patients the care they need at the time they need it.
Another area that we have continued to work on is process improvement. We are educating are staff and utilizing PDSA (Plan-Do-Study-Act) cycles and principles of a process improvement model called LEAN. Everyone in the office can put forth an idea for how to improvement the way the office works to improve how we do our work and how we provide care for patients. The patient is at the center of all of this work.
So what does all of this have to do with your residency experience? Residents are involved in this process at multiple levels and put forth ideas for how to improve the way we do our work. Residents get to train in a model of care, the PCMH model that is becoming the standard of how care is delivered. Residents don't just hear about PDSA cycles and process improvement, they become part of the process and help lead that change. It prepares you to be an effective part of a health care team no matter where you go.
Come join us to become an integral part of this exciting change!
Contact Dr. Gilchrist with questions at David.Gilchrist3@umassmemorial.org