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Practice Modifications: Outpatient Transition Clinic
Objectives
Improve workflow efficiency
Maximize staff resources
Implement innovative strategies
Implement patient satisfaction tool
Implement online questionnaire
Review questionnaire and implement changes accordingly
Implement physician liaison service
Improve relationships
Increase referral base
Workflow Efficiency
Optimal use of resources
Providers
Direct patient care appointment
Address chief complaint(s)
Medication reconciliation
Initiate patient centered action plan
Patient education
Disease management
Symptom control with a patient + provider action plan
Ongoing disease process, medication education, and support
Patient centered care team (Meyers et al., 2010)
Initiate innovative solutions (The IOM Health Care Quality Initiative, 2012)
Phone follow-up
Continue education, support & revision of action plan
Consider “mobile” accessibility at referral office(s)
Ancillary staff
Phone/fax management
Appointment scheduling
Increase availability of ancillary staff to answer phones/fax paperwork/schedule appointments
Workflow Chart
Appointment Scheduling Process
Increase ancillary staff phone availability to 8-5 M-F
Provider Appointment
Address chief complaint
Phone Follow-up
Symptom control
Outcomes
Improved patient
Medication Reconciliation
Initiate action plan
Education
Support
Optimal use of staff/provider resources
Ancillary staff review of fax machine daily
Education
Support
Action plan revision if necessary
Offer appointment at surgeon office
Outcomes
Response time <24 hours
Decrease in 30 day readmissions
Patient Satisfaction
Patient/Family satisfaction
No current formal assessment
The U.S. Department of Health & Human Services recommends utilizing a patient satisfaction tool in primary care setting (Primary Care: The Health Center Program)
Initiate AHRQ supported questionnaire (Agency for Health Care Research and Quality, 2012)
Provide questionnaire online
Educate patient on use of online access when appointment is made
Reinforce completion of survey at appointment check-out and offer paper form
Evaluate data at 3 & 6 months
Make adjustments to clinic accordingly
Consumer Assessment of Health Care Providers and Systems (CAHPS)
Evidence based and validated
Efficiency + Patient Centered Care + Patient Satisfaction = Positive Patient Outcomes
Improved Patient Outcomes
Improved Patient Satisfaction
Continuous Practice Modification
Quantifiable Patient Satisfaction Scoring
Implementation of Technology
Workflow Efficiency
Institute for Health Care Improvement, 2012.
Patient Referral System
Physician Outreach Service
Designated liaison
Promote relationships
Collaborative patient care
Build efficient relay of patient information
Fluidity of patient information between offices
Provides management source for referring physicians (Healy, 2011)
Increase referrals
Innovative changes to facilitate referrals
Control Variables
Illness severity
Diagnosis
Evidence based guidelines
Explanatory Variables
Geographic measures
Practice style measures Referral to Transition Clinic
Specialty
Satisfaction with practice
Collaborative relationship
specialist- liaison – clinic
Patient Referral System
References
Agency for Healthcare Research and Quality (n.d.). Retrieved September 20, 2012 from http://bphc.hrsa.gov/policiesregulations/performancemeasures/patientsurvey/satisfactionsurvey.html
Institute for Health Care Improvement. The Patient Experience: Improving Safety, Efficiency, and HCAHPS through Patient-Centered Care (2012). Retrieved October 14, 2012 from http://www.ihi.org/offerings/Training/ThePatientExperience/2012MarchThePatientExperience/Pages/default.aspx
Healy, B. (2011) Starting a physician liaison program to market your practice. Efficiency in practice, an InHealth company. Retrieved September 20, 2012 from http://efficiencyinpractice.com/starting-a-physician-liaison-program-to-market-your-practice
Institute of Medicine for National Academies (2012). Crossing the Quality Chasm: The IOM Healthcare Quality Initiative. Retrieved October 8, 2012 from http://www.iom.edu/Global/News%20Announcements/Crossing-the-Quality-Chasm-The-IOM-Health-Care-Quality-Initiative.aspx
Meyers D., Peikes D., Genevro J., Peterson G., Taylor E.F., Lake T., Smith K., Grumbach K. The Roles of Patient-Centered Medical Homes and Accountable Care Organizations in Coordinating Patient Care. AHRQ Publication No. 11-M005-EF. Rockville, MD: Agency for Healthcare Research and Quality. December 2010.
U.S. Department of Health and Human Services (USDHHS) : Primary Care: The Health Center Program. Retrieved September 20, 2012 from http://bphc.hrsa.gov/