Situation: Cornerstone Family Practice was selected as a 2015 MiPCT Best Practice site based on high HEDIS scores in preventative measures. The practice achieved this by finding ways to establish a trusting relationship with patients and families and the care team. This was done through development of shared tools. Cornerstone Family Practice’s tag line is “Your Foundation for Good Health”.
Strategy: Cindy Denk, PA and Care Manager in the practice states that patients and their families are actively engaged in improving their health and receiving quality care (HEDIS measures) over many touch points in the practice. The practice started with creating the Welcome Patient Information Brochure. This introduction to the practice lays the foundation for a trusting partnership between Cornerstone Family Practice and the patient/family. The brochure provides patients and families with key information regarding what is a medical home, scope of their practice, practice responsibilities, patient responsibilities, communication methods, open access and preferred urgent care facilities. To take this a step further, the practice provides each patient with a Patient Visit Information form to fill out and utilize during each visit to help document their needs, describe chronic condition control and work on an action plan to improve their health. From the front office to the back patient room clinical area, all staff members are aware of and working with the patient on goals and closing gaps in care. They use standard chart preparation, chart flags, standing orders and a referral coordinator who works to schedule tests and appointments with the patient and family. In addition the practice has developed specific responsibilities for the MAs to create standard work and reminders.
The practice uses monthly staff meetings as the opportunity to review data and reasons for missed gaps in care. The meeting is centered on how the team may improve their process and care for the patient.
Cindy states “We achieved these results because everyone including the patient is actively involved and on the same page in improving care both in the office and in the medical neighborhood.”
For more information regrading this story please contact Cindy Denk @ firstname.lastname@example.org