Situation: With 100,000 patients visiting the UMHS Canton Health Center practice annually, the practice needed a robust system to ensure that quality patient care is rendered at every visit and that gaps in care are closed. Their system starts with clearly defined team roles, shared responsibility, accountability, team problem solving, recognition and rewarding staff for key successes.
Strategy: Clear roles and standard work help staff take responsibility for HEDIS measures starting with the initial call into the clinic, at the front desk, throughout the visit and at checkout. Accountability for outcomes takes place during the Daily Huddle held at 9 am around the Lean In Daily Work board. The board displays quality data as well as problems documented on the Everyday Lean Idea (ELI form) that identifies a probable cause and suggested improvement. The ELI problem and suggestion is discussed and a decision is made to implement the idea or to further investigate. The Everyday Lean Idea (ELI) is posted on the board until the problem is resolved. The board also includes quality performance trend reports, STAR performance, and gap reports that help identify patients missing certain health screenings. The team also celebrates success through recognition when improvements impact outcomes on the daily board. They annually share rewards for meeting measures by way of a quality performance bonus. This success is shared through a staff letter indicating points earned based on metrics, along with the appropriate bonus going to staff. In addition, the team has worked on adding flags within the EMR alerting staff of gaps in care to be addressed regardless of the reason for the visit. Furthermore, the practice was innovative in filling their panel manager role by hiring a nursing student. This allowed for more flexibility in times to reach out to patients during off office hours such as evenings and weekends, to help remind patients of their needed tests. The practice also worked on an Introduction to their Care Navigator letter that is shared with the patient to help them understand the services the care navigator provides. Included with the introduction is the CN contact information and a warm handoff from the physician to the patient.
Cheryl West the administrative manager stated “Our success is not linked to one improvement but to the team’s focus on the patient, the data, using their voice and vigilance to spot problems and commitment to continuing improvement. These improvements also include the patient as a partner in the quality of their care.”
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