240715 Enhancing continuity for patients and clinicians: The care team model

Monday, October 31, 2011: 8:30 AM

Ethan Jacobi, BA , Ambulatory Care Services, Metropolitan Hospital Center, New York, NY
Marcie Sara Rubin, MPH , Business Development/Ambulatory Care Services, Metropolitan Hospital Center, New York, NY
Background: Continuity between a patient and his/her medical providers is paramount in providing care that reduces preventable illness cost-efficiently. It has been shown that lower continuity in an outpatient setting is associated with a higher rate of emergency room admissions. In addition to exploring the Care Team Model as a means for improving patient-physician continuity, permanent staffing assignments will be used to reduce waste and improve clinic flow. It is common for hospital personnel to be misallocated due to a lack of standard procedures and the inability to predict patient volume in a clinic that has not achieved sustainable continuity. The result is wasted resources or overburdened staff. Methods: The Care Team Model sought to improve continuity between patients and physicians and to implement a standardized staffing schedule. Patient-provider assignments were based on previously established continuity and patient preference. Staff scheduling was rearranged to encourage continuity among nursing, clerical, and medical staff. All clinic personnel were given a designated location to ensure that they work with the same team on a regular basis. Results: Preliminary results suggest that visit volume increased by about 2%; productivity increased by about 15%; and continuity increased by about 45%. In addition to improving these metrics, the clinic ended the practice of canceling patients due to staffing shortages. Instead, coverage was provided for all scheduled patients and all walk-in patients have been accommodated. Conclusion: Although greater success is predicted over time, data trends already indicate a large improvement after implementation. Every member of the Adult Medicine clinic team has had a chance to participate in the changes and most of the feedback has been positive. The result has been a marked improvement in the flow of patients through the clinic and significant improvements in staff satisfaction.

Learning Areas:
Administration, management, leadership
Conduct evaluation related to programs, research, and other areas of practice
Program planning

Learning Objectives:
Evaluate models for improving adult primary care; Assess methods for increasing continuity of care; Describe effective PCP staffing models.

Keywords: Primary Care, Quality Improvement

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I work in an administrative role in the Ambulatory Care department at a large urban public hospital.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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