Practice Redesign for Specialists
Patient-Centered Medical Home (PCMH) activities are not exclusive to primary care practices. The PCMH is designed to support continuous, comprehensive, coordinated care, with an emphasis on prevention and chronic disease management. Therefore, the patient, primary care physicians and specialists must be united regarding the patient’s plan of care and coordination-of-care priorities.  To optimize the patient’s experience along the care continuum and maintain the quality of care, specialists can make system-redesign changes to enhance their role as PCMH neighbors. HealthTeamWorks has created a program to meet the needs of interested specialty practices. Primary care practices not yet ready to undertake the complete PCMH transformation can also use these resources.
Program Description HealthTeamWorks presents its Practice Redesign for Specialists Program in a two-day, on-site, coached visit format. We work with your personnel to establish teams with related work flows using a “small tests of change” approach. Many of our strategies apply to effective participation in an integrated medical neighborhood. Our visits often encourage practices to maximize the use of health information technology. The intervention can support progressive transformation, allowing a practice to work gradually toward improved cost-effectiveness and quality of care. The coach-facilitated sessions use the practice's processes and technology to introduce physicians and staff to quality-improvement tools and the principles of team-based care. Your practice may choose facilitated support in some or all of the following areas during the on-site visit: Population management Coordination of care Patient access Patient self-management support Early work in building a medical neighborhood   HealthTeamWorks' services support work-flow redesign and practice transformation tied to outcomes measurement. Our experienced team can  take a practice from basic education through work-flow improvements to active membership in an integrated care community. The team strives to achieve the paradigm shift in care delivery from reactive, episodic care to proactive, planned, coordinated care. This new model permits the integration of the medical home model with a high-functioning “medical neighborhood.”   Program learning objectives The practice team will have a basic understanding of the evolution of the medical home approach to care. The practice team will have a basic understanding of how the Institute of Medicine’s “10 Simple Rules” relates to the need for practice transformation and a basic understanding of where the practice fits in the PCMH-Medical Neighborhood landscape. The practice will begin to use team-based strategies to identify and solve problems and deliver care. The practice will get acquainted with basic quality-improvement tools in the coaching visit, including work-flow mapping, root cause analysis and use of the Model for Improvement to set-up small, initial tests of change. What can I expect from the coaching visit?  The on-site coaching consultation introduces ways to improve office work flow, patient satisfaction and provider/staff satisfaction. We want your investment in the training to last well beyond our visit. During the consultation, we will: Focus on one to three improvement areas, depending on complexity. Use teams representing multiple departments and involving physicians or midlevel providers. Emphasize a transition to team-based care. Emphasize an improved patient experience. Conduct eight to 12 improvement team sessions, depending on the complexity of the focus area. Introduce the improvement team to the use of basic quality-improvement tools, such as work-flow mapping, tests of change (Model for Improvement) and measures for success. Strive to engage all staff in understanding the relationship between planned team care and practice efficiency, as well as experience in mapping a work-flow process. Give the practice a chance to test and refine the new process before the visit ends. Allow practice leaders to plan the next steps.
For more information or to request a start-up application, e-mail Elaine Skoch, Director of Practice Transformation.