Utah County Clinics Improve Patient Care, Earn NCQA Recognition
Paige Fieldsted, Sr. Communications Specialist, HealthInsight Utah
After more than two years of hard work, changing processes and documenting every detail along the way, two of Premier Family Medical’s clinics were recently awarded the Level 3 Patient-Centered Medical Home (PCMH) recognition from the National Committee for Quality Assurance (NCQA). The Premier clinics in both Lindon and Pleasant Grove earned the recognition.
The process of becoming a PCMH wasn’t an easy one. Christy Houghton, quality care supervisor for Premier, said the clinics changed numerous processes including how diabetes eye exams were conducted, cancer screenings ordered and specialty referrals were tracked. The clinics also established daily huddles between medical assistants (MA) and physicians, and improved their educational materials to ensure patients’ health literacy levels are considered to improve their understanding of treatment and self-care. But Houghton said one of the biggest and most challenging changes made was the change in provider and staff attitude.
“Changing attitude is hard,” Houghton said. “At first it was a struggle and we are still working on it, but our staff and physicians are starting to see improvements in our outcomes. And we are seeing increased revenue and payments from incentives because of the work we’ve done.”
The Premier Clinics started work on becoming a PCMH in 2012 after being chosen as one of six clinics to participate in a PCMH Pilot program with HealthInsight Utah’s Regional Extension Center. The clinic formed a quality improvement team that met weekly for nine months to learn about PCMH and associated processes. The team consisted of staff representing nursing, billing, reception, administration and included a provider champion.
“They got the philosophy and the concept of what patient-centered care is pretty quickly,” Janet Tennison, the PCMH project manager at HealthInsight said. “They had a strong team that was really committed to patient-centered care. It was awesome to see their understanding and commitment to the PCMH model increase from week to week. They required more hands-on assistance in the beginning, but were developing their own improvement ideas by the end, which was great to see. I just sat back and let them go—it was so rewarding.”
Implementing MA/physician huddles was a big change the clinic put in place. Wendy Palepale, MA at Premier, said the change has allowed the MAs to be more proactive and has helped improve relationships at the clinic.
“The MAs have become a lot more self-sufficient and communication has improved,” Palepale said.
Palepale said doing huddles with the doctors in the morning before patient visits begin allows them to be more prepared for appointments by gathering lab results or specialist reports needed for the visit. Tennison said that the team quickly realized holding daily huddles saved time later on. She said the very first day the clinic implemented huddles the team found a patient had been scheduled twice on the same day and were able to confirm the correct time and give the other appointment to another patient.
Care coordination is another area the clinic has made big strides in since beginning the work to become a PCMH. Palepale said previously doctors and MAs had the attitude that patients didn’t want to be pestered about improving their health, so they tried to provide the least invasive care. But now she said they have realized patients appreciate the change.
“If we implemented a change, the patients saw what we were trying to do for them,” Palepale said. “We want to care for the whole body and whole patient instead of just taking care of an illness. They understand and appreciate that.”
Cindy Marlin, clinical supervisor at Premier, said after all the changes the bottom line is the clinic is providing better patient care.
“We aren’t going to herd patients in and out of the clinic like sheep because we care about them as people,” Marlin said. “We can be proud of what we are doing here.”
Houghton said getting ready and applying for the NCQA recognition is one of the hardest projects she’s ever taken on, but said the clinic has seen improvements in the quality of care they are providing. She said the change isn’t easy but it is doable.
“You have to eat it one bite at a time, you have to do it as a team,” She said. “It takes more than one person and it takes times but don’t give up.”