Becker's Hospital Review

October 2016 Hospital Review

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106 Executive Briefing and future care. It has also helped staff, working as a collabora- tive team, look at trends in their own practice and develop specific care protocols based on patterns they see. TR: Technology has definitely helped practitioners. We have satellite locations access and transfer data with our EHR. It's all about working together, but technology only allows it to a certain degree. The rest has to be teams of people, externally and internally, who work together to determine how we can use technology to make sure our patients are safe. Q: How do you think advanced practice clinicians will im- pact patients' views of practitioners and the perceived val- ue of care? SN: That's complex. Most people like seeing an advanced prac- titioner — they have more time and availability to sit down with patients, communicate care plans and coordinate care — but it's somewhat generational. It also depends how advanced practi- tioners work in a practice — some do sick visits, others do well care or overflow care. In general, people are becoming more accustomed to advanced practitioners and find them helpful in terms of rendering care. DPS: Physicians are increasingly working in team environ- ments, and my perception is patients will be seeing more of this team approach. Patients may not distinguish between the work a physician, NP or PA is doing, because if it's a well-or- chestrated collaboration, everybody will be interacting with the patient at the right time. At times, the physician should conduct the visit because of the diagnosis, or it may be the exact right time for the PA and NP to have that interaction with the patient. My hope is that patients value the right team member at the right moment. TR: We are putting a care coordination model in place that pairs an advanced practice clinician with a primary care physician and develops them as a team. Basically, it allows both practitioners to work at the top of their licenses, work as a cohesive team and support each other. It helps the patient's view of both. APCs will play a key role in the future of healthcare, and when paired with physicians, they both provide a much greater value of care. The model has been working really well for us. Q: How does your organization encourage and support co- ordination among members of the care team? SN: [Lee Memorial] uses a patient-centered medical home model. All care team members contribute to the overall wellbe- ing and outcomes of the patient. We are still in the early phases of the broader work — how to reach out to home health agen- cies, skilled nursing facilities and other members of the com- munity. What it really means to be clinically integrated and have a community-based health system is not as well organized yet. DPS: One way is safety rounding. All members of the team par- ticipate and focus on patient safety — making sure we have the best environment for patients. We do hospital rounding with an orchestrated team of practitioners, sometimes including phar- macists, nutritionists and social workers, who all meet to make sure patients are getting the exact treatment and interventions they need. In the clinic setting, we use a dyad leadership mod- el, where a physician and an administrator manage the prac- tices. And systemwide, we are creating a model called rela- tionship-based care as a fundamental model for care delivery. There are a number of tenets, but it's really all about building the relationship with the patient from all caregivers' perspec- tives. TR: We are in the process of putting in place a new care coor- dination model. We put a resiliency officer in place to work with providers, leaders and other employees. The specific concept is to focus on helping them with quality of life and work. We also use a dyad leadership model throughout the system with an administrative person and a clinical leader. It's really helpful, because you have the medical and business perspective and end up with better decisions. Lastly, we try to have fun. We try to have regular social gatherings — because how can you support each other if you don't know each other? n "Patients may not distinguish between the work a physician, NP or PA is doing, because if it's a well-orchestrated collaboration, everybody will be interacting with the patient at the right time." — Diane Postler-Slattery, PhD, President and CEO of MidMichigan Health Gallagher Integrated is a top healthcare consulting firm prepared to not only help you survive the coming changes, but to succeed in a post-reform world. We offer a wide range of comprehensive solutions—across healthcare compensation consulting, governance, physician services, employee & physician engagement, and executive placement— to help you align people, pay and performance.

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