Transformation Success - YVFWC Tracks Progress Toward PCMH!
Monday, December 16, 2013
Posted by: Joy Ingram
by Juan Carlos Olivares, Chief Executive Officer, Yakima Valley Farm Workers Clinic
As the healthcare industry begins to shift to quality-based, shared
savings payment models, and Medicaid continues to expand, the need to
transform care delivery models into one that is population-based,
scalable, proactive, and efficient becomes more critical than ever
before. YVFWC is at the forefront of this industry-wide transformation,
and is leading the charge in the community health center (CHC) space by
implementing tools, methodologies, and frameworks that will align the
organization with the new models of care delivery and reimbursement.
September of 2012, the Yakima Valley Farmworkers Clinic (YVFWC)
launched a 15-month transformation effort with the objective of
transforming all 14 of its eligible sites to operate as Patient Centered
Medical Homes (PCMHs) and gain level 3 PCMH recognition. Guided by
practice coaches and PCMH experts from Arcadia Healthcare Solutions,
YVFWC's ultimate objective stretched beyond PCMH recognition. The end
goal was to implement sustainable change and the necessary workflows,
staffing models, and day to day operations that would allow them to
function as a PCMH and position the organization for success in the new
era of healthcare.
This transformation engagement will not only
accelerate YVFWCs path to PCMH recognition, but will strategically
position the organization to thrive under new quality based, shared
savings payment models, and enable it to quickly deploy quality
improvement initiatives to ensure YVFWC is delivering the highest
quality of care to its patients. New change processes will enable the
organization to be more dynamic and quickly respond to the new
initiatives and requirements in the rapidly evolving healthcare
industry. YVFWC's strategic partnership with Arcadia provides the tools,
resources, support, and expertise to execute this transformation
quickly, effectively, and in a sustainable and scalable way.
say the least, PCMH transformation across a large organization is
difficult. Not only must the organization implement new technology,
business functionality, and various processes that will allow it to
function as a Health Home, leadership must fundamentally change the way
the organization thinks about and implements change. In order to
accomplish this, YVFWC has adopted a standardized change methodology
that now serves as the vehicle for implementing change across the large
organization. This methodology has been leveraged to implement a number
of functionalities required for PCMH, as well as other various Quality
Improvement initiatives in the organization. The new process and
methodology ensure that change is timely, standardized, and scalable
across all areas of the organization.
Despite its challenges and
the level of complexity associated with a transformation effort of this
magnitude, the organization is already beginning to show measureable
signs of improvement. Thanks to the hard work and dedication of team
members across all levels of YVFWC and dedicated support from Arcadia,
measureable improvements are being seen throughout the entire
Evidence of Change
An initial survey was administered across the organization at the
start of the project to both qualitatively and quantitatively assess the
state of the organizational culture and where sites were within the
transformation process, and assess their general "readiness" for PCMH.
Upon re-assessment of the clinics six-months into the transformation
process, measureable improvements had taken place in regards to the
readiness and current state within the PCMH transformation process, or
the "cultural change" associated with PCMH transformation. The survey
revealed measureable improvements across all 8 key drivers in the assessment, indicating that the organization was becoming more patient centered (shown below).
Additionally, a drop in standard deviation across all drivers demonstrated a growing alignment in practice operations and improved communication across the organization (shown below).
Improvements were observed beyond PCMH, in areas that were not
focused on in the transformation. This was evidence that the improvement
processes are taking hold in the organization and practice teams are
taking initiative to drive change in other areas.
YVFWC has shown improvements across MU measures
(shown below), indicating an improvement in EHR adoption as well as the
ability to identify, target, and improve quality and patient care with
the use of data.
Noticeable improvements that have been noted from practice coaches, care team members, leadership, and patients include:
- Quality Outcomes: Improvements in the quality of
care are beginning to surface, and the organization is beginning to
leverage data to provide proactive care to its patient population.
- PCMH Recognition: All sites currently have between 68 and 73 of the required 85 points for level 3 PCMH recognition.
- Care teams creating a high quality and consistent patient centered experience
- All staff members driving standardization in practice operations across the network
- Increasing consistency, reliability and understanding of reporting across the organization
The most critical indicator that will measure the success of the
transformation is the satisfaction and quality of care being delivered
to YVFWC's patients. The following statement came to YVFWC unsolicited
in regards to its improvements four months into the engagement:
"I don't know what you guys are doing
differently there but it's so great! A year ago, no offense, your
clinic was a mess. I couldn't get a call back for days, no one would
contact me with results, I couldn't get an appointment and now
everything is easy and organized. I can tell that you guys are working
to make everything better and I wanted to let you know it's working."
- Unsolicited Patient Feedback to YVFWC
All of this is evidence that the transformation is taking hold, and
the organization is heading in the right direction. A significant amount
of work from YVFWC team members and Arcadia staff remains, but there is
a great deal of momentum moving forward in the process. YVFWC is
excited about the opportunity to drive a real difference in the
community and is motivated to work to improve the quality of care and
the overall health of their patient population.
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