Page 19 - Christiana Care Focus November 2018

A digital strategy is also helping to boost efficiency and increase access. Christiana Care is developing a platform that will let patients schedule appointments online. Primary-care employees will also use an online platform to access information. A dashboard interface will allow practices to view key metrics, such as patient and caregiver satisfaction results and finances.
A team approach to care
To create a better experience for patients and employees, Christiana Care will form “teamlets” within each primary-care practice.
“We were driven by the question: ‘What
is an ideal practice going forward?’”
Dr. Donohue-Henry said. “Over the long term, a team really is the solution to caring for a large panel of patients.”
Christiana Care already has teams in place in its Independence at Home program. Primary-care practices in Woodstown
and Carney’s Point, New Jersey, have patient-focused care teams as part of Comprehensive Primary Care Plus — a public-private partnership between the U.S.
Centers for Medicare and Medicaid Services Eand private insurers.
ach primary-care teamlet will consist of one physician, one advanced-practice clinician — such as a nurse practitioner or
physician assistant — one registered nurse and three medical assistants. Leadership roles include a practice manager and clinical leader. In the future, each practice may also have a nursing leader.
Among the teamlets’ support services are office assistants, patient service representatives, pharmacy technicians, Carelink CareNow care managers and behavioral health consultants.
As opposed to the traditional model that puts a health care provider at the center of the processes, the teamlet model allows the primary-care practice to “share the care,” said Cynthia Griffin, MS, RN, CPHQ, CCM, chief nursing officer, Community Care.
For instance, an RN might handle annual wellness visits while an LPN handles simple wound care and a medical assistant talks with patients about their care plan.
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The approach has been successfully tested at Christiana Care’s Smyrna practice as part of the “PACT” or “patient anchored care team”.
“One of the best parts of the model is the weekly meetings attended by all our staff,” said Priyanka Dixit-Patel, M.D. “This is
a time for reflection when we reviewed complex patient issues, [and] our data and used the time to do some referral tracking.
“This allows us to approach patient care in a cohesive manner. We look for ways to
Pimprove the care of our patients.”
rimary-care practices are now dedicating one hour a week to population health competencies, which focus on managing
disease and encouraging wellness in the community. That time will gradually increase, said Marina Zeltser, M.D., MBA, quality and safety officer for Primary Care and Community Medicine who emphasized the need to make time for training, care standardization and team meetings.
The teamlet model will require additional staff, McMullen said. Recruitment has started and teamlets should be fully staffed in 2020. She urged the crowd to offer feed- back throughout the implementation. “You know best what’s working and what’s not working,” she said.
Dr. Donohue-Henry agreed. “The evolution will be a reflection of our learning, adapting and responding,” she said.
Many attendees had a positive reaction to the event. “I love how everybody got together and gave their input,” said Sonja Dallas, a medical assistant.
“It was nice to meet people from other offices,” said Kim George, an office assistant, who is looking forward to being part of a teamlet.
Sarah Schenck, M.D., FACP, was enthusiastic about the retreat. “This is officially the most exciting day of my career at Christiana Care,” said the clinical director of Practice Transformation for Primary Care. “I have been an advocate of team-based care for years, and this [event] — to me — marks the milestone that we’re on our way,” Dr. Schenck said. 
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