QUALITY IMPROVEMENT STUDENT PROJECT PROPOSAL: Bon Secours Virginia Medical Group:
Bon Secours, a pioneer in implementing medical home and accountable care initiatives, has committed to implementing a sustainable care delivery model that is aligned with health care reform across all of its providers and locations (Bon Secours Virginia Medical Group, 2019).
Executing a sustainable care delivery model that is in harmony with health care reform throughout its providers and locations by implementing medical home and accountable care programs is a critical issue in Virginia in the United States.
Health Care Service:
The case study focuses on accepting PHM as the result of a methodical approach to reengineering primary care practices, integrating new technologies into care team workflows, and including patients in their care. This case study delves further into Bon Secours’ strategy for achieving quality outcomes and financial success in the shifting healthcare landscape. The initiative began five years ago as a pilot. Since then, NCQA has designated eleven practices as patient-centered medical homes. Improved capacity is one of the most important goals of the Advanced Medical Home Project.
One of the main problems in the case is the overburdening of the healthcare providers and constraints in delivering quality care to the patient. Due to a smaller number of care providers or physicians, delays are witnessed due to the lack of enough healthcare providers to meet the needs of patients hence they end up sacrificing quality care since they overburden themselves. They also have challenges of reengineering practices in the medical institution as it requires Creating high-performing physician-led care teams necessitate workflow modifications, new care coordination activities, and carefully delegated clinical tasks across the care team.
Barriers to Quality:
The physical aspect is a barrier since the location might be almost always in a hallway, near to a whiteboard, and never in a private room, and presentations are regularly interrupted, and the turmoil of an overloaded emergency room creates a lot of background noise and also attendants routinely converse with one another and think that the resident can hear what they are saying. Additionally, if the information is coming from an Attending physician, residents are unlikely to ask questions during the handoff. Since sign-out involves all working physicians in the ED at the same time, all transfers are verbal, none are standardized, and time demands are well recognized. Therefore, the above actions present a huge barrier to the quality delivery of patient care.
First, an organization must explicitly state what it is attempting to accomplish by establishing “time-specific and measurable goals.” Following that, an organization must devise metrics to determine whether the improvement is effective. Changes that lead to an improvement must be identified and tested in a Plan-Do-Study-Act cycle. Change must be planned, tried, and studied, and then members must act on what they have learned in the third stage. However, before attempting PDSA cycles in a large institutional setting, they should be tested in a small group and finally, the changes should be implemented throughout the organization.
The process entails allowing care teams to double the size of their patient panel without becoming overburdened or sacrificing the quality of care. This project will attempt to address the issue of non-uniform patient handoffs which will be a challenge for the process. Thus, there will be a significant lack of access to high-performance physician-led care teams and also nurse navigators in all the 140 locations in Virginia.
The project objective is to redesign primary care practices, incorporate new technologies into care team workflows, and involve patients in their care, and to improve capacity
1. STRATEGY FOR IMPLEMENTATION
The first step in this strategy’s implementation will be to identify early adopters and process owners from the organ, the implementation team will then work on the process to ensure successful project implementation.
Bon Secours has made significant investments in integrating care managers into the primary care team to facilitate this process. Compliance with the SBAR format will be measured using an “all or nothing” metric, and provider satisfaction will be measured using a survey that will include questions about perceived time savings.
Barriers to Change:
The case identifies potential barriers including concerns on technology reliability and it’s also difficult for patients to be engaged in their care, and lastly, financial constraints are a huge barrier to the implementation of this change.
Bon Secours’ strategy will be effective for achieving quality outcomes and financial success in a changing healthcare environment.
There are no additional costs associated with this process change.
To sum, the future mantra of Bon Secours is “healthcare without walls.” The organization is pursuing remote, noninvasive monitoring for highly acute case management aggressively. Their vision is to use technology to bring care outside the four walls of the hospital and into the patient’s home. They are putting in place a geriatric medical home, which will allow patients to age in place while receiving preventive and acute care at home. This model will transform the healthcare organizations (Bon Secours Richmond Health System Announces New Partnership With Wound Care Advantage (WCA), 2019).
Bon Secours Richmond Health System Announces New Partnership With Wound Care Advantage (WCA). (2019). Www.healthitoutcomes.com. https://www.healthitoutcomes.com/doc/bon-secours-richmond-health-system-new-partnership-wound-care-advantage-wca-0001
Bon Secours Virginia Medical Group. (2019). Primary Care Collaborative. https://www.pcpcc.org/case-studies/bon-secours
Making physicians pay off. (2018, February 22). Modern Healthcare. https://www.modernhealthcare.com/article/20140222/MAGAZINE/302229986/making-physicians-pay-off
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