Leading the way toward efficiency, effectiveness
A coalition of more than 250 executive leaders, managers and frontline staff are working together to address key quality and patient experience measures amid the steadily increasing number of patients.
The Efficiency, Effectiveness and Patient Centeredness initiative, also known as EEPC, is directed by David S.Guzick, M.D., Ph.D., UF senior vice president for health affairs and UF Health president, and a steering committee composed of leaders from across UF Health. Staff from core UF Health service areas comprise the committee, which oversees 14 interdisciplinary work groups and is assigned to analyze and improve factors that affect patient experience and length of stay. A data support group tracks the teams’ efforts in real time with a quality metrics dashboard to help them stay on track.
Like pieces in a puzzle, each group relies on the others to help advance our big-picture goal: To deliver exceptional service, value and quality to every patient at every encounter.
Here, we explore three of the groups’ activities. To learn about the other teams, see Guzick’s article “Enhancing Quality While Accommodating Growth”— UFHealth.org/on-the-samepage. Other teams will also be highlighted in upcoming editions of The Q Report.
Patient-Centeredness at Faculty Practices: Our patients’ perspective
Co-chairs: Marvin Dewar, M.D., J.D., and Laura Gruber, M.B.A., M.H.S.
Patient-centeredness is increasingly recognized as a key measure of high-quality care at health systems around the country, and it is a principal goal at UF Health. Aligning health care around patients is shown to increase both their satisfaction and clinical outcomes, while enhancing efficiency and establishing patients as active participants in their care.
Still, measuring this concept is a challenge for health systems. That’s why the Patient-Centeredness at Faculty Practices team is gathering patient feedback to assess and enhance care. “For us, patient-centered care means that we exceeded the expectations of the person we’re here to take care of,” said Marvin Dewar, M.D., J.D., UF Health Physicians chief executive officer and UF College of Medicine senior associate dean. “People need to feel respected and good about their provider and their interactions with our system. At the end of the day, it boils down to whether the patient is satisfied and glad that they chose to receive their care from us.”
Electronic surveys are being emailed to all patients who visit any of the 58 UF Health Physicians outpatient practices. Specific questions gauge aspects of the patient experience such as access, timeliness, hospitality and service and communication. Because patient-centeredness relies on patients’ perceptions, the answers provide crucial insight about our service.
“The questionnaire provides us with real-time data and shows trends to see if we’re getting better or worse,” said Laura Gruber, M.B.A., M.H.S., UF Health Physicians senior director of administration, strategy and education. “We can compare ourselves internally and to national standards, then change our behaviors based on the results.”
The group is analyzing incoming data and using it to take action, Gruber said. Early results indicate that communication across our organization needs to improve. As more results are compiled, the team will develop and initiate plans to address opportunities.
“The surveys are showing that we do some great things, but we’re not there yet in all domains,” Dewar said. “We will use these surveys to identify what is most important to our patients and then focus on excelling at that. It’s a journey — we’re rethinking what represents quality care.”
Community Engagement: The tools to succeed
Co-chairs: Anthony Clarizio, M.B.A., and Peter Carek, M.D.
As the landscape of health care evolves, governmental organizations are placing a greater emphasis on the health and wellness of community populations. For the Community Engagement work group, that means proactively reaching beyond the walls of hospitals and physician practices to match community members with local health care resources and reduce unnecessary hospitalizations.
“Many of our patients lack basic needs like food, clothing, shelter and transportation, which exacerbate problems that you or I would have the resources and capacity to deal with,” said Anthony Clarizio, M.B.A., executive director of UF Health Shands HomeCare and ElderCare of Alachua County. “But these individuals end up in crisis and at the emergency room.”
In several units at UF Health Shands Hospital, the subcommittee has a pilot program to evaluate behavioral health and social indicators at the point of care. The assessment tool indicates patients’ needs and links them with case managers to help develop an effective care plan and improve patient outcomes through transitional planning and advocacy. Health coaches also work with patients for an extended amount of time to help with essentials such as transportation, meals and health screenings. Most importantly, they help patients enroll in local health service programs.
“Matching patients to resources is the next significant and largest step to take to ensure that social factors don’t determine their overall health,” said Peter Carek, M.D., chair of the UF College of Medicine department of community health and family medicine. “We have to keep progressing forward to make sure the connections are made and we’re changing the way our patients think about health care.”
The pilot program has been successful and partner community organizations are enthusiastic about pooling resources to implement enduring change.
“Community engagement is really what happens when we manage patients over a period of time,” Clarizio said.“Our goal is to treat the condition the patient is here for, then prepare them for what comes next.”
Medicine Geocentricity: Finding the right home
Co-chairs: Robert Leverence, M.D., Diana Richardson, M.B.A.
The Medicine Geocentricity team is using geolocation and a designated observation unit to help our staff quickly and effectively serve our growing patient volumes.
Medicine geocentricity is the concept that patients who need similar health services should be located together along with their care teams. This eliminates the need for providers to move between units, which increases the efficiency and timeliness of care. Patient satisfaction also rises, length of stay is reduced and communication between teams improves. As logical as this all sounds, it is challenging to achieve when beds are full and additional patients need immediate care.
“In an environment of limited capacity, geocentricity is a real challenge, but we feel that it’s the best choice for our patients. When staff and provider teams function together in the same space, strong relationships are formed and so care and efficiency are improved,” said Robert Leverence, M.D., UF College of Medicine department of medicine vice chair of clinical affairs and chief of the division of hospital medicine.
The subcommittee recently achieved geocentricity in two general medicine units at UF Health Shands Hospital. They also ensured that the Admission Discharge Transition Unit, a 25-room medical/surgical unit, is used as a short-stay, or observation, unit. Because many patients who come to our emergency rooms don’t require full hospitalization, the observation unit provides an alternative for patients with short anticipated hospital stays. That frees up beds for those who need traditional inpatient services.
“We’re developing ways to get the patients what they need in the shortest amount of time possible,” said Diana Richardson, M.B.A., UF Health Shands vice president of operations. “Our reports have shown that we’re doing a pretty good job of making that happen in our pilot units. Now we’re developing processes to support it long-term.”
