from provider-centered to team-based care: our experience mary szecsey, executive director

From Provider-Centered to Team-Based Care:OUR EXPERIENCEMary Szecsey, Executive DirectorDana Valley, Clinical Support Manager

• Clinical Sites:– Primary Care – Occidental, Guerneville, Sebastopol– Dental and Mental Health Services – Guerneville– Teen Clinic – Forestville– Graton Labor Center Outreach – Forestville Wellness Center

Patients 12,990 individuals, 85 % under 200% of poverty level

2012 Budget $10 million 70% patient fees, 30% grants, contracts, fundraising

Staff and Providers– 135 employees in seven locations; 107 FTEs– 17 medical providers, 2 dentists, 7 mental health counselors and including .6 FTE psychiatrist

2

Provider

Chronic Disease

Monitoring

Preventive Med

Intervention

Mental Health Provider

Referral to Specialist

after Assessment

Medication Refill

New Acute Complaint

Certified Medical

AssistantCase

Manager

Test Results

HealthcareSupport Team

There has to be a better way!

Our ProcessAdopted Principles of CareDefine Care Team RolesEMR (Data)Patient EmpanelmentWorkflowsDocumentationImplementation TrainingSustain

WCHC Principles of Care

Relational AccessTeam basedComprehensive Primary CareAdaptable and measurableCost effective

Medical Staff RatiosProvider : MA = 1:1.5Provider : RN = 1:1Provider : FO = 1: 1.5

9

Quality Dashboard

55% 55% 63% 65% 72% 74%

0%20%40%60%80%

100%

Feb-12

Mar-12

Apr-12

May-12

Jun-12

Jul-12

Diabetic foot exam Good

6

Quality Dashboard

67% 67%

100%100%100%100%

0%

20%

40%

60%

80%

100%

Feb-12

Mar-12

Apr-12

May-12

Jun-12

Jul-12

A1C >9 & care plan

6

Quality Dashboard

70% 70% 69% 70% 68% 68%

0%

20%

40%

60%

80%

100%

Feb-12

Mar-12

Apr-12

May-12

Jun-12

Jul-12

DM on ASA Good

2

Quality Dashboard

58%72% 66% 78% 84% 65%

0%20%40%60%80%

100%

Feb-11

Mar-11

Apr-11

May-11

Jun-11

Jul-11

% charges collected at time of service

Good

21

Creating a Culture

Changing the way we do business!

Thank you!Mary Szecsey, mszecsey@wchealth.orgDana Valley, dvalley@wchealth.org