Fifteen years ago, PRHI presented a bold premise that has now been proven repeatedly. It posited that the same quality improvement techniques that had produced near-perfect performance in high risk, complex industries like aviation and nuclear power, could be applied successfully in health care to reduce errors, improve reliability and create efficiencies. We now know that techniques like Lean and PRHI’s own Perfecting Patient CareSM (PPC) method can reduce infections, improve patient flow, reduce laboratory errors, and enhance the management of chronic diseases.
But all these small, targeted efforts have not produced widespread and sustained quality and efficiency improvements. PRHI’s new book, Moving Beyond Repair: Perfecting Health Care demonstrates that such “spot repair” is not a substitute for enterprise-wide adoption of quality improvement methods applied to daily work in all its facets. They won’t produce the broad transformational improvements in quality and efficiency that patients seek and deserve.
Moving Beyond Repair highlights success stories of using PPC methodology to repair broken processes and to drive the larger transformation of entire organizations. Providing added momentum are new reimbursement methods, widespread adoption of information technology and increased data availability, public reporting on comparative performance, substantial incentive payments and penalties tied to achieving certain quality and safety targets. The tools and training to achieve transformation are available through PRHI.
Our aim in the book is to challenge healthcare leaders to aspire to the highest performance that system-wide adoption of Lean thinking and Perfecting Patient CareSM methodology can produce. We welcome partners who want to engage in this transformation process.
Partners in Integrated Care – Hamilton Health Center
The patient arrived at Hamilton Health Center, a Federally Qualified Health Center (FQHC) in Harrisburg, for a routine physical. A native New Yorker, she moved to central Pennsylvania to be closer to her family. But she felt isolated in her new environment. She couldn’t find work, and she stopped crafting the custom pieces of art that once proudly decorated her home.
The woman suffered from depression, which remains undiagnosed in about half of primary care patients with the condition. Through the Pittsburgh Regional Health Initiative’s Partners in Integrated Care (PIC) program, a collaborative care team at Hamilton Health Center was able to treat the patient’s physical and behavioral health needs right in the doctor’s office. Read More
Regional Extension and Assistance Center for Health Information Technology – Cornerstone Care
Transitioning from paper charts to electronic health records (EHRs) presented logistical, technical, and philosophical challenges for Cornerstone Care. A non-profit network of ten Federally Qualified Health Centers (FQHCs) and practices, Cornerstone Care counts around 200 medical, administrative, and support staff, and more than 80,000 patient visits per year for medical, dental, and counseling services across primarily rural sections of southwestern Pennsylvania, northern West Virginia, and eastern Ohio.
“We have so many providers, and we’re so spread out,” says Cornerstone Care Quality Manager Cathie Strope, LPN, who is helping to coordinate the EHR project with office managers. “We had to update old data and communication links, and we had to get staff buy-in on changing some ways that we have delivered care for years.”
Strope says Cornerstone Care now uses EHRs to deliver safer, streamlined, and patient- focused services thanks to customized, on-site assistance provided by the Pittsburgh Regional Health Initiative (PRHI). Read More
Safety Net Medical Home Initiative – UPMC Matilda Theiss Health Center
Eletta Cameron took a road trip in search of a patient who had not been seen in a month at UPMC Matilda Theiss Health Center. Then a social worker and patient integration specialist at the center, Cameron knew the woman needed her diabetes medication. Cameron left messages for the patient and cold-called family members, but no one could track her down.
“So I knocked on her door, meds in hand,” Cameron says. “I discovered that her husband had died two months prior. She was being evicted, and she was smoking furiously. I’m thinking, ‘no wonder she hasn’t made an appointment.’ We delivered her medication, started to address her smoking issues, and connected her with housing services. That visit allowed us to re-engage with her and resume her weekly appointments with our care team.”
This level of outreach would not have occurred before UPMC Matilda Theiss partnered with the Pittsburgh Regional Health Initiative (PRHI) in PRHI’s Safety Net Medical Home Initiative (SNMHI). Read More