minimally disruptive care
TRANSCRIPT
Minimally Disruptive Care Care Delivery Model for Chronic Disease ManagementApril Boddy RN,MN,NP-C DNP (student)
Aligning Cost, Quality, and Health• Background of Minimally Disruptive Care (MDC) Model
• Proposed MDC Solution
• Solutions to meet needs of Slave Lake Family Care Clinic (SLFCC)
• Change Process for MDC Implementation
• Expected Outcomes for SLFCC
• MDC aligned with Current Health Financing Context
Background of Issue
• Historical need for comprehensive primary/preventative care services to address longstanding healthcare analytics
• Perfect storm of factors outside of control for population members
• Traditional challenges for recruitment and retention of health care providers in rural underserved areas with strong comorbid disease
The Proposed Solution
Minimally Disruptive Care Model
A Win-Win Situation?
Proposed MDC Solution Tailored to SLFCC
• Incremental approach to change
• Pilot project monitored provincially with evaluation component
• Policies and incentives
• Patient Health outcomes & efficiencies focus
Proposed change process to implement delivery model
Initiatives to Meet Needs
Define MDC indicators for patients satisfaction
Build a Culture of Improvement by establishing a patient based steering committee
Focus on minimally disruptive care examples in multi-disciplinary biweekly quality rounds which are already in existence
Present testimony to all stakeholders from patients and their experience with MDC
Establish clear reporting accountability and responsibility to members of public using waiting room public video messaging, handouts of MDC care and community presentations at local health and wellness initiatives
Expected Outcomes
Clinical Outcomes
• Overcoming “system” inertia
• Expelling health care paternalism
Research Outcomes
• Appropriate level of diagnosis and treatment for patients with comorbid disease burden
• policy and evidence based practice which champions MDC
Realistic Implications and Health Finance Context
•
• Tangible Culture of Caring• Proven MDC model cited as a recruitment & retention Incentive• Improved Patient-derived health indicators• Regular MDC Community Engagement• Increased patient satisfaction for comorbid population • Improved adherence rates and buy in for provider engagement • Sustainability and champions of MDC care dispersed throughout
greater Slave Lake region• MDC employed as a Quality Improvement indicator
•
References
• Muth, C., van den Akker, M., Blom, J. W., Mallen, C. D., Rochon, J., Schellevis, F. G., ... & Perera, R. (2014). The Ariadne principles: how to handle multimorbidity in primary care consultations. BMC medicine, 12(1), 223.
• Richards, T., Coulter, A., & Wicks, P. (2015). Time to deliver patient centred care. BMJ, 350, h530.
• Rosenthal, T. C. (2016). Are We Learning More about Patient-centered Medical Homes (PCMHs), or Learning More about Primary Care?. The Journal of the American Board of Family Medicine, 29(1), 4-7.
