Your Practice Transformation Companion

Self Management Enters the Primary Care Vernacular

2012-03-02T09:36:00.001-08:00

One of the hallmarks of the Patient Centered Medical Home (PCMH) and Patient Centered Health Care Home (PCHCH), and likely any other acronym that arises to emphasize patient-centric care, is self-management support. Self management is a growing practice in primary care for working with patients with a chronic condition(s). Self management techniques can also be used with well patients who want to maintain a healthy lifestyle.

What does self management support mean? In a nutshell, it is a means to teach patients to take ownership for their illness or care and live a healthy life with a chronic condition. Self management support is a proven method to teach problem-solving skills to help patients overcome the physical and emotional problems caused by the disease. Patients learn how to set short term goals that are actionable and specific. Through self management support and active goal setting, patients learn how to take care of their illness, how to carry out normal daily activities and to manage the emotional changes that occur with a chronic condition. By setting small, specific goals, patients become an active participant in their health care and gain a sense of accomplishment and empowerment as they achieve success in managing their illness.

How do patients learn these skills? By working with trained staff in their primary care physician’s (PCP) office. These trained individuals can be any member of the PCP office, both clinical and non-clinical. Another learning method is to take a self-management course that is offered in the local community or through another health care venue. With self management skills, individuals are better equipped to accept responsibility for managing their chronic condition. The key to success in transferring self management skill knowledge, as with most things, is education. What do you have to say about teaching your patients self management skills? PTI wants to hear it.

Linda Mackensen, R.N.

Executive Director, Practice Transformation Institute

A Word on Validation

2012-02-21T05:45:00.000-08:00

We all want validation in our work. For primary care physician practices, validation has taken on an entirely new meaning in recent years with the aggressive move towards transformation to Patient Centered Medical Homes (PCMH) and URAC’s Patient Centered Health Care Homes (PCHCH –https://www.urac.org/healthcare/prog_accred_pchch_toolkit.aspx).

For practices seeking official validation as a PCMH and/or a PCHCH, it is important to make sure that all practice members have been involved in the transformation process and are prepared to be part of the validation visit. The ultimate goal of validation is to assess/confirm the transformation of a practice from the ground level up to ensure that optimal patient- centeredness has been achieved. This undertaking requires full commitment by members of the office team, not to mention an investment of time and money for practice reengineering.

Not only must a practice be ready for a validation visit, but the person performing the audit also must fully understand the PCMH/PCHCH process to be able to assess the practice appropriately. An auditor should be able to offer suggestions and guidance to make sure that the changes the practice is making are sustainable in the long-term. Whether you are the auditor or a member of the practice team, we all want the same thing- to improve the quality of care for the patient and the health care system.

2012 will see a surge in validations now that URAC is launching its PCHCH Practice Achievement Recognition program on an international scope. When you are looking for a validation team, consider PTI. Why? Experience counts. We have trained auditors and are the first organization to receive PCHCH Certified Auditor status.

What do you have to say about validation? PTI wants to hear it.

Linda Mackensen, R.N.

Executive Director, Practice Transformation Insitiute

It’s a Lovely Day in the (Medical) Neighborhood

2012-02-02T09:44:00.000-08:00

Just when the majority of the primary care community gets familiar with the Patient Centered Medical Home/PCMH terminology, a new term moves in next door. The Patient Centered Medical Home “Neighborhood” entered the primary care vernacular in 2011 but is sure to increase in usage and understanding in 2012. So just who are these neighbors? Simply, they are specialists who are neighbors to the primary care home. Examples of neighborhood specialists who could serve the medical home include oncologists, nephrologists, endocrinologists, cardiologists, neurologists and gastroenterologists. With the primary care physician handling coordinated care in the medical home model, it makes sense that specialists who serve patients with chronic and often complex illnesses be welcomed into the neighborhood of care. Stay tuned while the financial structure of PCMH neighborhood physicians takes shape.

What do you have to say about the medical neighborhood? PTI wants to hear about it.

Linda Mackensen, R.N.

Executive Director, Practice Transformation Institute

Your Practice Transformation Companion

2012-01-12T05:42:00.000-08:00

The concept of practice transformation was developed over the past decade, but not until recently has the phrase started to have tangible meaning for those most impacted by it: physicians and their primary care practice teams. In simple terms, practice transformation aims to realign the physician’s office to a more patient-centric practice, generally known as a Patient-Centered Medical Home (PCMH) or, following URAC, a Patient-Centered Health Care Home (PCHCH). Practice Transformation Institute, established in 2007 was the first non-profit organization in Michigan to address the need for training and education to realize the goals of practice transformation.

Practice transformation is accomplished by taking baby steps towards the particular goals that you have identified for your practice. Each baby step inches towards milestone goals like meaningful use technology, accessible office hours , coordination of care between the physician’s office, specialty physicians and myriad community resources, planned visits and team huddles, and smart office administration policies that address hiring, firing and performance reviews. Phew, that’s a lot of milestones! Don’t worry though. The most difficult part of practice transformation, like most journeys, is the first step. In this case, that is accepting the need to transform and investing time and money (at least up front) to make it happen. Once acceptance has been achieved, the practice transformation journey does get easier. That’s because there is an understanding and appreciation of the ultimate value in developing patient centric practices: improving patient health and quality outcomes and office efficiencies and creating a stronger, empowered physician/practice team.

This PTI blog, starting with today’s introductory post, isn’t intended to create converts to PCMH or PCHCH. It’s to serve as a soul mate on the journey for those who have decided to hit the patient-centric trail. I’ve done about 240 PCMH on-site validation visits in my career and am gearing up for URAC validations (PTI is the first organization in the nation to receive URAC’s PCHCH Auditor Certification) so expect to do hundreds more. I’ll offer input, suggestions and who knows, maybe even an occasional gripe along the way. Your comments are always welcome.

Linda Mackensen, R.N.

Executive Director, Practice Transformation Institute