Patient Involvement from Boardroom to Exam Room

by Farrell Davies
Heartland Community Health Clinic

The best care is achieved through active patient participation.

Health reform calls for a higher performing healthcare system that will recognize and reward models of care for quality and clinical effectiveness. As a community health center, Heartland Community Health Clinic by its nature is a model of care focused on meeting high standards for quality and clinical effectiveness, especially for the medically underserved.

Dr. Donald M. Berwick, former administrator of the Centers for Medicare and Medicaid Services, described the health center model and its role in improving the healthcare system as follows: “The way to assure that we can have the care we want and need is to continually improve the delivery of care. The nature of the community health center model—team-based, population-minded, prevention-oriented, focused on the needs of patients—can provide the template for the redesign and improvement of the entire healthcare system.” A key factor noted in Dr. Berwick’s comments is the focus on the patient’s needs in the delivery of care. At Heartland, the focus on the patient’s involvement extends from the boardroom to the exam room.

A Unique Perspective
As a federally qualified health center (FQHC), Heartland’s board of directors is comprised of a majority of members who must be patients representing the community served by the clinic. These board members serve as community representatives and actively participate in managing the health center to assure responsiveness to local health needs and to guarantee the quality of life of the clinic’s patients. As fellow citizens and leaders in their communities, they know their neighborhoods and community healthcare needs. Their unique perspective assures that the services provided by Heartland respect the individual differences of the patients.

Respecting these individual needs means that the patient must be actively involved in his or her own care. To further increase patient involvement in care, the board approved the pursuit of two major initiatives focused on Heartland’s adoption of a model of care that will improve quality and clinical effectiveness through patient involvement: the Patient-Centered Medical Home model (PCMH).

A Patient-Centered Medical Home is a physician- or nurse practitioner-led medical practice that provides continuous, comprehensive, coordinated and patient-centered care. In the end, the success of the model is based on the relationship between the medical team and the patient. The patient participates in all decision-making and communicates with the team about his or her individual needs, experiences and treatments. Additionally, the patient shares information with the team about his or her health needs, including visits to other healthcare providers, so that everyone knows how to best proceed.

Involving the Patient
The first patient involvement initiative is designed to attain PCMH recognition from the National Committee for Quality Assurance. Working with the PCMH Learning Community for Illinois Community Health Centers, Heartland has selected a team to work with other Illinois community health centers to achieve PCMH status. The Learning Community will assist health centers to improve primary care by organizing care around patients, working in teams, and coordinating and tracking care over time.

The second patient involvement initiative is the Federally Qualified Health Center Advanced Primary Care Practice demonstration, funded by the Centers for Medicare and Medicaid Services. This demonstration is designed to improve quality and efficiency of care and help avoid preventable emergency and inpatient hospital care. Heartland is one of 500 federally qualified health center sites in the nation selected to test the effectiveness of the PCMH in improving care, promoting health and reducing the cost of providing care to Medicare beneficiaries served by FQHCs. As a participant, Heartland will make changes to how it delivers services to patients by focusing on topics such as team-based delivery, the use of data for performance improvement and improving the patient experience during a transition in care.

Going above and beyond to involve patients from the boardroom to the exam room, Heartland Community Health Clinic is committed to its participation in these opportunities to improve the quality and clinical effectiveness of its model of care. iBi

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