Journal of Healthcare Management - March/April 2014 - (Page 104)

J o u r n al of H ealt H care M anage Ment 59:2 M arcH /a pril 2014 also addressing that with our ADD and ADHD patients who get medication. [Patients] need to follow up with their protocols as far as the yearly physicals and the med updates. So you know it's kind of similar in a way to the asthma protocol." Another practice leader explained the spillover benefits of the registry, commenting, "We're doing better with our mammography [and] pneumococcal vaccinations. So when we look at those parameters and we're actually tracking them . . . we are seeing them in other areas, not just diabetes." Several other practices noted that they had not yet observed spillover but believed it would occur. One practice staff member said, "I think [IPIP] will [spill over]. We'll be more conscious. It is kind of early." In general, spillover benefits appeared to have happened more quickly in practices focusing on diabetes than those targeting asthma because of the prevalence of multiple chronic conditions in adult patients compared to pediatric patients. Improved Efficiency and Care Quality With the exception of one provider, there was general agreement that transformation improved efficiency, care quality, or both. One practice leader commented about the self-reflective benefits for the practice, noting, "You really do think through your work flows and think about how everything will be impacted by the changes that you want to make, then really things go pretty smoothly." Another practice leader commented, "[The IPIP process] just forces you to take a hard look at . . . what you're doing and helps you get to a better place. And knowing that you're providing better patient care." Other practices took an altruistic view of transformation. One leader noted, "I think whether or not you do controlling asthma, controlling diabetes, whatever that end goal is going to be, [IPIP leads to] healthier people and less costs for the state and less tax we have to pay to really achieve the goal." Improved efficiency and care quality were often described as an enhanced knowledge of the patients' needs and an ability to give them truly patient-centered care. One practice leader expressed some frustration with the transformation process and uncertainty about its effect on quality, stating, "Going back to, 'Does it improve quality of care?,' sometimes I think it makes [the care I provide] worse because I'm spending so much time making sure I'm documenting it right that I'm not getting to think about a patient." Although no other practice expressed this sentiment directly, a staff member from another practice described difficulty convincing some providers to change their current processes. Professional Benefits There was broad agreement among sites that transformation provided professional benefits. These benefits fell into three categories. First, among both practice leadership and staff, a common theme emerged of increased job satisfaction. As one practice leader described, "[What the nurses experience is satisfaction in terms of] 'I know what I need to do for this asthma patient. I know what we need to discuss.'" Second, both practice leadership and staff noted the recognition they received as a result of transformation. One practice staff 104

Table of Contents for the Digital Edition of Journal of Healthcare Management - March/April 2014

Journal of Healthcare Management - March/April 2014
Contents
Interview With Marna P. Borgstrom, FACHE, President and Chief Executive Officer, Yale New Haven Health System, and Chief Executive Officer, Yale-New Haven Hospital, Connecticut
Specialties: Missing in Our Healthcare Reform Strategies?
Costs and Benefits of Transforming Primary Care Practices: A Qualitative Study of North Carolina’s Improving Performance in Practice
Governing Board, C-suite, and Clinical Management Perceptions of Quality and Safety Structures, Processes, and Priorities in U.S. Hospitals
Use of Electronic Health Record Documentation by Healthcare Workers in an Acute Care Hospital System
Why Hospital Improvement Efforts Fail: A View From the Front Line

Journal of Healthcare Management - March/April 2014