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Patient empanelment: A strategy to improve continuity and quality of patient care
Ellen Christiansen1, Michelle DeCoux Hampton2, Meghan Sullivan3
1Department of Nursing, School of Health and Natural Sciences, Dominican University of California, San Rafael, California.
Problem:
In some Federally-Qualified Community Health Centers (FQHCs), patients do not have a designated primary care provider (PCP). Patients see any provider who is available. This leads to fragmented care, poorer outcomes, and higher costs.
Design:
Patients were empaneled to a designated PCP. Continuity, quality, and efficiency measures were collected at baseline, 6-, and 12-months postempanelment.
Background And Setting:
Three rural FQHCs on the coast of Northern California performing about 18,000 patient visits annually.
Key Measures For Improvement:
Patient cycle time, percentage of patient visits with designated PCPs, completion of cervical and colorectal cancer screenings; blood pressure, low-density lipoprotein, and hemoglobin A1c control in patients with diabetes.
Strategies For Change:
The senior Leadership Team initiated the patient empanelment project with the assistance of an outside consultant.
Effects Of Change:
After 12 months, 100% of the FQHC's patients were assigned a PCP and saw that provider on ≥63% of visits. Quality indicators improved by an average of 9% and cycle time decreased by 12 min. per patient allowing providers to see approximately four more patients and generate an additional $2212 per day.
Lessons Learnt:
Project outcomes supported the importance of a designated PCP to achieve improved quality and efficiency of care.
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