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The University of Wyoming Family Medicine Residency Program in Casper (UWFMRP-Casper) recently received Level 3 patient-centered medical home (PCMH) recognition from the National Committee for Quality Assurance (NCQA).
Following two years of modifying workflows, increasing continuity of care practices and meeting the required PCMH standards, the residency program is now the only health care facility in Casper with the highest Level 3 recognition.
“NCQA patient-centered medical home recognition raises the bar in defining high-quality care by emphasizing access, health information technology and coordinated care focused on patients,” says NCQA President Margaret E. O’Kane. “Recognition shows that UWFMRP-Casper has the tools, systems and resources in place to provide its patients with the right care, at the right time.”
Established in 2011, the PCMH recognition process was developed to assess whether clinician practices around the nation function as medical homes. Once evaluated and identified as PCMH clinics, those practices are then recognized for their efforts.
The patient-centered medical home model focuses on the patient through specific health care interventions and approaches that transform primary care delivery. Under this model, the provider team considers the varying needs of an individual to better understand how social, financial and behavioral factors greatly affect overall health. Patient engagement is paramount to this team-based approach, because patients are much more likely to play an active role in improving their own health if they are respected and supported by their provider teams.
Health care organizations receive Level 1, 2 or 3 recognition depending upon a scoring system that tallies points from six standards, 28 elements and 152 factors. The six standards -- enhance access and continuity; identify and manage populations; plan and manage care; provide self-care support and community resources; track and coordinate care; and measure and improve performance -- must be tracked and reported to NQCA, along with 28 elements that include after-hours access, comprehensive health assessments, medication management and demonstration of continuous quality improvement.
Scoring for Level 1 is 35-59 points, Level 2 is 60-84 points, and Level 3 is 85-100 points. UWFMRP-Casper scored a total of 85 points and will not need to reapply for recognition until Jan. 30, 2018.
“Level 3 reflects a transformation of our processes and systems,” says UWFMRP-Casper Program Director Dr. Beth Robitaille. “Our dedicated staff worked for months to achieve this recognition, and they met their goals by providing individualized patient care, by tracking quality measures and by increasing their focus on preventative health care delivery. We continue to build upon our workflows and protocols by reviewing our performance and identifying areas of improvement, and we track our success from those interventions.”
As part of the application process, residency staff uploaded 266 supporting documents such as preventative planned care visit documents, documentation of chronic disease management and relevant visit forms. A relevant visit focuses on a specific condition, not an acute illness such as cold and coughs. During these visits, residents and providers discuss with patients the barriers they face when managing chronic illness such as diabetes. By further involving patients in conversations about their own health and diagnoses, providers have a better chance of helping patients overcome those barriers.
The medical home model is a continuous quality improvement process, so the PCMH team meets every week to discuss quality measures and staff involvement. Led by UWFMRP-Casper Associate Program Director Dr. Brian Veauthier, this interdisciplinary team includes the program director, clinic director, physician assistants, faculty members, nursing manager, front desk staff, quality director and resident physicians.
“Resident physicians want to learn in a PCMH-recognized facility, because this health care model creates a high-quality, evidenced-based approach to patient care,” Veauthier says. “Ultimately, Level 3 recognition speaks to the excellent care that we provide as we track and monitor our practice and increase the level of patient engagement at every visit.”
By improving the culture of quality at the program and by providing the tools for staff to become more proactive, the Casper residency program continues to place the needs of the patient first as it makes systematic improvements for the benefit of the entire program.
“By providing better patient-centered care, we will decrease the number of unnecessary admissions and readmissions to the hospital and emergency room,” Robitaille says. “We help save the health care system money while we increase the likelihood that our patients will become their own advocates as they partner with their provider to improve their own health.”
NCQA is a private, nonprofit organization dedicated to improving health care quality. Celebrating its 25th anniversary in 2015, NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA’s Healthcare Effectiveness Data and Information Set is the most widely used performance measurement tool in health care. NCQA’s website (www.ncqa.org) contains information to help consumers, employers and others make more informed health care choices.