This article was originally published in February 2012.
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Washington Park Medical Center, a family medicine practice located in Centralia, WA is working toward the medical home model and was among the nation’s first wave of practices to successfully attest to meaningful use of an electronic health record (EHR) system. “Our staff works well together and gets a lot done,” said Paul Williams, MD, Washington Park’s medical director.
However, even this high-performing team has a few troublesome spots. “Childhood immunizations are hard to deliver effectively....I knew we could do it better, but we just couldn’t get it on our own. We needed someone on the outside to help show the way,” Williams described. When he heard about Qualis Health’s new Medicare-sponsored Cardiac Learning & Action Network, which includes workflow workshops, Williams thought he may have found the answer—but didn’t want to wait until the initiative kicked off in 2012.
Since Washington Park Medical Center is already enrolled in another Qualis Health-led project (the Washington & Idaho Regional Extension Center (WIREC), which is funded through the HHS Office of the National Coordinator for Health IT), it only took a bit of coordination to schedule a workflow workshop that built on the practice’s work in WIREC and paved the way for participation in the upcoming Cardiac Learning & Action Network.
The workshop featured elements of both the WIREC and Cardiac Learning & Action Network programs. The combination of topics (IT-related, workflow, and clinical) made for a particularly efficient use of time, and helped staff see the ways in which they contribute to the larger picture.
The practice closed for the day of the workshop, in order to allow all staff members to take part. “Having everyone there means everyone will be engaged and gets us all on the same page,” Williams said. He admits that it’s difficult for a practice to invest that much staff time in an initiative but says “It’s the best way to do it...top-down implementation just won’t work.”
And was the workshop worth that investment? “It was highly valuable,” Williams relates. “Often workshops can be frustrating because you don’t do what you had set out to accomplish, but this was really set up well.” In fact, 100% of the of the staff members who completed Qualis Health’s post-event survey rated the workshop as a 6 or 7 on a 7-point scale.
During the workshop, the team mapped their current process for managing immunizations during a well-child visit or sports physical, then identified all the areas of wasted time and effort. On the post-event survey, one participant called the map “eye-opening.” From there, the team designed a more streamlined process.
Before the workshop, Williams said that patients often had to wait until the end of the visit to get their immunizations and might be in the office for up to 90 minutes. After the workshop, staff began ordering the immunizations before the visit and similar appointments now require only about 20 minutes. The team experienced this dramatic improvement right away.
“Now we see that we can really solve tough challenges. [The Lean workflow methodology] can get us from Point A to Point B,” Williams said. “If we can do this with childhood immunizations, then we can tackle anything.”