Improving Specialty Care Access

New Toolkit Available for Transitioning Patients Back to PCP

A new toolkit is available to assist specialties in developing a process to transition stable patients back to their primary care physicians (PCPs) in an effort to improve new patient access. Items in the toolkit include training materials, talking points, workflow diagrams, and staff checklists.

The new workflow, focused on communication and handoffs, was created during a pilot project with Dermatology and developed by Health Link analysts, health systems engineers from the Quality, Health and Innovation (QSI) Department/UW Health Improvement Network (UWHIN), and industrial engineering students.

During the pilot in April, 81 stable dermatology patients were transitioned back to their PCP after an in-person review of a transition plan with their provider. The process has been well-received by patients (4.85 out of 5 satisfaction rating during the pilot), providers and staff, and was recently rolled out to all dermatology providers and locations.

“Our providers and staff have been very engaged in this process, which has been used with more than 600 patients so far,” says Eric Berg, MD, Professor and Vice Chair of Clinical Affairs, Department of Dermatology. “We now emphasize to patients that our goal is to successfully diagnose and treat their condition, then celebrate with them when they no longer need specialty care. We also reassure them that we’re here whenever they might need us.”

“For the most part, patients have been understanding and receptive to the change,” says Lisa Hilker, clinic supervisor. “Several commented that it will save them time and a co-pay to continue their care through their PCP.”

The Dermatology team aspires to meet, then exceed the UW Health specialty care service standard of new patient access within 30 days or less by June 2015. “Early indications suggest that our access is improving,” says Dr. Berg.

Utilization of the UW Health Primary Care/Specialty care coordination agreement helped ensure a smooth transition by clearly outlining expectations for primary care and dermatology.

“The process has been well-defined with clear documentation using the problems list in Health Link, which is a model we plan to use with other chronic conditions,” says Sandra Kamnetz, MD, Vice Chair, Clinical Care, Department of Family Medicine, UW School of Medicine and Public Health.

“We’re now planning a pilot to assess how we can assist primary care with this new model of health care delivery,” says Dr. Berg. “We’ll use the innovative format of ‘academic detailing’ to customize basic dermatology training/education to what may be needed at a particular primary care practice site.”

The pilot team credits support of QSI/UWHIN, which “brought new perspectives, data and quality improvement tools to help us make better decisions, determine next steps and effectively communicate what we were doing,” says John C. Roy, Administrator, Department of Dermatology. “Their support was invaluable,” agrees Hilker. “By handling the behind-the-scenes work, we were able to focus on running a busy clinic,” she says. “We never would have been able to get this process going as quickly as we did without them.”

“This is an excellent example of leveraging our resources and collaborating, including with our patients, to reach a goal,” says Linda Vesterdahl, Program Director, Ambulatory Access. Patient feedback was gathered through surveying and the Primary Care Advisory Council, comprised of Patient and Family Advisors.