Redesigning Primary Care, Top-Down, Bottom-Up and Inside-Out

UW Health implemented a new pilot program designed to focus on the big picture of treating patients.Any primary care clinician will tell you: It’s rare in a hectic patient care practice to simply step back and reflect.


The big questions - how can we be more efficient, more patient-centered, more engaged and fulfilled in our work? - are all too often left for another day.


That’s why the Microsystems program under way in UW Health primary care clinics is so special. As part of UW Health’s five-year primary care redesign initiative, a pilot group of nine care teams was given the time - and the tools - to meet regularly and analyze the way they deliver care. Working with coaches, they developed and tested improvements.


At learning sessions every few months, they came together to share their progress and hear innovative ideas - from how to reduce wait times to improving patient education and chronic disease management - to take back and implement in their clinics.


As the first wave moves from pilot mode to sustained use of the Microsystems approach, a new cohort of clinics is receiving their initial training. The cycle will continue until a critical mass of care teams is on board, making Microsystems “the way UW Health does improvement” in primary care and beyond.


“The enthusiasm is infectious,” says family physician James Shropshire, MD. “With Microsystems, it’s not about the care I provide, it’s about the care we all provide as a team. We are working better together to learn about our processes and improve what we do for our patients.”


While Microsystem improvements are bubbling up at the care team level and spreading from site to site, content-focused teams are tackling a series of objectives to improve efficiency, consistency and quality of care. The Health Maintenance team is leveraging the power of UW Health’s fully implemented electronic health record (EHR) to alert clinicians when patients are due for breast screening mammography or colorectal screening. As part of the Primary Care Redesign objective to standardize care processes throughout UW Health, another group is using the EHR to implement a consistent protocol for all patients receiving anticoagulation therapy. A third group focuses on EHR “optimization,” a post-implementation push to increase clincian mastery of EHR capabilities and maximize benefits of the EHR for quality and safety of care.


Describing her Microsystems experience, UW Health quality analyst and Microsystems coach Linda Sauers makes an observation that could well be said of the entire primary care redesign initiative: “What I like about the organization’s approach is they’re setting up a structure and a support mechanism for teams to keep moving forward. This isn’t just ‘Oh, let’s try this’ and then goodbye. They’re really setting things up for the long haul.”

Date Published: 08/09/2010

News tag(s):  james h shropshire

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