by Heather Grimshaw, Director of Communications, Strategic Partnerships, Colorado State Innovation Model (SIM)
Featured in the March/April 2019 Colorado Medicine.
Two Colorado Transforming Clinical Practice Initiative (TCPi) practices were recognized for the exceptional work they do for patients during the 2019 Centers for Medicare & Medicaid Services Quality Conference in January, which focused on “innovating for value and results.”
Executives from SurgOne, Englewood, Colo., and the PIC Place, Montrose, Colo., presented their stories to hundreds of attendees and were both selected “best in category” for medication management and patient and family engagement, respectively.
“It was an eye-opening experience for me,” said Rena Bach, chief executive officer, SurgOne, who represented the group. “It was great to see so many like-minded individuals,” she added, citing the diverse nature of attendees including SurgOne as well as smaller practices and Medicaid-based clinics engaged in practice transformation efforts to improve quality.
Bach says she was especially inspired by the PIC Place story presented by Melanie Hall, executive director, during the conference. “She really inspired me to continue to get better,” Bach said. “It’s just day to day for us, but she makes it seem like I’m standing still.”
Perspective is everything and looking at the stories that Bach and Hall presented, it is clear that no one is standing still. Both teams have ambitious plans to improve patient care, experience and outcomes.
SurgOne obtained significant physician buy-in throughout the practice and cut its opioid prescriptions (number of pills prescribed) by 50 percent in 2018. In addition to a lower surgical infection rate, SurgOne’s use of ambulatory surgery centers saved $10 million dollars annually.
The message conveyed to all physicians was to cut the number of pills in half. In other words, for physicians who were prescribing 30 the request was to reduce the number of pills to 15, and a process change so that all patients who requested refills had to be seen by a SurgOne physician. Despite initial fears that patients would complain or that the process change would diminish a physician’s quality of life due to last-minute or after-hours requests for refills, the change has been almost seamless, Bach says.
The key is setting patient expectations. The new patient policy is as follows: Physicians explain to patients that there will be a certain amount of pain with a surgery and provide some perspective on what is normal pain and what’s not. They also explain that they’re prescribing a certain amount of painkillers, which should handle that pain and, if it doesn’t, they need to see that patient before refilling the script.
“Our goal is to have fewer pills sitting on the shelf, fewer pills that could be taken by someone else and fewer pills that lead to heroin addiction,” Bach explains.
Both SurgOne and the PIC Place have reassessed processes to meet patient needs and have seen positive results from their work.
The PIC Place developed an internal, complex needs team that was recognized by the federal CMS for excelling in patient and family engagement work. This team engages patients by asking what their best version of health looks like.
Regular reviews of these journeys engage the patient and provide opportunities to celebrate success and address health concerns before patients and providers start to feel overwhelmed. Get more details about how PIC Place accomplished its work and learn more about SurgOne’s approach to reducing opioid use and reducing surgical infection rates at www.co.gov/healthinnovation/TCPisuccesses.