Quality Of Our Care
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Quality Of Our Care |
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QUALITY OF OUR CARE AT BAYSIDE
It is very hard for patients to know how good the quality of their medical care is. You can evaluate toasters, cars, and shoes pretty easily. But medical care? You can tell if the office is friendly, if the waiting time is acceptable, and if the practitioners appear to care about you. But it is very hard to tell if you are being advised well on prevention, if the proper tests are being done, or if diagnosis and treatment are appropriate. It’s just hard to tell.
Well, believe it or not, discerning their own quality is hard for practitioners, too. We may think we are doing a good job, but without looking closely, we really can’t tell for sure. In fact, because it’s hard to do, a whole field of study has arisen, called “medical care quality.”
At Bayside, we understand that evaluating and upgrading quality is a difficult proposition. But we also know that the quality of what we do is supremely important to us. We want to serve you as well as we possibly can, and we want to take pride in our work. So we need to take on this difficult task directly.
Here is what we have done. We have made ourselves expert in the field of quality. Budd Shenkin, Bayside’s president, has even written a paper on the subject of quality. Download it here. Then, we have taken many individual steps to heighten our quality, and we continue to take more. You probably won’t notice these when you come to our office, but because we think you deserve to know what we are doing, we are listing lots of the steps we take here in this section of our website.
The Theory of Quality
Before we list all the things we do, we need to talk a little theory.
Quality of care has three parts:
- First, the substance of the care. Are all indicated preventive measures being taken? Are the proper steps taken in diagnosing an illness? Are the proper medicines prescribed? Etc.
- Second, the manner in which care is given. According to the Institute of Medicine, this means: timeliness, patient-centeredness, safety, effectiveness, efficiency, and equitableness.
- Third, helping the individual patient and the community by more than just strictly bio-medical medicine. That is: being compassionate with each patient and forming a “therapeutic alliance,” helping patients find necessary resources, or in short, caring for the patient. In addition, the highest quality practices will contribute to the health of the community by participation.
Improving quality of care can be done in two basic ways:
- Professional enhancement. This means improving the knowledge, skill, and motivation of the clinician.
- Systematic Reengineering. This means improving the system of care, the operating mechanism of the practice within which the clinician performs.
Bayside’s Program of Quality
The most important thing we do at Bayside is to take quality seriously and to look at our quality constantly. Quality of care is one of the most important items on the priority list of our president and our Medical Director. We look at the three sectors of quality carefully and seriously, and we use the two means of intervention available to us.
Here, then, are examples of what we have been doing to push our quality to the highest level.
| Immunization survey and recall | We search our database to find out which patients are missing immunizations, and contact them to come in to be immunized. |
| Patient recall for chronic disease followup | We search our database to find out which patients need other tests and checkups |
| Clinical encounter templates | We have proprietary patient encounter forms that help us ensure that everything that needs to be done at each visit is indeed done |
| Extensive handouts | We have over 50 proprietary handouts to explain to patients both steps to keep well, to understand and guide their children, and to explain illnesses |
| Screening questionnaires | We use questionnaires at specific ages, and we screen for maternal postpartum depression, developmental delay, and autism |
| Diabetic, lipid flowsheet | For our adult patients we use flow-sheets to ensure that all indicated screenings and examinations are done for patients with diabetes |
| Preprinted Rx forms | We have specific and detailed prescription forms to ensure accuracy |
| E-prescribing | We use electronic prescribing, an advanced capacity to ensure accuracy and detect drug interactions |
| Hospital-to-office info notes | We use special information transfer forms to ensure that hospitalized newborns get their full information transferred to the office |
| Clinician conferences | We have an extensive program of noon and evening conferences to keep our clinicians up to date |
| Mutual chart review | We have regular sessions of 3-5 clinicians reviewing each others charts for knowledge base, diagnostic workups, and documentation |
| Intra-practice listserve | We use a listserve for our clinicians to interchange information with each other on strictly medical matters |
| Hiring practices | Bayside has been successful in hiring exceptional clinicians educated at leading institutions |
| Certification requirement | We require that all our clinicians achieve Board Certification and maintain their credentials by recertifying as required |
| Advanced use of website | As you can see, we make extensive educational resources available to patients on line, and enable patients to fill out questionnaires prior to the visit |
| Teaching students | Bayside clinicians regularly accept students and residents in our offices, which is a community service, and also keeps our clinicians sharp |
| Patient Total Visit Time | To ensure timeliness, we regularly measure the total time that visits take in our office to promote efficiency and respect for patients’ time |
| Promoting breast feeding | We have a lactation consultant available, and several of our clinicians are accomplished in coaching breast feeding |
| Telephone Mystery Caller program | We regularly make fake calls to our own offices to ensure that patients are treated well on the telephone |
| Patient surveys | We survey our patients in each office regularly for areas of satisfaction and dissatisfaction |
| Customer service training | We have regular training for our staff in how to treat patients well |
| Compassion emphasis | Bayside’s leaders emphasize the importance of and teach newer clinicians about allying with patients, understanding temperament, etc. |
| Accept Medi-cal | We accept patients with Medi-cal coverage, in service of the goal of equity |
| Advocate for patients | We teach and activate our staff to make referrals quickly and accurately to expedite the course of our patients’ diagnosis and treatment |
| Serve as medical leaders | Bayside physicians have served as Chief of Pediatrics at several hospitals, and on the Boards of Independent Physician Associations |
| Serve on Community Board | Bayside physicians have served on the Public Health Committee of two cities |
Finally, let us say this. We would like you to be part of our quality improvement program. If we don’t know it’s broken, we can’t fix it. We solicit your input. What could we do better, and what are your ideas of how we could do it better? Don’t be shy – we need to know.
