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Adding value to health care

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Patient focused and cost-effective care

We deliver care in a way that offers more value to patients. As a physician-led multispecialty provider, The Everett Clinic has brought about several innovative ways to make health care patient-focused and cost-effective.

Generic drug prescribing

The Everett Clinic saves money without affecting quality by prescribing generic drugs when appropriate. We've increased generic prescriptions from 41% in 2001 to 90% in 2013. This approach saves about $88 million a year.

A typical example of savings is using generic drugs for acid reflux. They are safe and work just as well as brand name drugs. But they cost $15 less per prescription.

We want to make sure that science, and not marketing, influences how we prescribe. So, we don't allow (let) pharmaceutical representatives and drug samples in our clinics.

Our pharmacists watch for and study new drugs. They alert our doctors when new, cost-effective generic drugs or care alternatives appear.

The Everett Clinic was one of the first groups in the country to ban pharmaceutical companies from doctor’s offices. We believe that the medicines we choose for patients should be based on research, not advertising.

Since the ban, we’ve saved patients more than $68 million per year (compared to the state average). We do this without sacrificing quality.

Our team of clinical pharmacists and doctors look for the highest-quality research on medicine use. From that research, they recommend medicines that will deliver the best results in healing our patients.

We don’t let sales representatives affect how we care for patients. As a result, we've lowered costs for patients and improved quality.

Preventive care and disease management 

We use evidence-based medicine to care for long-term medical problems like diabetes, asthma, heart disease and high blood pressure.

Our doctors guide patient care and stay on top of problems. They track patient progress and give each patient the information they need to stay as healthy as possible.

One promising prevention (to help stop) program is our outreach program. It connects with patients on key birthdays to remind them of tests they may need.

Healthy adults are urged to get their cholesterol tested. Taking care of high cholesterol early can lower your chances of having a heart attack (a sudden and serious heart problem) or stroke.

These programs help us find problems early and improve our patients’ quality of life. Our patients have fewer trips to the hospital and our cost of care is lower.

Bringing lean to The Everett Clinic 

The Everett Clinic has adopted the principles of "lean management." They come from the Toyota production system. Both manufacturing and health care involve complex production processes.

In health care, these include admitting a patient, conducting a clinic visit or doing surgery. The lean management method helps workers get rid of mistakes, reduce delays, lower costs and improve the overall quality of care.

Using the lean process also helps us find and get rid of waste, like duplicate tests and forms. Lean can improve patient flow through the clinic and show where work slows down.

When lean is used in a clinic setting, it improves patient safety and reduces delays. Results and care are delivered more quickly. Staff have less rework and more time for patients.

Altogether, the lean system aims to better understand and go beyond simply meeting our patients' needs. We work hard to raise the bar for patient satisfaction, quality and safety, cost effectiveness, secure future and staff satisfaction.

 

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  • Working together to offer our Medicare patients the right care at the right time

    We used lean to design an accountable care coordination pilot. This program will pair patients with a doctor and a dedicated registered nurse care manager.

    Each patient will be interviewed thoroughly, and get a physical exam and tests. Together, the team and the patient will create a care plan.

    Then the team will follow the patient with a series of in-person and phone meetings, as well as email messages. It will be carried out similar to the Boeing Intensive Outpatient Care Program. 

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  • Our Behavioral Health department partnered with Regence and ACORN to measure how well patients did with the care. After each visit, patients were asked to fill out questionnaires about their care.

    The study found the Clinic meets or goes beyond all of the ACORN Criteria for Effectiveness. Patients felt they improved as a result of the care. By tracking their progress, we can find ways to improve both the quality and the cost of the care we deliver.

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  • Admitting a patient to the hospital is smoothest when there are few “handoffs.” Staff work hard to make sure the reason for hospital care is clear for every patient.

    As a result, a patient can leave a Clinic facility and check into a hospital bed with no stops in between. Just one phone call from Clinic to hospital staff is needed.

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  • Every month, 55 Clinic patients learn they have diabetes. Nine out of 10 of them will attend a diabetes class to learn more about it. But at the follow-up class, only two out of 10 show up.

    We used lean to find a solution. The result was the Diabetes Clinical Care Pathway. For the program, a care manager (CM) is assigned to each patient so no one “falls through the cracks.” The CM carefully guides new diabetes patients through the care they need for a full year.

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  • Diagnostic imaging is one of the fastest-growing and most expensive elements of health care. When unneeded MRI, CT scans, and PET scans are ordered, the gains can be small and the cost high.

    A team made up of several specialists created evidence-based criteria to guide the use of advanced imaging. Now doctors can order advanced procedures only when certain criteria are met.

    These protocols reduced the unneeded use of imaging by 39% in two years. The Clinic saved more than $3.2 million annually. MRIs for back pain were cut by 14%. MRIs for brain and other similar problems were cut by 64%.

    This effort cost The Everett Clinic $1.5 million in revenue in just one year. But ordering the right test at the right time reduces costs for patients and insurance carriers/sponsors.

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  • Our vaccine refrigerators need to be carefully organized to make sure patients get the right vaccine at the right dose. A lean team set up a color-coding system with picture labels to help categorize stored items.

    The system will be carried out at all Everett Clinics. This will help make sure that no matter where an employee works, they will find the same organized store of vaccines.

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  • The Cancer Partnership staff decided they wanted to improve the work process for the phone triage center where nurses answer patient calls. Until recently, nurses handled many extra tasks. This took them away from patients and lengthened their workday.

    Now, nurses' time is more focused, thanks to a more efficient work process and phone system. Medical assistants’ roles were redefined to help pick up some of the work.

    As a result, patients are more likely to reach a person rather than voicemail. Hold times are shorter, and patient and staff satisfaction are both improved.

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  • Our Everett campus pharmacy staff decided to study the process for refilling a prescription. They found they could redesign the workflow and cut the number of steps from 26 to 12. The result? A faster turnaround, fewer chances for errors and lowered costs.

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  • Occupational Medicine worked on a project to cut the amount of paperwork and time involved in worker’s compensation claims. The team found steps in their process that slowed work and added costs for L&I partners.

    The group created standard processes and templates to reduce duplicated work and extra steps. Now, they can process 80% of forms in just two days, rather than several weeks.

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  • We used lean tools to reduce steps and barriers involved in making a complaint about patient care and satisfaction. A long, complex form was reduced to a few questions and placed online. We’re testing the new form as part of a pilot program.

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