HealthPartners Central Minnesota Clinics (HPCMC) is a primary care clinic located in west central Minnesota. In addition to the main medical and dental clinic, they offer services at St John’s University, Well@Work clinic and HealthStation. The clinic ended 2012 with 53.1 percent of asthma patients considered to be “optimally managed.” Although the clinic had completed some training and workflow redesign, staff knew they could do more to improve the outcome for these patients, and identified several opportunities as they moved into 2013:

• Identify and utilize available resources to help meet goals.
• Work with team members and peers to identify barriers to the consistent use of existing tools.
• Leverage the expertise and enthusiasm of successful teams to build on skills throughout the practice.

Because HPCMC felt it was important to review past strategy and plans as a team, they initiated physician-led care team meetings held every two to four weeks before the start of the clinic day. The goal of these meeting was to:

• Review quality outcomes, best practices and celebrate success.
• Work collaboratively to develop pilots for improvement and initiate those that were successful into the workflow.

As care teams evolved, staff members really took ownership of quality outcomes, with impressive results. The clinic’s August 2013 Optimal Asthma score was 74.1 percent, a 21 percent increase.

“We have learned that it takes the whole team working together to ensure optimal outcomes for our patients,” noted Denise Rudningen, RN, Epic specialist and quality support. “Allowing staff to ‘own’ the outcomes, optimizing workflows, and mentoring each other are keys to the whole team being successful, and we have used the same approach to improve Optimal Diabetes, Immunizations and Depression Management,” she added.

Best Practices

Based on team input, following are some successful and sustainable practices that HPCMC found to be effective:

• Hold quarterly “lunch and learns” to continually enhance registry skills and rooming staff/team support for dedicated registry time. Can also be done 1:1.
• Include midlevel providers on the team for an outstanding Asthma Management Plan (AMP).
• Rooming staff should “own” completion of Asthma Control Plan (ACT) across clinic specialties at all sites to ensure completion. If an AMP is needed, encounter is sent to primary care provider to complete.
• Complete ACT/AMP at the same time as "meds at school" forms and sports/camp physicals.
• Invite “special guests” from the multidisciplinary team to review topics as initiated by the team.
• Share ideas across teams on how to engage patients and what tools have been successful (letter format, scripting, use of scheduled telephone visits).
• Consider making changes to the physical layout of the clinic to optimize teams.
• Celebrate success!

For more information, contact Denise Rudningen at 320-203-2057.