Case Management Improvement Project—
and Beyond—at PDR
In 2015, Physicians' Diagnostics & Rehabilitation Clinics (PDR) completed a quality improvement (QI) project to improve their case management as part of the process of becoming a new ICSI member. Their strategy to save staff time and improve the patient follow-up response rate was to:
- Create an electronic report to determine which patients required follow-up action
- Eliminate extra paperwork and dictation by training their case managers to use electronic medical record (EMR) documents
- Create standardized secure patient messaging communications to replace mail and phone calls
A close examination of the process revealed some redundancies and non-value added steps that could be improved or eliminated. They found that ICSI’s QI model created focus and helped them adhere to a reasonable timeline to accomplish their goals. By charting data throughout the project, they could see what was happening and let the data drive their planning and decisions. They also found that establishing team champions and communication planning were essential to support the change process.
Following their initial project, PDR identified and began working on several other QI opportunities. The operations team presented a short in-service staff training on QI basics and introduced a project plan with the aim of “revolutionizing the patient experience,” according to physical therapist Jennifer Missling. Each department conducted its own QI initiative focused on improving patient treatment retention, and continued to report quarterly on their PDSA cycle results. Some ran multiple cycles throughout the year.
As a result, patient retention did not significantly improve. However, each department noted other positive effects and outcomes on their leading measures, including:
- There was a significant reduction in patient phone calls going to voicemail by utilizing a new answering service and phone triage plan
- A new shared decision-making tool used at initial consultations demonstrated that patients felt prepared to begin treatment
- Physical and occupational therapy created an evaluation summary tool that involved the patient in setting goals and their plan of care
- Patients met with the billing department after their initial consultation to discuss financial responsibilities and understand their insurance coverage
- Patients surveyed reported high customer satisfaction and felt more informed around their treatment
“Through this experience, all departments have a greater understanding of the quality improvement process and the importance of measuring change along the way,” Missling said. “We used a variety of data methods including patient survey, provider survey, and testimonials to help create momentum for change. Further, using thoughtful communication strategies, we were able to manage adaptive barriers to change very successfully. Although we did not see an overall improvement in patient retention rates, we felt that the supportive measures were important and the changes made were valuable to the patient experience and employee satisfaction.”