As part of Carolinas HealthCare System's commitment to patient experience, Care Redesign was first introduced in 2013. It entails extensive restructuring of primary care practice operations. To ensure patients have the right care at the right time in an optimal environment, the daily management of patient flow and standardized care protocols are being adjusted. The initiative touches doctors, nurses and support staff. Changes are being implemented at every primary care practice across the System, impacting 650 providers across 136 practices. System-wide implementation should be complete by the first quarter of 2017.
One of the key components of Care Redesign is that a clinical assistant (CA) now accompanies the physician during every patient interaction. While the CA enters notes into the computer, the physician can focus on the patient.
"It's all about devising ways to let our people do what they do best," said Zeev Neuwirth, president and chief clinical executive at Carolinas Healthcare System Medical Group. "It allows our doctors the time to listen to our patients and involves other members of the healthcare team in detailed reporting. It's good practice. The old model of care is unsustainable. It is our desire to not react to these changes, but to lead them."
Union Family Practice, in Monroe, NC, was one of the first facilities to implement the change. "The old way of doing things really slowed us down," said Will Lester, MD. "We seemed to be doing a lot more typing. Now, the patients like it. When we explain the change to patients, knee-to-knee, they're really happy. They like that I'm focusing on that doctor-to-patient interaction rather than sitting behind a computer."
Lindsay Johnson, MD, also of Union Family Practice, agreed. "This redesign is so much better. There is hope. Our staff is getting out of work on time, which was not the case before. They have much more time with their families. They have really taken to it. They're positive and they love it. The doctors have a life. When they leave here, they go to be with their families. This new care redesign lets them do more of that."
This simple change has empowered CAs, as well. Being in the room with the patient allows them to understand patients' needs first-hand, thus increasing accuracy of record keeping and their own knowledge base. Nina Bdap-Vu, CA at Union Family Practice, has been with the System for eight years and welcomes the change.
"The biggest difference now is that I'm a partner with the physician, every step of the way. We get to hear things directly. We're there with the physician, learning alongside them."