Primary Care Practice Redesign Newsletter
Cohort 1 | Issue 7
March 20, 2019
This newsletter is a biweekly forum to keep practices
connected and informed on the Cohort 1 Redesign efforts.
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For previous newsletters you may have missed, please visit MSHP's News and Media page .
We Have Something New to Share with You!
You asked for a demonstration of efficient huddles and we listened!
By now, all Cohort 1 practices are huddling in some form and using these short, daily meetings to plan for more efficient patient visits and better quality care. Watch this 3-minute video on how Mount Sinai’s 1090 Amsterdam Avenue primary care practice prepares for and implements its daily huddles. Thank you to the 1090 team for taking the time to prepare this training video.
New! Practice Resources Web Page
Sign in to mshp.mountsinai.org for resources to help optimize your practice operations and improve the quality of patient care.
All Cohort 1 participants now have access to Mount Sinai Health Partners’ Provider Portal, where you can view a library of resources to help run your practice. It’s as easy as 1-2-3!
 
  1. Direct your browser to https://mshp.mountsinai.org and click on “Sign in” in the upper-right-hand corner.
  2. Enter your Mount Sinai email address and the password you use every day to access your Mount Sinai account. You may be asked to enter your cell phone number for a code or to set up security questions for authentication.
  3. On the Provider Portal homepage, click on “Practice Resources.”
 
Once you access Practice Resources , you’ll be able to view and download key information to help you optimize practice operations, including Primary Care Redesign Best Practices and provider and patient materials. Is there something you’d like to see on this page? Reach out to lisa.bloch@mountsinai.org
A Conversation with Your Practice Facilitators
Here’s what George Lourentzatos and Chris Scalamandre had to report
on their progress with Cohort 1 primary care practices
There is a growing body of evidence supporting practice facilitation as an effective strategy to improve primary health care processes and outcomes through the creation of an ongoing, trusting relationship between an external facilitator and primary care practices (Erin Fries Taylor, 2013). Mount Sinai has brought this resource to its primary care practices for a period of six months to help support practices in reaching incremental and transformational improvement goals.
 
We sat down with George Lourentzatos , Senior Manager, Practice Facilitation, and Chris Scalamandre , Practice Facilitator, to learn more about their roles and achievements over the past few months. According to George, “It is the norm in primary care for each role to work in silos. Where we come in is to enable team members to take a step back, evaluate their interdependencies, and plan how they can work together to achieve efficiencies in their common goal – providing exceptional patient care.”
 
Chris explained, “Change is hard. But you cannot improve upon what you do not measure. I see my role as helping the practices realize the importance of incorporating ongoing quality improvement into their workflows. For example, the goal of one PDSA (Plan Do Study Act) exercise is to help physicians manage their in-baskets more efficiently, employing the skills of the medical assistants to answer patient messages and leaving the physicians more time to spend with their patients.”
 
One of Chris’s key goals is ensuring that staff are working to the top of their licenses, and she finds that “people find more satisfaction and gratification in their work if they are leveraging the skills they were trained on to affect patient care.”
 
Teamwork
“It’s a win-win for everyone when patient care is the focus and the entire staff are working together to the top of their abilities to make an impact on the patient experience and health outcomes,” Chris commented.
 
In a team-based practice, it is not only the physicians that contribute to patient care. It’s empowering for a medical assistant to review a chart and make recommendations to the physician or for a front-line staff person to suggest changes to more efficiently register and room patients. Both George and Chris empower staff to ask the question “Why?” and engage everyone in the practices in finding solutions to problems. Front-line staff know the problems and they also know the solutions, they commented.
 
Practice Improvement Skills: PDSA
One key tool that the facilitators have introduced to practices is rapid-improvement PDSAs, exercises that are being employed to improve wait time or phone response rates by problem-solving in a very specific way. If one method doesn’t work, then it’s time to try a new one until you come up with something that makes a measureable difference. Process improvement is continuous.
 
George commented, “Our goal for this program is to allow practices and staff to really be able to try out different solutions. That means making the time to evaluate, problem solve, and experiment. Since we are only there for a short period of time, the key is sustainability – and we are seeing staff at the practices truly own process improvement. While everyone’s main focus is patient care, it’s also okay to take time to work on process improvement activities that will impact that care.”
 
He continued, “Primary care is often a patient’s first access point into the Mount Sinai Health System and our primary care practices are the face of Mount Sinai. It is important that practices run well, and that staff are vested in their work in order to care for our VIPs—our patients.”
Your Practice Facilitators
George Lourentzatos
Matt Miesle
Chris Scalamandre
Podcast
 
Dr. Fields makes a guest appearance to discuss the state of primary care, changing healthcare economics to support population health, and how he uses data in his role at Sinai to address social determinants of health. He and host Saul Marquez finish the episode with a lightning round Q&A.  
 Tip of the Day
Watch 1090 Amsterdam demonstrate how they run their daily huddles. Also, check out this checklist prepared by Dr. David Coun of Mount Sinai Doctors Brooklyn Heights. What information from this checklist can you incorporate into your daily huddle?
Transformation in the News
The key to tackling physician burnout: listening to each other
The American Medical Association published this article on ways to tackle physician burnout. As explained in the article, “appreciative inquiry,” developed at Case Western Reserve University in the 1980s, guides staff through a five-step process to boost resilience and collaboration in the office setting.

“Some ways to incorporate this include appreciative “check-ins” at the start of meetings; “shout outs” where team members share something positive that they observed recently about another member’s actions or performance and “positive gossip” where staff members share favorable vignettes or inspiring patient quotes. The team also can turn a barrier into an opportunity and find the value behind a complaint.”

Think about how you can incorporate appreciative inquiry into your practice and catch someone doing something right today!

Would you like to learn more about Mount Sinai’s physician wellness activities? Please visit the Office of Well-Being and Resilience's website or contact Dr. Jonathan Ripp at jonathan.ripp@mountsinai.org .
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If you have any questions please contact Stella Safo, MD, MPH at stella.safo@mssm.edu . Is there a topic you'd like to see covered in a future issue? Reach out to Lisa Bloch at lisa.bloch@mountsinai.org .