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Managing the Continuum

Marianne Aiello, for HealthLeaders Media, October 13, 2011
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This article appears in the October 2011 issue of HealthLeaders magazine.

When Mayo Clinic leaders decided to improve how they manage the continuum of care they started with the patient population they know best—their employees.

Four years ago the Rochester, MN–based health system launched an initiative with its 35,000-strong workforce testing for a way to streamline care so that it improved patient outcomes while minimizing expenses. They developed a user-friendly electronic medical record so any Mayo clinician the patient sees will have immediate access to the patient’s health history. They created express care centers, modeled on retail clinics, and a medical home project, targeting people with chronic conditions. And they piloted using time-saving online consults via e-mail and video chats.

At the heart of this project is the belief that the patient—not the hospital—is the primary site for patient care and, therefore, improvements must be made to provide the patient with seamless care within and beyond hospital walls.

“I start with the patient because the focus is his or her care and figuring out how we can make care deliverable, usable, and accessible to the patient,” says Patricia Simmons, MD, executive medical director of health policy for the 21-hospital system. “It’s philosophically different if you approach care in a different way—you come up with other solutions.”

Once project leaders saw success in their employee-based effort, they rolled it out to the broader patient population. Since the initiative launched in 2007 Mayo realized a 4% decrease in the cost of care per patient per month. The project also yielded an 8% decrease in hospital days for all patients and a 15% decrease in hospital days for Medicare patients.

“One of the neat things that can happen is when you free up hospital beds then you’re able to provide tailored care for other patients, so it’s good for the institution to triage the use of those hospital beds,” Simmons says.

A growing number of organizations are finding that process changes and sometimes even simple tweaks can save time, free up patient beds, decrease insurance denials, boost patient satisfaction scores, and even improve physician relations.

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