Care teams for expectant mothers and babies are often made up of clinicians across multiple specialties and different locations. This means patients with complex cases may have to travel or be transferred to numerous sites in order to receive the care they need.
These moments, often at the most critical stages of pregnancy, create disruptions in care continuity and increase patient safety risks.
Integrated Care—an Efficient, Patient-Centric Model
Envision Physician Services’ integrated care model offers a more effective, patient-centric approach to care for moms and babies. Our comprehensive women’s and children’s services eliminate silos around teams, empowering our clinicians to more fully consider each patient’s journey and work together to ensure continuity of care.
As a leading national medical group, Envision delivers care when and where it’s needed most. We support more than 120,000 newborn deliveries annually and provide compassionate, high-value care throughout each stage of pregnancy.
Maternal-Fetal Medicine
OB-GYN Hospital Medicine
Neonatology
Pediatric Hospital Medicine
Universal Newborn Hearing Screening
Pediatric Emergency Medicine
Pediatric Critical Care
Through collaboration, shared best practices and a patient-centric approach, our teams deliver successful outcomes for patients, improve the patient experience and create a more effective care continuum for our hospital partners.
Nurse Navigators—Patient Advocates
The journey for both mothers and newborns can be fraught with unexpected developments and confusion. Patients deserve to have advocates that help them navigate their journeys.
Envision’s perinatal nurse navigators personalize maternal care and support each patient’s journey through pregnancy, NICU stay and discharge. By linking expectant mothers and newborns to qualified specialists for birth, NICU and subsequent lifetime follow-up care, this model elevates patient experience and outcomes.
Envision’s perinatal outreach nurses support top-of-scope care at our partner facilities, allowing more infants to receive care in their communities without requiring transfer to outside facilities.
We recognize that metrics and outcomes don’t tell the whole story of the patient journey. To develop true data insights, quality programs must perform holistic, multidisciplinary reviews of targeted data.
That’s why Envision develops programs that are large, diverse and cohesive. By implementing multidisciplinary teams and capturing targeted data, we help our partners institute sustainable quality programs that implement meaningful changes and improve outcomes.
For one Envision partner facility, our quality reviews pinpointed a number of process bottlenecks. By engaging the clinical teams at this facility, Envision was able to ensure buy-in for process improvements and revamped workflows that significantly boosted premature infant survival rates:
0% to 25% in infants weighing less than 500 grams
40% to 70% for infants weighing 501-750 grams
76.6% to 83.3.% for infants weighing 751-1,000 grams
To see how Envision Physician Services’ integrated care models helped this partner facility improve the overall quality of its care and elevate patient experience, read our case study.
As America’s leading medical group, Envision Physician Services delivers care when and where it’s needed most and treats more than 32 million patients each year.
Working with our hospital partners, we often provide care for patients with complex and chronic medical conditions.
Our hospital partners face unique challenges as they work to reach the Quadruple Aim of better outcomes, lower costs, improved clinician experience and better patient experience.
For patients with progressive illnesses, long-term health needs and multiple comorbidities, their continuum of care often involves an array of clinicians from multiple specialties and can require them to travel to numerous sites to receive the care they need.
Envision’s commitment to integration means we offer a more effective, patient-centric approach to care delivery--one that unlocks value for our hospital partners and our patients by streamlining the continuum of care and improving care quality.
Integrating emergency medicine (EM) and hospital medicine (HM) services eliminates silos around those individual teams, helping EM and HM clinicians more fully consider each patient’s journey and work together to ensure an uninterrupted continuity of care and achieve better outcomes and patient experience.
Ongoing care for complex and chronic conditions often involves a number of clinicians, including the patient’s primary care physician and multiple specialists. Envision’s integrated practices facilitates streamlined communication between these clinicians, helping them more efficiently address the needs of their patients.
Our integrated care model establishes a cohesive team of emergency medicine physicians and hospitalists who are well-equipped to work together and tackle even the most challenging of cases.
Working together, the integrated EM-HM team helps:
identify at-risk patients;
engage and educate patients and families;
set realistic expectations;
navigate patients through the complexities of their condition and the health care system;
support clinical care by streamlining communication and the transmission of clinical data between the emergency department and the inpatient unit;
And reduce administrative burdens.
For one Envision partner facility, our integrated EM-HM services improved communication and ensured alignment across the care continuum. Prior to partnering with Envision, this facility struggled to reach acceptable CMS quality benchmarks for patient readmission rates stipulated in the Affordable Care Act, triggering sizable reimbursement penalties. After implementation of our integrated services, the hospital’s 30-day readmission rate was reduced by 55%, helping avoid further revenue loss as a result of Medicare reimbursement penalties.
See how Envision Physician Service’s integrated care model helped this partner facility’s EM and HM services thrive together. Case Study
Envision’s focus on evidence-based medicine creates higher levels of clinician engagement and satisfaction, and it allows us to deploy advanced data analytics to provide both clinicians and hospital partners with real-time feedback on performance and outcomes.
An effective management approach must also be able to address multiple specialties’ distinct practice patterns and rapidly evolving clinical protocols. Envision’s integrated care services provide tremendous insight to each patient’s clinical journey, improving care across the continuum.
Often Envision emergency department and hospitalist performance metrics are connected to the hospital’s key operational performance metrics. For one Envision partner facility, our integrated EM-HM services improved performance across several metrics related care quality and efficiency:
75% improvement in arrival-to-greet time, from 40 minutes to 10 minutes
70% reduction in patient leaving against medical advice (AMA), from 3.27% to 0.98%
43% improvement in low-acuity length of stay, from 151 minutes to 86 minutes
25% improvement in admit length of stay, from 353 minutes to 264 minutes
To see how Envision’s integrated care model helped this partner facility reach its goals and improve the overall quality of its care, read our case study.
Learn how an Anesthesia Care Team model was developed for this small rural Louisiana hospital to meet the needs of their health system.
Goal
Alignment with Health System Requirements
At a small hospital in rural Louisiana, Certifi ed Registered Nurse Anesthetists (CRNAs) had been providing quality anesthesia services under the supervision of the surgical staff. However, the hospital sought to partner with a large health system, and the health system’s by-laws required a dedicated anesthesiologist to provide oversight of the anesthesia department.
Strategy
Deployed an Anesthesiologist
Envision Physician Services partnered with the hospital and immediately deployed an anesthesiologist to facilitate the adoption of practices that were in line with the expectations of the hospital’s new health system partner. The entirety of the CRNA practice was retained, with only one provider retiring shortly after implementation.
Results
Improved Anesthesiology Program
With the help of Envision Physician Services' experienced clinical and business leaders, the hospital revised its own by-laws to align itself with its new health system partner and:
Developed a cost-effective, medically-managed rural anesthesia program
Fully leveraged the CRNA practice in a non-opt-out state
Improved operating room administration
Gained compliance with the health system’s by-laws
Implemented a robust quality reporting program with recurrent metrics
Supported anesthesiologists with clinical protocol development.
To prepare for an anticipated increase in patient volume at this hospital, Envision Physician Services worked collaboratively with emergency medicine physicians, case management and others to improve system-wide patient flow.
Strategy
The hospitalist team focused on coordinating early morning discharges for patients who are ready to leave the hospital. Early morning discharges, when medically indicated, reduce average lengths of stay (ALOS), increase patient satisfaction and allow for new direct admits as well as admissions from the emergency department (E.D.). Improved flow from the E.D. effectively increases capacity. Over a six month period, Envision Physician Services provided the following tools and resources:
Lean facilitation and coaching in Studer Group® tactics
Training in early morning discharge process Implementation of Rapid Admission Process and Gap Orders™ with Rounding Charge Capture (RAP&GO™/RCC) patient flow software
Using our rounding and charge capture system throughout the day, the hospitalist team and case managers began to effectively identify patients who could be scheduled for discharge the following morning.
Results
The hospital saw a 47 percent increase in discharges occurring before 11 a.m.
