This story originally appeared in IHI's 2008 Annual Progress Report.
“Continuity is king,” says Carolyn Shepherd, MD, Vice President for Clinical Affairs at Clinica Campesina Family Health Services, a federally-qualified community health center with three locations in north central Colorado.
Knowing the positive impact that continuity of care has on patient engagement and satisfaction, and ultimately on outcomes, Clinica Campesina has kept continuity in sharp focus through all its improvement work. “We try to drive up continuity in every change we do,” says Shepherd.
Clinica uses several approaches that support continuity. First, all three locations have been renovated and organized into “mini-clinics” or pods so that a consistent team of providers works in a designated physical space caring for the same panel of patients. Open access scheduling means that most patients can get same-day appointments
, reducing the use of hospital emergency rooms for acute and primary care, and also reducing the clinics’ no-show rates.
Additionally, group visits
, which combine a physician visit with an educational and support experience, have been so popular and successful that Clinica now offers them for diabetes, prenatal, depression, ADHD, and chronic pain patients. “That sense of community and continuity has been very effective in motivating patients’ compliance with needed self-care,” says Shepherd.
Data show these steps have driven continuity (patients seeing a member of their own team) at all three clinics toward and occasionally above 90 percent. Now, says Shepherd, the clinic is working toward a new goal: that patients will see their individual primary care provider 90 percent of the time.