Through serving the Bethel housing area at Langley (Va.) Air Force Base, the 1st Fighter Wing Satellite Clinic is able to meet the 5,000 residents' healthcare needs and boost its own productivity.
Located four miles from the base and the 50-bed 1st Medical Group hospital, the clinic provides primary-care services, including family practice, pediatrics, gynecology, dental care, a laboratory and a small pharmacy. To offer one-stop efficiency, the staff reorganized the clinic's relationship with the main hospital and its internal structure.
Starting July 1, 1993, the clinic's chief began reporting directly to the commander of 1st Medical Group, which eliminated two management layers. The 14 staff members who previously reported to departments in the main hospital now report to the clinic's chief.
Reorganization prompted the small staff to take on unusual roles. One dental technician now is certified as an emergency medical technician.
"When you empower people and you give them a free reign, they will do things beyond what you can imagine," said Col. Anthony M. Policastro, M.D., commander of 1st Medical Group. Teamwork brought patient-service improvement without financial investment.
New programs include:
A telephone triage program to safeguard against clinic overcrowding.
A tracking system to ensure follow-up on referrals.
Coordinated medical and dental appointments.
A computerized immunization tracking system pushed the immunization rate in the 1,400-unit housing area to over 90%, according to Dr. Policastro.
An unexpected drawback to providing complete care is the increased demand for services, according to Lt. Col. Barry MacDonald, chief of the clinic and a pediatric dentist. "Patients can get what they want at any time."
"One of the nice things about having only 5,000 patients is that you get a feeling for what they need," Dr. Policastro said. "Everybody knows everybody. That's something that doesn't happen very often in the military."
The satellite clinic now screens and treats 43% of patients within 15 minutes, compared with 26% treated in that time at the primary-care clinic at the main hospital. In addition, the satellite markedly improved accessibility.
"The staff has just gone above and beyond to fill the needs of our patients," Lt. Col. MacDonald said.