In the past three years, Erie Family Health Center has boosted the portion of mothers who seek prenatal care in their first trimester to 77% from 44% and reduced babies with low birth weight to 5% from 8%, all while seeing a 73% increase in patients.
The effort began when nurse midwives said they were concerned that collaboration was lacking, resulting in fragmented services, an opinion later independently expressed by obstetricians and case managers, says Xichel Woods, president and chief executive officer of the Chicago-based center, which has eight ambulatory-only locations and saw 28,000 patients in the year ended Oct. 31.
A process-improvement team composed of physicians, behavioral health therapists, case managers, nurses and others worked to design a model to best serve a population that is 87% Hispanic, 70% low-income and 53% uninsured.
This team produced a comprehensive patient-care model that features multidisciplinary teams, co-location of disciplines within a clinical area, defined roles and monthly review meetings.
For this work and the results it has produced, Erie Family Health Center has won the Spirit of Excellence quality award.
The model did not fall into place easily, Woods says. "There were various and fairly vigorous debates as to what the model needed to be," she says, but the team reached an understanding on the tough questions.
The reaction "has gone from a benign acceptance of a nice theory to a truly committed buy-in."
Lee Francis, vice president of medical services and medical director, says his staff immediately understood the need. "They're totally mission-driven," he says. "They work at Erie because they want to serve the community."
Gil Reid, chief obstetrician-gynecologist, remembers hesitation related to the burgeoning volume, which recently has begun to test the facility's physical limits.
"The more capacity we offer, the more patients we see," he says. "Every time we add a doctor or a midwife or open up a new schedule, it fills."
The new care model has cost the center $143,200 for renovations and equipment and another $102,000 annually for two new positions, Woods says.
Erie is investing another $410,000 in renovations and equipment that will be in place by spring 2006.
"We believe in quality and we know that pays for itself," she says.
Scott Murray, who judged the quality category, says Erie presented a strong empirical case and a healthy sense of teamwork.
"They clearly had some nice data to support their effectiveness," says Murray, network behavioral healthcare line director at VA Healthcare Network Upstate New York, Albany. "They both gave it the attention and did it in a nice way that showed real investment and creativity."