The Journey of Care

Joshua Kline, MD, chief medical officer, Parkview Physicians Group, has a passion for helping people. Given his career path as a physician, that may seem evident, but treating patients and helping people are not always the same thing. The needs of patients, how they choose to receive care and what they desire from their experience, continue to evolve. At Parkview Physicians Group (PPG), patients are finding they now have more people collaborating on their care, partnering together with them on their health care journey. Over the past few years, Kline has worked to help PPG evolve its care model by spearheading the group’s initiative toward patient-centered care.

“We’re asking questions like, ‘How do we meet patients’ changing needs? How do we put them in control of their own journey,’” says Kline. “We continue to focus more on the patient by improving the process.”

Kline serves as the physician leader for PPG’s primary care service line, a role he takes to heart. As the health care environment evolves, he understands that the traditional delivery system has to change. To be successful, he says, it requires a commitment from everyone involved.

“It’s important that we work in teams to bring value to our patients,” says Kline. “As a team, we can surround the patient with the care they need.”

What this means for PPG patients is an enhanced care delivery method called, aptly, the patient-centered care model. It considers what a patient needs as he or she embarks on a journey of care, and then rises to meet those needs. 

“We look at the patient instead of the medical record,” explains Kline.

Each patient is served by a core care team as well as an extended care team. The core care team consists of two clinical staff which may be a medical assistant or a nurse, along with a nurse practitioner or physician assistant, and a physician. It also includes the front office staff, which plays a significant role in helping the patient feel welcome and comfortable in the clinic environment.

The extended care team assists when patients need additional care or resources outside the primary care setting. A nurse care coordinator works with high risk individuals or anyone needing follow-up services. A behavioral health professional such as a licensed social worker connects people with counseling, community services and other resources to help improve the opportunity for wellness. A pharmacist reviews prescriptions, addresses potential interactions and helps educate patients about their medications.

“Some folks need an extra level of care, such as social or emotional needs, that fall outside what we provide as physicians,” says Kline. “With this enhanced model of care, now we have additional resources to offer.”

In this collaborative setting, daily huddles allow the team to discuss goals and engage each staff member in patient care, no matter what his or her role. It’s a philosophical change that allows care providers to tailor a personalized health journey specific to each patient, helping those patients reach their own unique goals.

“Now everyone is part of the solution and partners with the physician.” explains Jerry Grannan, chief operating officer of PPG. “Patient care becomes a team activity.”

Kline agrees. “It helps everyone understand the ‘why’ behind what we do. It unlocks all kinds of ideas,” he says. “It’s about how we collectively work together better.”

At two new facilities that recently opened, the St. Joe Center Road Family Medicine and the Lima Road Family Medicine locations, the model even goes beyond the care team; it incorporates facility design, as well. The layouts incorporate an onstage/off-stage concept to minimize intrusiveness to patients. Paperwork, prep and back-office functions take place behind the scenes so the patient receives the full attention of the care team, without administrative distractions. In fact, one of the first things people notice when they visit one of these facilities is the peaceful atmosphere.

“When you walk in the door, you’re not hearing the phone ringing constantly,” says Grannan.

The welcome area features short counters that allow patients access to the reception staff without putting a barrier between them, and incoming calls are not received in this area. Exam rooms feature two doors, one for patient entry and one for caregiver entry. Wide hallways and directional cues allow patients to comfortably move through the facility on their own. The layout puts people at ease and allows more effective interactions between patients and caregivers.

“These facilities amplify the ability to provide good care,” explains Kline.

None of this happened by accident. More than two years ago Kline assembled a team and began investigating new ways to approach the care experience. They started looking at national models, made site visits and examined their own data. They identified six pillars of work that comprise patient-centered care and engaged staff around making improvements. Their ultimate goal is to keep people healthy –and that’s significantly different than simply treating illness.

“It really connects with why we went into medicine in the first place,” says Kline.

The experience of care provided at the St. Joe Center and Lima Road facilities is only the beginning for PPG.

“We’re in the infancy of the journey,” says Grannan. “We’re looking to expand the process across our entire care network. There’s really no end to how we continue to evolve this.”

PPG is transforming care to improve quality, create a better care experience for the patient, and improve the work environment for physicians and staff. Based on a foundation of continuous improvement, the end goal is patient health. After all, as health care continues to advance, so must the system that delivers it.

“We’ve spent a lot of time thinking about the journey of care and how the future will look,” says Kline. “The great thing about this is that we’re looking at it through the lens of process improvement. We’re recognizing the changing needs and desires of our patients and trying to adapt. We want to help people make transitions and provide the best value of care.”

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