Rheumatology Care Team Models: An Integrated Approach
The Division of Rheumatology has developed and piloted a team-based clinical care model during the past three years in response to an unprecedented volume of requests for new patient evaluations and the challenges associated with the delivery of internal medicine subspecialty healthcare in satellite locations.
The typical healthcare team consists of 3-5 physicians, a nurse practitioner, a registered nurse, a clinical pharmacist, and a dedicated core of medical assistants and is structured so that all team members can work at the top of their license. The patient-away work from all clinic locations, including patient phone calls, MyChart inquiries, specialty pharmacy authorizations and medication refill requests is directed to a central clinic hub and assigned to the team member with the appropriate expertise. Two new patient coordinators receive and triage all requests for new patient evaluations.
While still a work in progress, this clinical care model has increased patient satisfaction and improved overall job satisfaction – work wellness – for all team members. An integrative approach to management has permitted an examination of potential barriers to quality care and efficiency by better aligning and unifying the efforts of the School of Medicine (faculty and nurse practitioners) and the Hospital (nurses, pharmacists, and medical assistants). Working together, the teams have developed work standards and developed protocols which a present permit a live member of the teams to answer phone calls in less than 30 seconds, decreased refill turn-around time and improved patient access from a wait time greater than 6 months to an average of less than 3 weeks. Improved Hospital employee retention has had a significant impact on overall efficiency and quality.
The essential elements of this clinical pilot include integrated management, healthcare teams where every member working at the top of license, and a centralized hub with subspeciality expertise to support satellite locations. While there is still much to do, this model provides a foundation for the expanding the University Health footprint.
From left to right: Kami Roake, Clinical Pharmacist; Nanette Hawkes, Medical Assistant; Dr. Julie Thomas, Assistant Professor, Rheumatology; Wendie Holmes-Harwood, Medical Assistant; Kristina Woolsey, Nurse Practitioner; & Laurie Demarest, RN