Case Study: Heartland Health Centers, Chicago, IL
Heartland Health Centers is a federally qualified health center serving Chicago’s north side. They operate eight community health centers and six school-based health centers. Four of their SBHCs are well established in Chicago. Two additional SBHCs opened in 2015 in the village of Skokie, a northwestern suburb of Chicago. The organization decided to pursue Joint Commission (JC) accreditation and medical home certification because of their dedication to safety and high quality health services. They previously received JC Accreditation in 2013 and are up for renewal in 2016.
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The Approach Taken
Preparing for the JC onsite survey was a team effort. There are five managers for their 14 sites and they’d been working together to prepare. They utilized QI nurses to train the managers on the accreditation standards, including infectious disease control, CLIA waiver requirements, and safety. The managers then did tracers (or walk-throughs) of clinics they weren’t managing to assess compliance in the various areas. They recruited IT staff to pull data reports as needed. To meet PCMH certification requirements, Heartland invested in several program improvements. These included creating a patient portal, establishing care coordination teams, and implementing a system to assure students were scheduled, as often as possible, with the same primary care provider.
The greatest challenge for the Heartland Health Centers has been coordinating preparation activities between five managers and 14 sites. In addition, clinic staff members are busy—so it could be a struggle to keep the process moving forward.
“We had some confusion and misunderstanding on the part of parents with the promotion of the PCMH model,” reported Maria Paredes, RN, Manager of the SBHCs (personal communication, March 14, 2016). As the importance of a primary care provider has been stressed, some parents feared losing their community provider if they accessed SBHC services. This has required ongoing education about the complementary role of SBHC services and PCMH.
Ms. Paredes believes the process has improved patient care, particularly follow-up and care coordination: “It was a good choice for us given the Joint Commission’s long history of assuring safety and quality.”
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TABLE 6: Joint Commission PCMH Standards
The Joint Commission’s Primary Care Medical Home Certification option is based on the Agency for Healthcare Research and Quality’s definition of a medical home, and includes these five operational characteristics.
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Note: These measures are validated by Survey Activity: Opening Conference/ Organization Orientation, Governing Board Session, Clinical/Leadership Sessions, Patient Tracer, Continuity of Care System Tracer, Medication Management System Tracer, Data Management Systems Tracers, and Competency Assessment.