It would be easy for a program that has reduced ER admissions by more than half to rest on its laurels. But that's not the mission of UCLA's Medicine and Pediatrics Comprehensive Care Center in Santa Monica. A program inspired by the Patient Voice project, MyCare is being studied for its emphasis on patients' thoughts and feelings about their treatment and utilizing that information to improve healthcare and increase patient satisfaction.
MyCare was developed to address the needs of patients at the Santa Monica-based office who have had two or more visits to the Emergency Department within a six-month period. Although these patients usually have a chronic health condition — unstable diabetes, congestive heart failure, recurrent bowel obstructions or the like — any patient who has used emergency services may receive this attention.
Once these patients are identified, they are assigned a healthcare team that includes a pharmacist, a registered dietitian, a psychologist and a care manager, in addition to their primary care doctor. These professionals spend time individually with the patient to help him or her manage the condition more effectively and avoid exacerbation that leads to an ED visit.
The program's success can be measured by the most recent data: ED visits in 2014 were reduced by 55 percent; all hospital admissions decreased by 48 percent; and re-admissions to the hospital within 30 days saw a 33-percent decline.
Improving the program with Patient Voice
Although these statistics are promising, Negar Kahen — a medical student in the David Geffen School of Medicine at UCLA — wants to further analyze the success of the project through the parameters of Patient Voice. The Patient Voice toolkit offers providers a systematic way to understand feedback from the patient's perspective. To this end, Kahen and her team are performing interviews with patients enrolled in the MyCare program to hear their thoughts on the benefits and deficiencies of their experience in the program. Physicians will also be interviewed to evaluate how the initiative is perceived from the provider side.
Along with Kahen, the Patient Voice project team consists of another medical student, a resident and Dr. Alice Kuo — director of the combined residency program and developer of the MyCare program — as well as those involved in the program itself. After each interview is complete, the team will discuss the results of the interviews and, in a synthesis meeting, identify common themes from which to develop an action plan that improves upon the program for the future.
A unique perspective
Kahen has personally conducted several interviews and contacted all the patients enrolled in the MyCare program to gauge their interest in providing feedback. Having been involved in the program for more than a year, she is looking forward to the data they will collect as they complete the Patient Voice project. "It's unique because we listen to the patients first and then develop a plan, whereas in other projects, the physicians would make a decision and develop a plan. But starting with the patient needs, especially in this population, can really improve the quality of our care," she says.
Results from the Patient Voice project will form an important part of MyCare, particularly as they are implemented across the UCLA healthcare system in the foreseeable future.
By Kyleigh Roessner