CitySquare clinic scores big!

What follows is a direct, cut and paste email message that I received recently from Frances Martinez, Operations Manager for CitySquare's Community Health Services. 

Our clinic, located in South Dallas-Fair Park just off the intersection of Malcolm X and Grand Avenue, scored big in the latest Health Texas Provider Network (the Baylor Health Care System's physicians group) audit of our Adult Preventative Services. 

The translation is very simple, and most encouraging:  our clinic ranked second among all the HTPN clinics in the system!  This includes the clinic that I call my medical home out in the North Dallas suburbs! 

Great work, CitySquare health care team!  Great work! 

Our patients receive the best care possible, and evidently the best care available! 

 

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Everyone,

Please see below, we are #2 in HTPN for the July-September Adult Preventative Services (APS) audit!!  Congratulations everyone!  It is definitely a team effort from scheduling WWEs, to requesting the tests, to putting in the orders, to scheduling the tests.  Please take a moment and give each other a high five!

 

Rank Practice Name

POA

1 Signature Medicine

N 278

95.41%
 

2 City Square Community Health Services

N 643

92.87%

Frances Martinez

Operations Manager

CitySquare-Community Health Services

2835 Grand Ave.

Dallas, TX 75215

214-421-1783

francema@baylorhealth.edu

CitySquare Community Health Services receives highest rating as "medical home"!

Great news for CitySquare's Community Health Services!  The National Committee for Quality Assurance, a private, 501(c)(3) not-for-profit organization dedicated to improving health care quality recently released the results of the following practices as receiving the organization's highest quality ranking:

Baylor Family Medicine at Legacy
Family Medical Center at Terrell
Baylor Occupational and Family Health Center at TI
City Square
City Square- Pediatrics

Since 1997, our Community Health Services department has partnered with the Baylor Health Care System and Health Texas Provider Network to bring extremely high quality medical services to inner city Dallas.  The following letter tells the wonderful story:

Congratulations!

We have not only completed the application process for NCQA Patient Centered Medical Home recognition for all of our adult, geriatric, residency and pediatric practices, but have now received the results. All practices received the highest possible level of recognition. Level 3 is the highest level for Electronic Health Record (EHR) practices and the highest for paper practices is Level 2. Out of a possible 100 points, our EHR clinics scored in the mid-90s on average. This means that we now have 60 practices, 271 physicians, and 59 non-physician providers (APRNs and PAs) in recognized medical homes. This is the second highest total of any system in the nation.

During this implementation and application process we have seen engagement in new discussions around topics like pre-visit planning, ambulatory care coordination, patient/family activation and patient access. More practices have extended hours than ever before. Heart failure readmissions have dropped significantly. Diabetes scores have improved. Guidelines have been standardized across our practices including many specialty practices. Insurers are coming to us asking for PCMH contracts that allow for new funded resources and opportunities for shared savings.

The journey started many years ago with the Quality committee's work on quality standards and measurement of preventive services and diabetes metrics. It continued with the work of the Service Excellence committee, the Ambulatory EHR committee, Patient Safety committee, Disease Management and EHR Content Committee, and then the PCMH Task Force. The medical home applications included work from all of these committees.

Join me in thanking the chairwomen/chairmen and members of these committees for their hard work as well Sarah Gahm and David Winter for their leadership. Of course we should especially thank Pat Link, the PCMH Director, and her team of consultants, writers and contributors: Endia Kendrick, Michell Martin, Niki Shah, Patrice McConnell, Ashley Wood, Vivian Plumlee, Joe Brumbelow, Nancy Trinh, Kelly Risinger, Beulah Casey, Cynthia Granade and Tim Houtchens. We also need to thank our physician auditor team who gave personal time to audit over 2,300 patient records, Drs. Hickl, Astbury, Aponte, Molen, Massey, Stroud, Thompson, Bassel, Berry, Caudill, Garcia, De Leon, Holbrook, McMillin and Sharp.

The journey of course never ends. We are already implementing the new PCMH criteria into our practices. Many of these are meaningful use criteria. We are also preparing to apply for NCQA recognition for our new practices under these new guidelines as well as preparing to support BQA non-HTPN practices.

We are blessed to have a group of physicians, nurse practitioners, physician assistants, administrators and staff who strive to provide safe, effective, efficient, equitable, timely and patient centered care. It makes our work more enjoyable and meaningful.

Thank You All,

Cliff Fullerton, M.D., M.Sc.
VP Chronic Disease Baylor Health Care System
Chief Quality Officer HTPN

What a privilege to be working in tandem with our partners at Baylor and Health Texas!  CitySquare continues to help provide the highest quality care possible to low income neighbors in the inner city of East and South Dallas. 

Way to go, CitySquare team!

Evidenced-based care

On Thanksgiving day, while walking down a very uneven sidewalk toward the park with the grandchildren, Brenda tripped and fell.  She broke her fall by stiff-arming the sidewalk.  She bumped and scratched her face and badly bruised her hand.  She shook off her injury and went on to the park! 

The next day, after a short visit with her doctor, she went to a local hospital emergency room to have her hand checked out.  After a lengthy wait and a couple of rounds of X-rays, she learned that no bones were broken.  During the exam, the examining nurse practitioner (she never saw a physician) questioned her about the scratch on her face, finally suggesting an MRI to make sure there were no broken bones in her face.  Brenda assured her that such a procedure was not necessary and that another X-ray would suffice, if even was really necessary. 

She left glad to know that there were no broken bones and with her hand and arm wrapped up to the elbow.  She also wondered if the attending staff was guilty of over prescribing treatment. 

In a "fee for service" health care system like we now experience, her suspicions make a lot of sense. 

Then, on Sunday morning, The Dallas Morning News carried a front page story on evidence-based medicine and cost sharing and the move of the Baylor Health Care System to such a strategy for providing care to its patients (by the way, the ER Brenda visited was not a Baylor hospital!). 

No one wants to talk rationally about health care realities these days.  But, in view of rising costs and our return in health and wellness benefits for what we pay, the time has come for serious discussions.  From the report it sounds as if Baylor will lead the way in that much-needed conversation.  Good for them! 

Be sure and read the story, "Baylor will try new Rx," by clicking here.

Hot streets

"There are no statistics on the street."

(Bernard Glassman and Rick Fields, Instructions to the Cook: A Zen Master's Lessons in Living a Life that Matters, page 149)

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The thermometer in the car read 113. It felt hotter.

At 3:30 p.m. we were just getting around to having lunch. The walk across the parking lot felt like a sauna complete with built-in aerobics.

113.

Not sure how accurate the instrument was, but clearly, well over the century mark.

My mind went to the street.

What's it like "out there" when it's this hot?

Even in the new homeless assistance center, The Bridge, Downtown there wouldn't be enough cool spots to accommodate the crowd.

Looking for shade. No place to shower or rest or use "the facilities."

113.

What would it be like?

_________________________________

Our Resource Center building on Haskell Avenue that doubles as our headquarters is now surrounded by Baylor University Medical Center development. The last pieces of the build out include a surface parking lot directly behind our building that wraps around us to the northeast and a multi-story administrative office building and parking garage just across Crutcher Street to our southwest.

Watching the construction has become a daily enterprise as we come and go from our offices. I've been amazed by the pace of the construction.

It's been hot.

113.

I've watched the labor closely.

Mostly Hispanic gentlemen who demonstrate great skill and impressive work ethic, to say the least. I've also noticed that they remain focused and cheerful.

One day recently, I watched as two men took alternating turns with two sledge hammers driving what started as a 5-foot stake in the hard dirt of the parking garage site. As they finished, I cheered them on. We shared a laugh and a brief exchange.

Hard working guys.

113.

Friends in the heat, whether at work or just trying to survive difficult circumstances.

Hot streets.

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New partnership means better access to better meds for the working poor in Dallas

Last Wednesday, Central Dallas Ministries (CDM) and CommuniCare, a non-profit organization in South Carolina, unveiled an exciting new partnership that will bring new prescription medicine benefits to thousands of low-income patients.

All of the major pharmaceutical companies in the United States have "indigent patient" medication programs that offer free medicines to low-income patients who qualify. The challenge with these programs has been with the procurement process. Until now, the process involved a physician or other medical staff being required to complete a rather long and tedious application every time a medication was prescribed. The time and administrative paper work requirement made the programs difficult to use, especially for clinics like ours that serve thousands of patients with a limited staff and few volunteers.

CommuniCare, under the leadership of Ken Trogdon, has worked hard over the past several years to develop a relationship with all of the major pharm corporations and a new process of accessing the indigent drug program. Thanks to CommuniCare, now our patients will need to qualify for such programs by means of one annual application and a $20 registration fee. One form and one fee for any and all prescriptions from any of the companies with the programs--huge improvement!

The outcomes for CDM and our patients are exciting. State of the art medications will now be available to patients at no cost beyond the registration fee, a fee we pay when patients cannot. We will achieve significant cost savings that will allow us to purchase more medications that are affordable and treat more patients in our clinic.

Beyond the benefit to CDM, as the new process is perfected here, we hope to "roll it out" across the Dallas area among our indigent health clinic partners.

This new development promises to have major positive consequences for the uninsured working poor men, women and children who come to us for care, as well as for our other partners who face similar challenges.

We are grateful to our partners at CommuniCare who are moving outside the state of South Carolina for the first time in this new initiative. As Ken says, "If we can make this work in Texas, we can make it work anywhere in the nation."

Thanks also to Dr. Jim Walton, Vice-President of Health Equity for the Baylor Health Care System and CDM Board member, for his tireless efforts in seeing this new partnership become a reality.

To view a WFAA Channel 8 television news report on our press conference announcing the new partnership just click on this link:

http://www.wfaa.com/video/index.html?nvid=232336&shu=1

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