May 15, 2016

Improving Outcomes with Small Clinical Teams

New incentives and payment models are inspiring health systems to escalate health care delivery innovation in many ways. Even in this continuously advancing environment, there is still one obvious method of care and financial outcome improvement that continues to be overlooked by the vast majority of systems.

Utilizing a small clinical team to design and administer care to specific factions of patient populations is a modest innovation that comes with low risk and high potential to be a win for profits and patients alike.

A Real-World Example

Essentia Health, a care provider in Duluth, MN, serves as the perfect example of the power of small clinical teams. In 1998, they assigned a team to care only for patients who had been released from the hospital after receiving treatment for congestive heart failure. At first, that team consisted only of one full-time nurse practitioner, one full-time medical assistant, a part-time medical director, and one cardiologist available on-call.

The Results

From the beginning, the success of the program was clear: patients were healthier, the number of hospitalizations decreased, and the number of emergency room visits plummeted. By 2016, Essentia’s team had expanded to include seven nurses and seven nurse practitioners, tasked with overseeing the care of more than 2,500 post-discharge congestive heart failure patients.

Providing treatment to patients freshly discharged from the hospital after congestive heart failure had been a big challenge for Essentia before developing the small clinical team solution. Developing a dedicated, small-team approach focused on time, trust, and education to overcome the confused state that most patients were in following a traumatic health event.

An Overlooked Solution

Any provider can attest that it’s extremely rare to find a device, drug, or innovation that can provide a double-sided win that boosts patient outcomes while reducing costs. At the same time, simple measures like the one taken by Essentia often go unnoticed. Few health systems are copying the successful model that has worked wonders for Essentia and a select few others around the nation.

Providers may view small, full-time teams as a potential net-negative because of fee-for-service reimbursement. This becomes a catch-all reason never to pursue such a strategy. In actuality, utilizing small, precise teams in situations where they can be effective is simply low-hanging fruit that no organization can afford to overlook.

Senior leaders at health systems would be wise to look to small clinical teams for a cure to some of the issues that ail their organizations.

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