Transcript Cities for Life Practice-Based Demonstration Project

Finding and Engaging Primary Care
Practices
Importance of Primary Care
Involvement
• Cities for Life has recognized the centrality of
primary care in diabetes management.
• It’s not enough for communities to offer a rich
set of resources that promote diabetes
management 24/7. Patients must be guided to
the availability of these resources and helped
to find those which might best meet their
needs.
Importance of Primary Care
Involvement
• Cities for Life uses patient navigators – trained
non-professionals who then help patients
consider and access resources that may be
helpful to them.
• Primary care practices refer patients to patient
navigators.
• The following slide shows a diagram of the
interactions between primary care practices, a
practice-based research network coordinating
center, patient navigators and community
resources.
Recruiting Practices
• Engage a local Coordinating Center. For
this role, consider working with a practicebased research network (PBRN).
– A local PBRN knows their practices and the practices
know and trust their local network.
– Members of a PBRN may be interested in participating
in the Cities for Life Steering Committee and serving as
the initial interface between the participating
practices and the patient navigators.
10 Essential Steps to Effectively
Engaging Physicians
•
We recommend the coordinating center follow the “10 Essential Steps to
Effectively Engaging Physicians,” by Dr. Howard Beckman (available at
http://www.cfmc.org/files/ACUploads/StrategiestoEngagePhysicians_0514
12_FINAL.pdf)
• The following steps are essential to effectively engaging physicians:
1.
2.
3.
4.
5.
Set a tone of collaboration – Make the time convenient for the clinician; go to
his/her practice. Open the conversation with, “I appreciate your visiting with us
today.”
Explain the purpose of the project. “We are looking for physicians who want more
resources for their patients who have or are at risk for type 2 diabetes. My visit
here today is tell you about the available community resources and explain our
patient navigation process.”
Be non-judgmental, allowing the clinician to become part of the solution. “We’ve
heard that many clinicians wish they had more time and solutions to offer
patients, but they simply don’t have the staff or resources. This project can help
you lead patients to resources simply by referring them to a patient navigator.”
Present ONLY enough data to inform the discussion and explain why you are
talking to him or her.
Listen carefully to his or her responses. Demonstrate you want to understand
without judging.
10 Essential Steps to Effectively
Engaging Physicians (cont’d)
6.
Engage other staff that might be present. “What do you hear from patients
as you work with them?”
7. Offer praise whenever possible. “It seems like you are really trying to offer
patients the information they need.”
8. Encourage staff to consider solutions to problems identified so the physician
won’t have to be the solution to each problem. “Can you think of ways to
respond to a patient’s needs before the doctor is involved? Have you talked
to staff in other practices?”
9. Conclude by asking if the clinician would refer patients to the navigators,
and whether the clinician would consider joining your Community Action
Team.
10. Send a follow up thank you note summarizing the results of the meeting.
Working with Practices
• The Coordinating Center gathers input from
community partners and leads the effort to
identify eligible and interested practices in
targeted neighborhoods.
• The Coordinating Center enrolls practices and
promotes quality improvement activities within
the practices.
• The Coordinating Center and the patient
navigators work with practices to establish
effective referral and tracking systems for
patients.
Working with Practices
• Use materials developed by Cities for Life to
help clinicians and staff members become
comfortable approaching patients:
– Talking points for providers (why participate,
addressing patient refusals)
– Posters
– Pamphlets
– Brochures for the waiting room