Hospital improves patient care, wait times with integrated care approach

by Jul 6, 2015NEWS ka-no-he-da0 comments





The Cherokee Indian Hospital is working to improve the overall care of its patients as well as improve appointment access with its integrated health care approach.

“Patients can come to their appointment, and they’re taken care of wholly,” said April Ross, RN case manager.  “The whole patient can be taken care of.  They can come see a pharmacist, a behavioral health specialist, a nutritionist, their health provider, a nurse.  We all take care of the patient in a team approach.”

The integrated health care approach, taken from a model of the Southcentral Foundation which provides health care for Alaska Natives, involves providers broken down into teams known as pods.  “It’s an interdisciplinary team taking care of the patient’s needs, and they can get it all in one visit or they can be separated into different visits,” said Ross.  “It’s a team approach to care.”

Dr. Carmen Nations, staff pediatrician, related, “Part of the team approach is that maybe not everyone who was coming in and taking appointment time needs to come in and take appointment time.  If you just need to talk about your referral, if you just need to talk about your medication refill, or you just want to talk to a nutritionist, we can do that now without you sitting in the doctor’s waiting room.”

She said patient service has increased since the integrated approach has been implemented.  “We’ve seen a huge decline in our no-show rates, and I think that is because they know when they come who they’re going to see and that they’ll see friendly faces, familiar faces, people who are happy to see them.  People used to call and we’d say, ‘call back tomorrow,’ and that’s not the case anymore.  Now, if the patient calls they should obtain an appointment really when they need it…that’s our goal – to really give patients what they need.”

Ross said one of their goals is educating patients about the program and how it can help them.  “I don’t think they understand the services that we can provide.  They can get all things in one visit in a day.  And, I don’t think they understand that they don’t have to see a doctor each visit.  They can call and talk to a nurse and see what the nurse can do for them, to determine if they can have their needs met by another provider such as a pharmacist.”

Cyndi Postell, RN case manager, said the program has been especially helpful to elders of the Tribe.  “For them to be able to come in and get everything done that they need in one day and not have to arrange for transportation three or four times helps them.  They seem to like it.”

Ross said pod staff will review a patient’s chart the day before their appointment to see which services they might need during their appointment.  They will make sure the proper team members, which could include pharmacists and nutritionists, meet with the patient during their visit to discuss all areas of their health.

She said the integrated health care approach has helped communication throughout the hospital staff.  “It has helped us all work better together because Pharmacy understands what our issues are in our department because they are right there in there with us.  They see our struggles and we see their struggles.  It has just helped us become better team members.”

Ross related a story of a patient of hers that had been admitted to another facility.  “They were trying to do discharge planning, and he was really adamant that they contact his nurse (me)…he told them that he has a nurse, he has a pharmacist…this approach helps build trust.”

Postell added, “I think it’s really important that they have that go-to person; that they are able to call that person and get whatever their need is that day taken care of.”

Sonya Wachacha, Director of Nursing, said the hospital is really working for excellence through the integrated care team approach, founded on the Patient Centered Medical Home structure, and related they are shooting for the Malcolm Baldrige Award, a Presidential Award given out for excellence in quality.  “That’s one of the things that we’re striving for.  It’s a journey for us.  It’s about caring for our patients through process improvement.”

Wachacha is also excited about the new facility and what it will bring as far as process improvement.  “Sometimes, people will build something and then shove their work processes into it, and so the really cool thing about our hospital is that we’re really building it around work flow.  We’re building it to facilitate the flow of patients in an effort to be a Medical Home to our Cherokee community.”

She said the pod space at the new facility is made to enhance communication between team members and decrease provision of care in a siloed method.


Cherokee Indian Hospital phone numbers

(828) 497-9163 main phone

Blue Clinic – extension 6602

Green Clinic – extension 6228

Analenisgi Behavioral Health – extension 7550

Orthopedic clinic – extension 6405

Specialty clinic – extension 6243

Pediatrics – 497-3800

Eye Clinic – 497-3979

Cherokee County Clinic – (828) 837-4312

Snowbird Clinic – (828) 479-3924

Family Care Center – 554-5565

Immediate Care Center – 554-5555