Epsom Family Medicine Takes A Team-Based Approach to Improving Care

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Team-Based Approach to Improving Care

Epsom Family Medicine Team Approach to CareAt Epsom Family Medicine, healthcare providers and staff are serious about a team-based approach to caring for their patients and managing their busy family practice. Motivational posters and teamwork reminders are on the walls, but they are much more than slogans. They are activities put to use every day. And they are paying off.

Much of the preparation and follow-up for their successful approach comes from weekly meetings in a conference room where the walls are covered with goals written on whiteboards, organizational charts and a photo of an ocean wave. Beneath the wave are the words: ‘Individually, we are one drop. Together, we are an ocean.’

“At the meetings, everyone has the same voice,” said Jodi Schroeder, an advanced practice registered nurse (APRN). “We’re all equal players. When we come up with a new idea or a problem we need to solve, instead of management saying ‘This is how we are going to do it,’ we all work together.”

Everyone at the practice meets every Wednesday for two hours in the conference room, beneath the ocean wave photo. Phone calls go to their answering service, except for emergencies, and everyone discusses how to improve.

“Sometimes, we say ‘Let’s test how to change a process,’ then we come back the next week and say ‘What went well? What didn’t go well?’ and we tweak it until we get it where we want it to be,” Schroeder said.

Initial sessions included training on how to hold such important meetings – being respectful, allowing participants to finish a thought, recognizing that everyone is just as important, and being open and honest. Another session featured hands-on training for the entire staff on motivational interviewing, where patients help establish their own goals for issues including losing weight, becoming more active or quitting smoking.

Their efforts have improved patients’ access to more timely appointments, improved patients’ health and satisfaction and improved morale among providers and staff.

One of the most significant successes was changing the way the practice handled patient phone calls. Previously, most patients calling for an appointment would reach a secretary, who would take a message for a nurse, who would return the call. With only one nurse handling such calls, only 40 percent of the calls went directly to the nurse.

The practice now has all nurses handling these ‘triage’ calls in the morning, when most calls come in. The percentage of patients who speak immediately with a nurse more than doubled, to 87 percent. Others receive much more timely return calls. Treatment teams also meet briefly every morning to review their daily schedules to anticipate and plan for specifc patient needs or ways to ease potential schedule bottlenecks.

As an APRN, Schroeder manages and cares for more than 600 patients of her own, as well as patients of other Epsom Family Medicine providers, if necessary. She also visits patients at nursing homes. Schroeder said before the concerted teamwork effort, providers worked more as individuals. Now, they collaborate to ensure patients receive timely appointments, to provide care and to help with each other’s workload.

“The morale for employees has improved a lot,” said Schroeder, “and the patients are getting better care.”