RESUMO
Addressing patient health and care behaviors that underlie much of chronic disease continues to challenge providers, medical practices, health systems, and insurers. Improving health and care as described by the Quadruple Aim requires innovation at the front lines of clinical care: the doctor-patient interaction and office practice. This article describes the use of Lean Six Sigma in a quality improvement (QI) effort to design an effective and scalable method for physicians to prescribe health coaching for healthy behaviors in a primary care medical home within a large integrated delivery and financing system. Building on the national Agency for Healthcare Research and Quality and Robert Wood Johnson Foundation-funded Prescription for Health multisite demonstration, this QI case study provides important lessons for transforming patient-physician-practice support systems to better address lifestyle and care management challenges critical to producing better outcomes.
Assuntos
Comportamentos Relacionados com a Saúde , Promoção da Saúde/organização & administração , Participação do Paciente/métodos , Atenção Primária à Saúde/organização & administração , Melhoria de Qualidade/organização & administração , Gestão da Qualidade Total/organização & administração , Registros Eletrônicos de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Capacitação em Serviço , Estudos de Casos Organizacionais , Assistência Centrada no Paciente/organização & administração , Fatores de Tempo , Estados Unidos , United States Agency for Healthcare Research and QualityRESUMO
The National Institute for Occupational Safety and Health Total Worker Health™ Program defines essential elements of an integrated health protection and health promotion model to improve the health, safety, and performance of employers and employees. The lack of a clear strategy to address the core drivers of poor health, excessive medical costs, and lost productivity has deterred a comprehensive, integrated, and proactive approach to meet these challenges. The Employer Health and Productivity Roadmap™, comprising six interrelated and integrated core elements, creates a framework of shared accountability for both employers and their health and productivity partners to implement and monitor actionable measures that improve health, maximize productivity, and reduce excessive costs. The strategy is most effective when linked to a financially incentivized health management program or consumer-directed health plan insurance benefit design.