New health initiative centers on patient, team

Published Dec. 8, 2010
By Marsha Nelson
81st Medical Group

KEESLER AIR FORCE BASE, Miss. -- The 81st Medical Group Hospital Family Health Clinic has been operating under the Air Force's Family Health Initiative since Sept. 1.

The initiative, launched in August 2008 at Ellsworth AFB, S.D., and Edwards AFB, Calif., is modeled on the patient-centered medical home, a 1960s concept that is making a comeback as the nation struggles to make health care more efficient. A patient-centered model consists of a primary-care doctor, nurse and technicians who work as a team providing treatment for most conditions and make referrals to specialists as necessary. During 2008-2009, 13 Air Force medical treatment facilities implemented the FHI. In 2010, 20 more Air Force facilities, including Keesler, have put the tenets of FHI into practice.

The model has the support of the American Medical Association, the American Academy of Family Physicians and other national health-care groups. Under the Air Force program, a family health team consists of a family practice physician, an extender (either a physician assistant or nurse practioner), a registered nurse and five medical technicians.

The FHI solidifies the Air Force surgeon general's vision that primary care at Air Force MTFs should be a medical home that is pleasing to both patients and medical staff. Primary goals are improved doctor-patient relationships, better access to treatment and higher-quality care.

Educating the Keesler community on FHI is the most important piece to the success of this initiative. FHI focuses on the personal relationship between patient and provider, creating a greater continuity of care. Building rapport with a medical team doctor, nurse and technician puts the focus more on preventive, proactive care instead of reactive care and ultimately leads to healthier Airmen and families.

Keesler is laying the groundwork to establish continuity among patients and the FHI team's staff. There may be a few "hiccups" along the way, but patient suggestions assist the staff in making FHI a success.

The family health clinic, which serves about 14,000 patients, is now composed of six family health teams. Each team has approximately 2,500 patients. Although the transition to the teams was virtually transparent to patients, dedicated appointments with an assigned team doctor or team extender will become more apparent as the clinic moves into the second quarter of FHI implementation. Patients no longer are booked among potentially 14 different clinic providers. Continuity of care is achieved by patients seeing their specific medical team. As continuity builds between the team and patient, so should trust, thereby resulting in a more satisfying health-care experience.

As with all military organizations, deployments and personnel transfers are a reality and result in periodic changes to a medical team. When the team provider is absent for an extended period, patients can anticipate an interruption in the continuity of care. For longer term absences, patients are temporarily seen by another team. The clinic staff does everything possible to ensure patients receive timely, quality care.

The clinic plans some upcoming events, such as patient days and team weeks, to educate patients about their respective teams and to acclimate them to the new patient-centered home initiative.