You can see, hear, and feel the positive and caring energy when you approach the check-in desk and patient waiting room for patients coming to Internal Medicine for their health care needs. That positive and caring energy becomes more pronounced when our patients are interacting with our nurses and providers. In October of 2018, the Onalaska IM team and La Crosse IM integrated. Nine doctors, three RNs, one RN care coordinator, eight LPNs, one CMA, and three registration/scheduling staff work on the second floor of the Skemp Building. The team is multigenerational and each member shares the same passion of caring for adults across the spectrum from healthy to complex illnesses. The team members feel comfortable being themselves, asking questions, sharing ideas, and trusting that their co-workers are there for them when needed.
The Internal Medicine culture is one in which each team member feels valued, respected and deeply committed to delivering Relationship and Team-Based Care. The needs of the patients are their top priority, evidenced by the daily, weekly, and monthly standard work related to the diabetic five quality indicators. The workload is shared and everyone pulls equal weight and helps one another accomplish individual and collective goals. The Internal Medicine Team demonstrates collaboration and accountability.
The Care Team RN role is to determine what can be affected by nursing review, assessments, and documentation improvement. Every Tuesday the Care Team RN leads a 30-minute review of the provider D5 report with LPN or MA to find those patients where provider input is necessary. That information is discussed with the providers to determine the following: which patients need a call from nursing to discuss diabetic education and the need for follow up care with their provider.
The LPN and CMA role is a daily review of the provider’s D5 report. The expectation is to review five patients daily to determine the following: patients who are no longer receiving care at Mayo, who needs a BP check, review tobacco assessment documentation, contact patient for office visit when no future appointment is scheduled, review medication list for Aspirin and Statin intolerances, update allergies to Aspirin and Statin as appropriate and utilize Epic “Track Pt Outreach” after each patient reviewed for efficient list management.
The provider’s role is to collaborate with Care Team RN regarding D5 patients that may benefit from medication management, a phone call from a provider, an office visit and other options.
Relationship and Team-Based Care is guiding the work in Internal Medicine. Their goal is to provide the best care to support the best outcomes. The team is diligent in addressing the gaps as they continually arise. Engagement from all members of the Internal Medicine team has made this improvement process possible and sustainable standard work. Of note, since November of 2018, the D5 compliance trend continues upward. In January 2019, the D5 compliance was 48%. As of today, the Internal Medicine Team achieved the target of 51%. Going into the future of 2019 the team’s plan is to be the enterprise leaders in achieving quality outcomes. There will be an atmosphere of celebration on April 8th in the Grandview Conference Room over the noon hour. The team will be eating Chinese food together. You will hear laughter and see the team celebrating that their work does make a positive difference in the lives of their patients and families.