Christiansen Ellen, Hampton Michelle DeCoux, Sullivan Meghan
Department of Nursing, School of Health and Natural Sciences, Dominican University of California, San Rafael, California.
School of Nursing, Samuel Merritt University, Oakland, California.
J Am Assoc Nurse Pract. 2016 Aug;28(8):423-8. doi: 10.1002/2327-6924.12341. Epub 2016 Feb 5.
In some Federally-Qualified Community Health Centers (FQHCs), patients do not have a designated primary care provider (PCP). Patients see any provider who is available. This leads to fragmented care, poorer outcomes, and higher costs.
Patients were empaneled to a designated PCP. Continuity, quality, and efficiency measures were collected at baseline, 6-, and 12-months postempanelment.
Three rural FQHCs on the coast of Northern California performing about 18,000 patient visits annually.
Patient cycle time, percentage of patient visits with designated PCPs, completion of cervical and colorectal cancer screenings; blood pressure, low-density lipoprotein, and hemoglobin A1c control in patients with diabetes.
The senior Leadership Team initiated the patient empanelment project with the assistance of an outside consultant.
After 12 months, 100% of the FQHC's patients were assigned a PCP and saw that provider on ≥63% of visits. Quality indicators improved by an average of 9% and cycle time decreased by 12 min. per patient allowing providers to see approximately four more patients and generate an additional $2212 per day.
Project outcomes supported the importance of a designated PCP to achieve improved quality and efficiency of care.
在一些联邦合格的社区健康中心（FQHCs），患者没有指定的初级保健提供者（PCP）。患者会看任何有空的提供者。这导致了医疗服务的碎片化、较差的治疗效果和更高的成本。
患者被分配给指定的初级保健提供者。在分配后的基线、6个月和12个月收集连续性、质量和效率指标。
北加利福尼亚海岸的三个农村FQHCs，每年约有18000人次患者就诊。
患者周转时间、看指定初级保健提供者的患者就诊百分比、宫颈癌和结直肠癌筛查的完成情况；糖尿病患者的血压、低密度脂蛋白和糖化血红蛋白A1c控制情况。
高级领导团队在外部顾问的协助下启动了患者分配项目。
12个月后，FQHCs的100%患者被分配了初级保健提供者，并且≥63%的就诊是看该提供者。质量指标平均提高了9%，周转时间每位患者减少了12分钟，使提供者能够多看大约四位患者，每天额外创收2212美元。
项目结果支持了指定初级保健提供者对于提高医疗质量和效率的重要性。
