Kaiser Permanente Washington Health Research Institute, Seattle.
Center for Community Health and Evaluation, Kaiser Permanente Washington Health Research Institute, Seattle.
Perm J. 2020;24. doi: 10.7812/TPP/19.010. Epub 2020 Mar 13.
Kaiser Permanente (KP) Mid-Atlantic States has partnered with communities in its service area since 2011 to provide health services to underserved individuals. As part of KP's Community Benefit investment, the Community Ambassador Program places KP advanced-practice clinicians in safety-net clinics to share best practices and to improve access and quality of care.
To report program outcomes and disseminate lessons learned.
Using data from participating clinics, we retrospectively evaluated the program and estimated Community Ambassadors' contributions to clinic capacity, patient access, evidence-based care, and clinical quality measures. Furthermore, we conducted 29 semistructured phone interviews with stakeholders. Questions focused on program benefits, challenges, learning, and sustainability.
From 2013 to 2017, Community Ambassadors filled up to 32.8 full-time equivalent positions and conducted 294,436 patient encounters in 19 clinics. In certain years and for subsets of clinics, Community Ambassadors performed above average on 2 high-priority quality measures: Cervical cancer screening for women aged 21 to 64 years and diabetes (blood glucose) control. Interviews with 15 Community Ambassadors, 15 health centers leaders, and 7 KP Mid-Atlantic States staff members revealed that Community Ambassadors improved patient access, clinic capacity, and care quality. Ambassadors also exported KP best practices and supported KP's community relations. Challenges included patient acuity, clinic resources, staff turnover, and long-term sustainability.
The Community Ambassador Program achieved its goals and had clear benefits, offering a model for large health care systems wanting to collaborate with community-based clinics. Careful planning is needed to ensure that positive results are sustained.
凯萨永久医疗集团（Kaiser Permanente，简称 KP）中大西洋地区分部自 2011 年以来与服务区域内的社区合作，为服务不足的人群提供医疗服务。作为 KP 社区福利投资的一部分，社区大使计划将 KP 的高级执业医师派驻到社区医疗诊所，分享最佳实践经验，并提高获得医疗服务的机会和改善医疗服务质量。
报告项目成果并传播经验教训。
使用参与诊所的数据，我们回顾性地评估了该计划，并估计了社区大使对诊所能力、患者获得医疗服务的机会、循证护理和临床质量指标的贡献。此外，我们对利益相关者进行了 29 次半结构化电话访谈。问题集中在项目的收益、挑战、学习和可持续性上。
从 2013 年到 2017 年，社区大使填补了多达 32.8 个全职等效职位，并在 19 个诊所进行了 294436 次患者就诊。在某些年份和部分诊所中，社区大使在 2 项高优先级的质量指标上表现出色：21 至 64 岁女性的宫颈癌筛查和糖尿病（血糖）控制。对 15 名社区大使、15 名医疗中心领导和 7 名 KP 中大西洋地区分部员工的访谈显示，社区大使改善了患者获得医疗服务的机会、诊所能力和护理质量。大使还输出了 KP 的最佳实践，并支持了 KP 的社区关系。挑战包括患者的病情严重程度、诊所资源、员工流失和长期可持续性。
社区大使计划实现了其目标，并带来了明显的收益，为希望与社区医疗诊所合作的大型医疗保健系统提供了一个模式。需要精心规划以确保持续取得积极成果。
