Becoming a Patient-Centered Health Home


As Mendocino Community Health Clinic continues its journey to become a nationally recognized Patient-Centered Health Home (PCHH), they've been making sure they have the basics down flawlessly, and that they provide staff training so patients receive the best possible care.

With the PCHH concept, health care is moving from “episodic” care (deal with problems as they come up) to helping healthcare providers become patients’ life-long partners in health. Rather than “Take two aspirin and call me in the morning,” they’re saying, “Let us help you manage your diabetes and hypertension so you feel better every day.”

With national changes in health care, a bit more funding is finally going toward preventive care. According to the Robert Wood Johnson Foundation, America currently spends more than $2 trillion annually on health care—more than any other nation—yet less than four cents of every health care dollar we spend goes toward prevention and public health. Even with the trillions spent on health care, people have been living shorter, sicker lives. 

So, the PCHH approach is brilliant both financially and more importantly because it helps people live healthier lives. 

One of the key components of the PCHH is measuring health indicators so health centers really know how healthy their patients are--and whether they’re getting better. For example, they're reviewing A1c results and body mass indexes (BMIs), and they’re paying more attention to whether high blood pressure is addressed. To do this effectively, they’re training (and re-training) medical assistants and nurses to be sure accurate information is gathered and recorded in the electronic health record (EHR).

Charles Hessom, RN, and EHR Trainer Bill Woodworth are working with the rest of the EHR trainers to assess which areas need improvement, and then developing curriculum to share. Every month, the new topic is presented at all three MCHC sites. The following week, the trainers visit the people who received training to make sure it's being put into practice.

This is definitely a team effort all the way around. Nursing, EHR training and development, and others communicate about what needs to be trained, how to make the EHR function well with patient work flows, and at the end of it all, how to serve patients as well as they can. Topics on the training list include taking vital signs, managing code blues, administering medication (specifically, injections), reviewing quality improvement, and more.

"Really, this is about putting the patient at the center of everything we do, and making sure we're constantly improving," Hessom said.

Next: Grateful Patient Gets back On His Feet →