Understanding Organized Care in Primary Care Settings
Organized Care refers to a natural community of caregivers with a shared commitment to proactive population and individual care management. Through effective and efficient practices, it serves the needs of patients across various settings and over time, with aligned goals and provider accountability. Managed Care, on the other hand, lacks coordination and is provider-driven rather than team-based. Organized Care offers benefits including strengthening the primary care foundation, enhancing clinical integration, reducing care variation and fragmentation, and ultimately improving patient outcomes.
- Organized Care
- Primary Care Settings
- Patient Care Management
- Provider Accountability
- Care Integration
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Presentation Transcript
Improving Organized Care: A Conceptual Framework Suzanne Braithwaite RN, BScN, MScN (student)
Acknowledgements Dr. Tammy O Rourke, Mentor Belleville Nurse Practitioner Led Clinic Team RNAO Advanced Clinical Practice Fellowship
Learning Objectives 1. Organized care in the context of primary care settings 2. Program management conceptual framework 3. Practical application of the framework and opportunities to implement in practice
Background Belleville Nurse Practitioner Led Clinic RNAO Advanced Clinical Practice Fellowship
Organized Care: Overview Natural community of caregivers defined by a share population Shared commitment to proactive population and individual care management Serves the needs of a community of patients in an effective and efficient manner across settings and over time Goals aligned All providers are accountable (Blue Cross Blue Shield of Michigan, 2012)
Organized Care vs. Managed Care Managed Care Organized Care Coordinated by providers themselves No coordination Provider driven Bureaucracy enforcement Self disciplined team for care Purpose and vision externally manufactured Common purpose Shared values and shared information (Ruffin, 1993)
Organized Care System: Benefits Strengthening the primary care foundation Increasing clinical integration among providers Decreasing variation in care Decreasing fragmentation in care processes Improving care quality and health outcomes for patients (Blue Cross Blue Shield of Michigan, 2012; Reinheimer, 2013; Robins & Freeman, 1999)
Organized Care System Shared Purpose ORGANIZED Integrated Process of Care Patient Registry CARE Performance Measurement (Blue Cross Blue Shield of Michigan, 2012)
Strong Community Ties Integrated Health Care Services Committed Leaders and Champions Evidence Based Primary Health Care High Tailored Environmental Interventions Performing Collaborators
Identify a need Evaluate outcomes Align with mission/vision and priorities BUILDINGTHEPROGRAM Strong Community Ties EVALUATINGTHE PROGRAM Integrated Health Care Services Committed Leaders and Champions Evidence Based Primary Health Care High Tailored Environmental Interventions Performing Collaborators Assess Barriers to knowledge use Monitor knowledge use Select, tailor, implement interventions
SUSTAINABILITY SUSTAINABILITY Identify a need Evaluate outcomes Align with mission/vision and priorities BUILDING THE PROGRAM EVALUATINGTHE PROGRAM Strong Community Ties Integrated Health Care Services Committed Leaders and Champions Evidence Based Primary Health Care SUSTAINABILITY Tailored Environmental Interventions High SUSTAINABILITY Performing Collaborators Monitor knowledge use Assess Barriers to knowledge use Select, tailor, implement interventions
Organized Care Conceptual Framework A Conceptual Framework: Clear As Mud? Image retrieved from http://www.mattmccomas.com/clear-as-mud-cowtown-to-urban-hipster-4/
Discussion - Questions Thank you! Suzanne Lynch Braithwaite RNBraithwaite@gmail.com
