Organized Care in Primary Care Settings

 
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
 
Background
 
Belleville Nurse Practitioner
Led Clinic
 
 
RNAO Advanced Clinical
Practice Fellowship
 
Organized Care
 
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
 
Coordinated by providers themselves
Provider driven
Self disciplined team for care
Common purpose
Shared values and shared information
 
Organized Care
 
No coordination
Bureaucracy enforcement
Purpose and vision externally
manufactured
 
(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: How will we know?
 
Organized Care System
 
ORGANIZED
 
CARE
 
(Blue Cross Blue Shield of Michigan, 2012)
 
Organized Care Management Framework
 
 
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/
 
Opportunities for Practice
Discussion - Questions
 
Thank you!
Suzanne Lynch Braithwaite
RNBraithwaite@gmail.com
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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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  1. Improving Organized Care: A Conceptual Framework Suzanne Braithwaite RN, BScN, MScN (student)

  2. Acknowledgements Dr. Tammy O Rourke, Mentor Belleville Nurse Practitioner Led Clinic Team RNAO Advanced Clinical Practice Fellowship

  3. 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

  4. Background

  5. Background Belleville Nurse Practitioner Led Clinic RNAO Advanced Clinical Practice Fellowship

  6. Organized Care

  7. 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)

  8. 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)

  9. 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)

  10. Organized Care: How will we know?

  11. Organized Care System Shared Purpose ORGANIZED Integrated Process of Care Patient Registry CARE Performance Measurement (Blue Cross Blue Shield of Michigan, 2012)

  12. Organized Care Management Framework

  13. Strong Community Ties Integrated Health Care Services Committed Leaders and Champions Evidence Based Primary Health Care High Tailored Environmental Interventions Performing Collaborators

  14. 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

  15. 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

  16. 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/

  17. Opportunities for Practice

  18. Discussion - Questions Thank you! Suzanne Lynch Braithwaite RNBraithwaite@gmail.com

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