The safety-net system in Montgomery County is complex. Within a single clinic, multiple people and processes work on behalf of every patient: receptionists, medical records staff, physicians and clinical staff. The system of care also extends beyond the walls of the clinic to include laboratory and radiology services, specialists, hospitals, community-based resources, social service agencies, and even the patient’s family. Streamlining the systems and processes with established process improvement techniques is essential to improving patient care and outcomes.
The Primary Care Coalition (PCC) is constantly implementing process improvement programs to move the safety-net health care system in Montgomery County toward better quality and greater efficiency of care. We encourage partners to use a formal process improvement method that includes four fundamental steps based on the Model for Improvement published in the 2009 Improvement Guide: A Practical Approach to Enhancing Organizational Performance:
- We start by creating the relevant infrastructure by measuring current performance, developing the necessary technology and other supports needed for the process changes to be successful.
- The next step is capacity building. The most important asset within the Montgomery Cares safety-net system is people; so in preparing for process improvement, PCC builds capacity in the workforce by engaging and educating the people whose work will be affected by the process changes.
- Then we go on to test and evaluate the new processes to learn what works well and what doesn’t. This step includes multiple small tests of change and processes may be adjusted and refined several times in order to have the greatest impact.
- Finally, we scale up and spread the improved processes to a larger area or population group.
Through a series of projects and grant funded-programs, the PCC continues to apply process improvement techniques to address the multiple issues that affect health care delivery to low-income, uninsured Montgomery County residents.