One of our key initiatives at the San Francisco Health Plan is improving our patients’ experiences with care. Our HEDIS scores are consistently high in our clinical measures, but our patient experience scores, as measured through the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey, show room for improvement in the areas of access and provider communication. To learn more about the drivers of dissatisfaction expressed in our survey, SFHP conducted a series of focus groups with patients and their providers in 2009. SFHP found dissatisfaction across all ethnic and language groups in key areas:  difficulty accessing adult primary care services, difficulty with the phone system, excessive wait times, problems with doctor-patient and staff-patient communication, and difficulty getting services when needed. Providers described similar frustrations about access and communication, explicitly requesting provider-specific surveys, communication skills training, and assistance with improving access through redesigned patient flow and office systems.  

Equipped with this information, we went after grant funding and secured enough to begin working on patient experience with a sample of clinics.Through an application process, we selected 10 clinics to test strategies in access and communication proven effective in other clinics in CA and across the country. We will learn from these clinics which strategies work best and plan to spread improvements to more providers over the next few years to have a broader impact.

San Francisco Health Plan is excited to announce that the following clinics were selected to participate in our two patient experience collaborative pilots:

Patient-Centered Communication (PCC) Collaborative

• Castro Mission Health Center
• Family Health Center at San Francisco General Hospital
• Mission Neighborhood Health Center
• Silver Avenue Family Health Center
• St. Anthony Free Medical Clinic

Optimizing the Primary Care Experience in the Safety Net  (OPCE)

• Chinatown Public Health Center
• Lyon-Martin Health Services
• Maxine Hall Health Center
• NEMS-San Bruno
• Southeast Health Center

About PCC
Over the next 12 months, 5 clinic teams, including providers and their staff, will work on testing and implementing communication techniques shown to save time during the 15 minute visit while enhancing the patient experience with care.  Some of the techniques include: making a personal connection, demonstrating empathy, using agenda setting to elicit patients’ concerns, and closing the loop with the patient at the end of the visit.  To assess the effectiveness of the techniques, patients will rate their care using a patient experience survey on a quarterly basis. The survey instrument addresses many dimensions of the patient experience, such as communication between providers and patients and access to appointments and office wait times. Click here to download presentations and tools from the collaborative.

About OPCE
 “See your own patients, don’t make them wait” is the mantra for the OPCE collaborative.  Over the next 12 months, 5 clinic teams, including providers and clinic leaders will test and implement changes to re-design their systems to ensure timely access and service for their patients. Teams will learn from expert faculty and each other how to optimize capacity utilizing strategies to reduce demand and increase supply; work down patient backlog and long queues, map current workflows to create office efficiencies and to develop contingency plans when dealing with absences, seasonal fluctuations etc.   To assess the effectiveness of the changes, clinics will measure appointment access using ”Third Next Available”, daily demand, supply, and activity;  in addition to cycle time and panel size. Click here to download presentations and tools from the Collaborative.