Patient empanelment: A strategy to improve continuity and quality of patient care.

PROBLEM: In some Federally-Qualified Community Health Centers (FQHCs), patients do not have a designated primary care provider (PCP). Patients see any provider who is available. This leads to fragmented care, poorer outcomes, and higher costs.
DESIGN: Patients were empaneled to a designated PCP. Continuity, quality, and efficiency measures were collected at baseline, 6-, and 12-months postempanelment. BACKGROUND AND
SETTING: Three rural FQHCs on the coast of Northern California performing about 18,000 patient visits annually. KEY MEASURES FOR IMPROVEMENT: Patient cycle time, percentage of patient visits with designated PCPs, completion of cervical and colorectal cancer screenings; blood pressure, low-density lipoprotein, and hemoglobin A1c control in patients with diabetes. STRATEGIES FOR CHANGE: The senior Leadership Team initiated the patient empanelment project with the assistance of an outside consultant. EFFECTS OF CHANGE: After 12 months, 100% of the FQHC's patients were assigned a PCP and saw that provider on ≥63% of visits. Quality indicators improved by an average of 9% and cycle time decreased by 12 min. per patient allowing providers to see approximately four more patients and generate an additional $2212 per day. LESSONS LEARNT: Project outcomes supported the importance of a designated PCP to achieve improved quality and efficiency of care. ©2016 American Association of Nurse Practitioners.