Final Featured Practices: Siloam Health, Salvus Center, Mercy Community Healthcare– Defining Exemplary Practices

As TCPi comes to a close, we want to showcase the performance stories of three of our MidSouth PTN clinics – Siloam Health, Salvus Center, and Mercy Community Healthcare. All three practices  demonstrate exemplary patient care and offer insights in successful clinical transformation and the future of healthcare.

Siloam Health is a non-profit community center where twenty-one clinicians as well as a team of dedicated staff care for approximately 5,600 under-served, culturally marginalized persons. Their 400+ volunteers donate more than 13,000 hours annually in clinical and non-clinical roles. Siloam did not regularly utilize group huddles until they began their work with TCPi. They started by sharing basic information such as assigning providers with rooms and pairing them with a nurse or medical assistant. Gradually, their group huddles grew into a time to share updates on available medication samples, availability of vaccines, and other announcements/brief discussions around process improvement.

Prior to TCPi, Siloam also had no means of providing pneumonia vaccinations to our uninsured patients due to the cost barrier. Under the guidance of TCPi, they implemented a system that effectively cuts down on the amount of time the patient must wait beyond the provider-portion of the visit. This team awareness of vaccine availability and organizing a work flow to increase access in a timely manner for patients contributed to improving their pneumonia vaccination rates for older adults, which increased by more than 25% from baseline in one year. To learn more about Siloam’s improvements since joining MidSouth PTN, please see their full performance story.

Salvus Center, Inc., is a faith-based Safety Net Clinic providing whole person wellness and healing to uninsured, working individuals and their families. Over the course of 2018, they saw 2,687 patients across 3,936 visits. In addition to providing intervention to one hundred diabetic patients to help improve their understanding of their care plan and to aid them in better management of their diabetes, they ensured one hundred fifty at-risk patients received flu vaccinations to protect them against contracting the flu and to reduce the severity of their symptoms should they contract the flu.

Salvus Center also knew it was important to increase breast cancer screenings among their patient population. To help raise the awareness of their team in this quality improvement effort, they created a simple process to remind doctors and practice managers through email to perform breast cancer screenings. Additionally, they standardized data input in the electronic health record. Whenever their patients receive a breast cancer diagnosis, their care coordination program aids the patient in navigating to TennCare for insurance coverage and ensures the patient is assigned an oncologist. For more, see their full performance story.

Mercy Community Healthcare is a Safety Net Clinic located in Franklin, TN serving a patient panel of approximately 9,700. Of those patients, nearly one in five are below the 100% federal poverty level and 26% are uninsured. As such, Mercy had a high percentage of uninsured patients who were not being screened for clinical depression. Upon conducting a root-cause analysis, they discovered that there was a separate charge for the screening form that would then be billed to patients, thus preventing providers from screening patients for this service. To address this barrier, they worked to include this screening service as part of the bundled services that is covered with the sliding scale fee. They also integrated behavioral health and psychiatric services within the clinic by relocating the annual visit sheet to the provider desk, as a reminder to distribute the screening form to the patients. This new process ensures the provider has the paperwork while the patient is present, allowing the provider to address any issues while still in the room with the patient.

Mercy also added clinical depression notes to their daily morning huddle sheets to alert the provider and nurses if the patient had not been given a clinical depression screening within the year. TCPi helped them encourage individual and group staff training, which successfully increased their clinical depression screenings by 28.9% as of Q1 2019. For further information, see their full performance story.

The views expressed in this story are those of the authors and do not necessarily represent the official views of Siloam Health, Salvus Center Inc., or Mercy Community Healthcare. Additionally, this work was funded by the U.S. Department of Health and Human Services – Centers for Medicare and Medicaid Services’ Transforming Clinical Practice Initiative, under grant number 1CMS331549-03-00. The contents provided are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.