The Journal of the Arkansas Medical Society Med Journal March 2020 Final 2 - Page 11

Good Communication Put in Practice Administrator Jo Lynn Varner by Casey L. Penn L ittle Rock Pediatric Clinic was the first pediatric clinic in Arkansas to be recog- nized by The National Committee for Quality Assurance as a Patient-Centered Medical Home for its use of evidence-based, patient-centered processes that focus on high- ly coordinated care and long-term, participa- tive relationships. With seven physicians, one nurse practitioner, and approximately 14,000 patients who make more than 29,000 office visits annually, doctor-patient communication can be an administrative challenge. LRPC Clinic Administrator Jo Lynn Varner has been on the job for 16 years. She shares insight into her clinic’s approach to effectively handling doctor-patient and staff-patient communication. AMS: As clinic administrator, how do you approach good patient commu- nication? Keeping the front desk focused on connecting to patients. for instance, we have a live person ready to pick up the phone. AMS: Patient satisfaction is a big part of LRPC’s success. How do you know pa- tients are satisfied? Varner: Communication with patients is hard. We focus on providing as many access points as we can for patients. We have a website and Facebook page, and we were one of the first pediatric clinics to set up a patient portal. Our portal allows for patients to send secure messag- es and photos to our staff. Last year, we started us- ing secure emails through Outlook. However, you can have all of that, but without doctors and staff that support that, it isn’t going to work. Our doc- tors and staff ensure that when a patient sends something our way, we respond. You have a lot of parents of children who don’t know if something their child is experiencing is normal, so it’s so im- portant to get back with them promptly. AMS: Phone systems have been a point of contention and frustration for many a patient. Tell me about yours. Varner: We have targeted questions on our patient experience survey. All clinics participating in Medicaid or Blue Cross are asking comparable questions to ours (it’s required). One of our ques- tions is, “How confident are you filling out medi- cal forms by yourself?” That’s in their registration and is answered periodically. As we identify folks who need help with that, we have referral options for Literacy Councils and other resources. Also, on our post-visit experience survey, we ask, “How well do you feel your physician listened and an- swered your questions?” Together, these are sort of a double check for us. We think we’re doing well at patient communication, but this lets us know if we really are. And this is something we get consistently high scores on. AMS: What about people who prefer a direct approach over patient portals or other online conduits? AMS: How do you help patients leave the clinic knowing what’s expected of them? We serve parents of growing children, so they’re coming to the doctor often. We change up survey questions annually since people tire quickly. We try different things, too. For instance, we had a patient family advisory group that met quarterly to get some face-to-face feedback. Over time, participation dwindled. We’re thinking about trying something like that again in a more virtual way to accommodate busy patients. We’ll see how it works. Communication is a continuing struggle. You must go at it from different angles and hope something sticks. Varner: With grandparents raising their grandchildren, our physicians today counsel a variety of age groups. But age aside, we have a fair number of patients and caregivers who sim- ply don’t want to be on the patient portal. For those people, we have a dedicated phone nurse. Our scheduling and billing are in house; in each area, we have a dedicated person to take phone calls. If patients have questions about their bills, Volume 116 • Number 9 Varner: First, I don’t have the front desk people in the phone tree. The front desk is fo- cused on people coming in the door. The phone team is not patient-facing and completely be- hind the scenes. We believe that the people in the waiting room should not hear a lot of phones ringing or people answering phones. Anyone answering the phone is, for the most part, in a restricted area. Second, we have tiered groups answering the phone. If the main phone group is full, calls roll over to the secondary group, and then to the third tier. Varner: We offer a lot of handouts. We’ve found that patients want to leave the clinic with something in hand. If it’s not a prescription, then something. So, we have a lot of illness-specific handouts. We give them developmental mile- stones to look for in the next year. We give them an updated shot record with information on when the next shots will be due. Doctors give them patient-education articles. MARCH 2020 • 203