Thursday, March 15, 2018 - Anchorage AK (Southcentral Foundation)
Today I spent the day at Southcentral Foundation in a primary care clinic. While here I worked with a registered nurse in the role of a case manager and got to see their integrated care team first hand. Each care team consists of a case manager, a provider, a certified medical assistant, a team coordinator responsible for scheduling, and a pharmacist. There are also behavioral specialists and midwives that work with a group of care teams as needed. During this time it was interesting to see how well the care team communicated together. They all stay in one large open area as a group, this seems to be successful because they are all able to easily communicate with each other if any questions arise as well as it helps to develop better relationships among the team. During my time in the primary care clinic I was amazed at how well the team worked together and there seemed to be no hierarchy among them.
One of the case manager’s roles at the clinic is to triage people as the call in. There were a few times that my nurse received messages of patients who would call in saying they had symptoms A, B, and C and wanted to know if they should go to the emergency room. Instead of going to the emergency room my nurse would be able to further assess the situation over the phone and then determine if it was non-emergent and they needed an appointment scheduled for later, semi-emergent and they needed to make time for an appointment that day, or emergent and should actually go the emergency room. This is important because then it saves everyone time and leads to less unnecessary crowding of the emergency department. Also Southcentral healthcare provids free services for the Native people and thus it is important to try to save money by treating things before they become acute and life threatening.
Each primary care team is also responsible for certain rural villages outside of Anchorage. The clinic that I worked with today was also responsible for three villages as well as people form Anchorage (About 1000 people total). Triaging over the phone is also important for people in the villages because this way they do not have to fly into Anchorage for something that is not life threatening. The primary care clinics role in the villages is to work with the patients when they are in Anchorage as well as traveling out to the village periodically. I was told that the provider will go out to the village twice a year to meet with the people and provide appointments and the case manager is able to go to each village once a year.
My time at Southcentral was interesting and I think the biggest things I learned was how important care coordination is for patients because it usually results in more effective care and prevention. I also really enjoyed the atmosphere among the integrated care team. There was so much respect for the different people in the team and it was very welcoming. When I mentioned this to a manager she said this was very apparent with there impressively low nursing turnover rates. Lastly, my day did not only consist of primary care but we even responded to a “code” that was called from the lobby of the clinic. Each primary care clinic is responsible for a section of the hospital and the one that I was with was responsible for the lobby so everyone ran to the lobby where an older man had passed out and was having trouble breathing. I always find it interesting to see how healthcare teams respond in emergent situations because communication is a huge factor and everything seemed so well organized and the communication was great. Because this code was called in the clinic even though the patient was surrounded by doctors and nurses the ambulance was still called to transport him across the campus to the emergency department.
As far as the rest of my trip, tomorrow I will be spending the day at the high school Alaska State Basketball tournament tabling and providing information about the harmful affects of tobacco. Then Saturday we will have most of the day for exploration and are planning to go to Alyeska for snowshoeing and cross country skiing before we begin our departure back to Minnesota with our flight leaving at 1:30 Sunday morning. My goal is to be back in Duluth by 3pm on Sunday. Overall this has been a great trip but I am also ready to head back home.
Today I spent the day at Southcentral Foundation in a primary care clinic. While here I worked with a registered nurse in the role of a case manager and got to see their integrated care team first hand. Each care team consists of a case manager, a provider, a certified medical assistant, a team coordinator responsible for scheduling, and a pharmacist. There are also behavioral specialists and midwives that work with a group of care teams as needed. During this time it was interesting to see how well the care team communicated together. They all stay in one large open area as a group, this seems to be successful because they are all able to easily communicate with each other if any questions arise as well as it helps to develop better relationships among the team. During my time in the primary care clinic I was amazed at how well the team worked together and there seemed to be no hierarchy among them.
One of the case manager’s roles at the clinic is to triage people as the call in. There were a few times that my nurse received messages of patients who would call in saying they had symptoms A, B, and C and wanted to know if they should go to the emergency room. Instead of going to the emergency room my nurse would be able to further assess the situation over the phone and then determine if it was non-emergent and they needed an appointment scheduled for later, semi-emergent and they needed to make time for an appointment that day, or emergent and should actually go the emergency room. This is important because then it saves everyone time and leads to less unnecessary crowding of the emergency department. Also Southcentral healthcare provids free services for the Native people and thus it is important to try to save money by treating things before they become acute and life threatening.
Each primary care team is also responsible for certain rural villages outside of Anchorage. The clinic that I worked with today was also responsible for three villages as well as people form Anchorage (About 1000 people total). Triaging over the phone is also important for people in the villages because this way they do not have to fly into Anchorage for something that is not life threatening. The primary care clinics role in the villages is to work with the patients when they are in Anchorage as well as traveling out to the village periodically. I was told that the provider will go out to the village twice a year to meet with the people and provide appointments and the case manager is able to go to each village once a year.
My time at Southcentral was interesting and I think the biggest things I learned was how important care coordination is for patients because it usually results in more effective care and prevention. I also really enjoyed the atmosphere among the integrated care team. There was so much respect for the different people in the team and it was very welcoming. When I mentioned this to a manager she said this was very apparent with there impressively low nursing turnover rates. Lastly, my day did not only consist of primary care but we even responded to a “code” that was called from the lobby of the clinic. Each primary care clinic is responsible for a section of the hospital and the one that I was with was responsible for the lobby so everyone ran to the lobby where an older man had passed out and was having trouble breathing. I always find it interesting to see how healthcare teams respond in emergent situations because communication is a huge factor and everything seemed so well organized and the communication was great. Because this code was called in the clinic even though the patient was surrounded by doctors and nurses the ambulance was still called to transport him across the campus to the emergency department.
As far as the rest of my trip, tomorrow I will be spending the day at the high school Alaska State Basketball tournament tabling and providing information about the harmful affects of tobacco. Then Saturday we will have most of the day for exploration and are planning to go to Alyeska for snowshoeing and cross country skiing before we begin our departure back to Minnesota with our flight leaving at 1:30 Sunday morning. My goal is to be back in Duluth by 3pm on Sunday. Overall this has been a great trip but I am also ready to head back home.