Photo By Douglas Stutz | Eligible beneficiaries were asked to share their patient experiences, voice concerns,...... read more read more
Eligible beneficiaries were asked to share their patient experiences, voice concerns, and question leadership at Naval Hospital Bremerton.
They did.
NHB held the inaugural Patient and Family Partnership Council, January 25, 2023, to discuss a variety of healthcare matters, ranging from pharmacy dissatisfaction, urgent care clinic availability, access to care and more.
“We’re delighted to have participation which will help make us better at what we do. Honest feedback will help us towards our goals in providing better care, better outcomes, at a lower cost,” said Capt. Patrick Fitzpatrick, Naval Hospital Bremerton director and Navy Medicine Readiness Training Command Bremerton commanding officer.
The original concept for implementing the council actually began several years earlier but was temporarily postponed due to the pandemic. Under Defense Health Agency guidance the process has been renewed and designed to help address, advocate and improve on the quality of patient-centered care for all patients and family members.
“The new DHA director, Lt. Gen. Telita Crosland, has said that our mission is making extraordinary experiences ordinary and exceptional outcomes routine. This [council] will help us get there,” added Fitzpatrick, also noting that the council was not intended to simply be an open forum to air complaints.
“There are specific topic criteria to follow. To stay true to the objectives of the council to improve patient experiences, all topics must meet the three criteria of relating to patient and/or family experience(s) when they are provided care at NHB and/or one of the branch health clinics; the hospital has the authority and capability to act on; and it’s not an individual grievance,” explained Lt. Cmdr. Shingmei Chang, NHB patient experience officer.
The initial discussion topic centered how to improve wait times with NHB’s Pharmacy. Lt. Cmdr. Jason Galka, Pharmacy department head, explained that work volume and staffing levels drive the wait time, which averages approximately 47 minutes for a new prescription.
“Over 1,200 prescriptions are filled per day. Going faster could only lead to mistakes such as wrong dose and wrong medication. We encourage the use of automated services” stated Galka, who readily advocated the ScriptCenter as a viable alternative to use to help eliminate the need for anyone to wait in the Pharmacy lobby to pick up their medication.
Yet feedback from those beneficiaries in attendance noted that the ScriptCenter, a self-serve dispensing service for prescriptions for anyone who needs after hours services and/or are reluctant to wait in the lobby, is not a universally known option for many.
“What’s the message we need to take away from this discussion?” prompted Capt. Mark Lund, NHB executive officer.
That the ScriptCenter is easy to use. The process starts when someone is requesting prescriptions through AudioCare at 360-475-4217, then select the ScriptCenter kiosk option at several pickup location.
According to Galka, when requesting for the first time, registration is required so a patient needs to refer to their 12-digit prescription number - starting with 000 - found on the medication bottle. For those who don’t have a prescription number, it is still possible to establish a username and PIN to access the ScriptCenter. Pharmacy staff can help complete the registration when the prescription is filled.
The difference between an emergency department and an urgent care clinic was also touched upon, driven by local media coverage of overwhelmed staff and long wait times at the ER in the local civilian hospital. Is the lack of an ER at NHB a burden on St. Michael Medical Center?
“Patients get seen – and triaged appropriately – based on severity. Those experiencing life, limb threatening or serious health problems come first,” Fitzpatrick said. “We shifted to our UCC [October 1, 2014] due to manning and simply not seeing enough actual emergencies to justify a 24-hour operation.”
The Urgent Care Clinic – which has an average census of 25-35 patients - is open 8 a.m. to 8 p.m., seven days a week, with walk-in availability for such needs as;
Minor injuries such as strains and sprains, back pain, minor cuts and burns, minor broken bones, and minor work and sport-related injuries.
Common illnesses such as colds, fever and/or flu symptoms, sore throats and coughs/bronchitis; migraines, allergies, rising temperature and rashes.
Specialty care versus primary care was also touched upon.
“Specialty care is based upon capability and capacity,” said Lt. Cmdr. Keith West, NHB Healthcare Business director, citing that even though the industry standard is 28 days for an appointment to get scheduled, patients are seen well within those standards with an overall average of approximately 15 days.
From cradle to age 64, NHB is available for patient care and is open to enrollment.
There was also discussion with NHB’s Labor and Delivery being on divert status since April 29, 2022 and OB/GYN services available.
NHB’s OB/GYN Clinic does provide patient-centered care to eligible beneficiaries, which include routine and acute gynecological evaluations by referral, and prenatal care for active duty which are then coordinated to network care by referral.
One concern raised was that it’s reported that some pregnant women have not been able to establish timely care with network OB/GYN doctors.
The healthcare business office representatives offered that there is an embedded referral specialist from the TRICARE contractor at NHB that connects each pregnant patient to a doctor via a “warm handoff” to ensure women are appropriately coupled with a provider.
“I’m very interested to hear of any problems our beneficiaries are having,” Fitzpatrick stressed.
“We need to know so that we can assist,” continued West. “It’s also based on when an expectant mother delivers. There’s a specific window of time that’s optimal to establish care with the provider. We want to make sure it’s timed right.”
Another participant asked, “What about women who PCS [permanent change of station orders] during pregnancy and have to scramble to find care at 30 weeks?”
“That’s when the referral specialist can help the most,” replied West.
Lt. Cmdr. Jennifer Squazza, NHB certified nurse midwife added, “We still do provide prenatal care here at NHB.”
There are two certified nurse midwifes and two OB/GYN physicians on staff.
“Expectant mothers can call us at Referral Management, 360-475-4455, for assistance as needed,” stressed Janine Wood, with NHB’s Referral Management and Case Management.
There are also walk-in contraceptive services held in OB/GYN, every Wednesday from 8 a.m. to 11 a.m. and again from 1 p.m. to 3 p.m.
NHB was amongst the first in the Defense Health Agency - starting several years earlier - in providing walk-in contraception counseling on the range of birth control options available; discuss and explain prescription options such as pills, patch, ring, which will be placed at the time requested for their pharmacy pickup with us or at a retail pharmacy if so chosen.
OB/GYN staff also handle same-day insertion of IUDs and Nexplanon (if pregnancy is ruled out); go over emergency contraception pill options and can provide Depo-Provera Injections in the OB/GYN clinic without requiring a pharmacy visit.
The walk-in services is on a first-come, first-served basis and available to all eligible beneficiaries – active duty, retirees, family member – in need of birth control services. Wait times and appointment availability may vary due to clinic volume.
The success and high volume of patient use and appreciation of the walk-in contraceptive clinic has also led the OB/GYN clinic to start walk-in cervical cancer screening every Friday, from 8 a.m. to noon.
The next meeting of the council will be in the March/April time frame. The continued goal will be to promote communication with patients to NHB leadership regarding issues related to access, quality, and experience of care.
PFPC members can assist in clarifying and sharing any questions or concerns during this time by providing a voice that represents other patients and family members. There are no special qualifications needed to be a council member. PFPC volunteer members will team up with staff members to promote patient and family-centered care and engagement.
Those interested in helping NHB improve patient and family experience can contact the experience officer: Shingmei.chang.mil@health.mil
| Date Taken: | 01.25.2023 |
| Date Posted: | 01.26.2023 18:36 |
| Story ID: | 437332 |
| Location: | BREMERTON , WASHINGTON, US |
| Web Views: | 176 |
| Downloads: | 0 |
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