Lakeland Regional Medical Center’s Family Health Center Oﬀers High Quality, Low Cost Primary Care to the Uninsured
Lakeland Regional Medical Center (LRMC) has a strong legacy in providing the highest quality care at the lowest possible cost to the patients and families of its entire community. Nowhere is LRMC’s commitment more apparent than its passion in addressing the lack of access to high quality primary care for patients and families.
Addressing the lack of access to high quality primary care begins in the Emergency Room (ER), the front door of LRMC, which, with more than 170,000 annual visits in ﬁscal year 2012, is the busiest single-site ER in the state of Florida. A direct cause of this, as shown by the LRMC Community Beneﬁt Plan, is due to there being only 61 primary care physicians per 100,000 lives in Polk County, as compared to 97 in Florida and 83 in Tampa Bay.
Coupled with this disparity is that fact that it is diﬃcult for members of the Lakeland community to get in to see their doctor; especially if they are a Medicaid recipient or do not have health insurance.
As the busiest single-site ER in Florida, LRMC has answered the community’s call for a quick and eﬃcient ER coupled with an alternative setting through which those needing primary care could avoid unnecessary visits to the ER.
By LRMC standards it was not acceptable to have patients and families waiting to be seen or admitted, or to have EMS delayed as they waited to bring their patients into the ER. In addition, it was not ideal for patients and families to seek out the ER for health care needs, such as chronic disease management that could be better cared for in a primary care clinic. Yet this was the climate in the LRMC ER that created a stressful, chaotic environment for staﬀ and patients.
LRMC’s answer to the community has set national standards for emergency care and created a Family Health Center on behalf of the community. A two-year Lean Project using scientiﬁc data analyses has re- engineered the ﬂow of patients through the ER, drastically reducing wait times, providing timelier diagnostic testing and treatment, and creating the highest quality of care for patients. Driven by the urgency and passion of its CEO, Elaine Thompson, PhD, FACHE and COO/CNE Janet Fansler, MS, RN, CENP, LRMC has prompted national attention with its results:
- 80 percent of all patients are treated and discharged or admitted in less than 3 hours;
- Door-to-Doctor time is less than 20 minutes; and
- The walkout rate is a mere 0.3 percent.
In addition to this success, LRMC opened its Family Health Center (FHC) in July 2012. The FHC is a seven-day-a-week medical home that oﬀers high quality, low cost primary care to uninsured and underinsured members of the community. It is staﬀed with a team of two full-time board certiﬁed primary care physicians and three full-time advanced registered nurse practitioners. Located directly across the street from the ER, the FHC is improving access to primary care by providing high quality care at the lowest cost that not only eliminates unnecessary ER visits, but also provides continual primary care to patients and families.
Once patients are received into the FHC either directly or from the ER, they enter into a patient and family centered medical home whereby they receive comprehensive care that is coordinated through a primary care physician to ensure appropriate and necessary care. This includes ensuring patients receive timely lab and diagnostic tests; screening exams, such as, mammography and colonoscopy; as well as extensive education on topics ranging from asthma management to lowering high cholesterol.
As of January 2013, more than 2,500 patients initially treated in the LRMC ER have been transitioned to, and are now cared for in, their new medical home at the FHC. Also, since opening the FHC, more than 1,500 patients who initially presented at the LRMC ER with non-emergency conditions have been established as patients at the FHC. Combined, these patients have beneﬁtted from more than 8,000 clinic visits at the FHC. These visits include, not only initial treatment, but also critical follow-up treatment and education that impacts quality of life and overall health.
“We have made great strides. However, there is still much work to be done. That is why we are bringing a graduate medical education program to our community with the goal of having over 200 clinical residents by 2020 – most of which will be centered on primary care,” said Dr. Thompson. “We believe providing every member of our community access to the highest quality and lowest possible cost of care is fundamental to our founding mission.”
“There’s a community need for more primary care, particularly for those with no insurance. Our mission is not just to treat illnesses but to provide preventive care, health screening, and management of chronic conditions.
– Kim Walker, LRMC’s Associate Vice President for Ambulatory Services