‘Medical Home’ is Transformed at Naval Hospital Pensacola

By Valerie A. Kremer, Bureau of Medicine and Surgery Public Affairs

WASHINGTON – Naval Hospital Pensacola is revolutionizing the Medical Home concept within Navy Medicine. From wireless technology to facility modifications to creating team-based environments, Pensacola has taken patient and family-centered care to a new level.

Implemented at several commands within Navy Medicine, the Medical “Home Port” concept emphasizes team-based, comprehensive care that is designed to fully meet the complete primary care health and wellness needs of patients. In the model, patients are assigned a team of health care professionals who support a comprehensive health care plan for the patient.

“Through Medical Home, the patient receives better care and sees better outcomes through leveraging continuity of relationships with team members,” said Capt. Maureen Padden, executive officer, Naval Hospital Pensacola. “There is also a greater satisfaction of the health care team.”

The U.S. Navy Bureau of Medicine and Surgery selected eight initial sites, including Naval Medical Centers and Family Practice Teaching Hospitals, to develop lessons learned and best practices with the goal of fully implementing Medical Home Port throughout Navy Medicine in 2012. The ultimate target is to achieve national recognition for Medical Home Port practices from the National Committee for Quality Assurance (NCQA). In Nov. 2009, the first Medical Home prototype was established at Naval Hospital Pensacola, which encompassed 4,000 patients, and focused on enrollments, access to care, staffing needs, and facility modifications.

“We focused on the colocation of practice,” said Padden. “We established pods, where doctors, nurses, and Corpsmen are in the same room, where there is cross talk - the integration of a team based process. We moved desks out of the way, went wireless, testing wireless computers and technology, optimizing the most out of our existing spaces.”

Naval Hospital Pensacola initiated seven Medical Home teams in Nov. 2010 now serving 22,000 patients. The seven teams consist of three teams in family medicine, two in pediatrics, and two in internal medicine. Residents are incorporated as part of their training into the Family Medicine Medical Homes.

Pensacola further expanded the Medical Home concept to 18,300 patients at its branch medical clinics Gulfport, La. and Millington, Tenn., along with the Naval Air Training Center (NATTC), located at the Naval Air Station Pensacola, Fla., where 8,000 Sailors receive schooling.

“We have been able to test how Medical Home is relevant in not just a teaching hospital, but also at the branch medical clinics,” said Padden. “Pensacola has shown successfully that you can implement Medical Home in a graduate education environment and achieve meaningful outcomes.”

Since the implementation of the Medical Home concept, Pensacola has seen process improvements in care and improvements in access to care.

“Now a patient can secure a same day appointment for acute primary care and within two to three days for non-urgent routine care, as opposed to seven days or longer in most practices,” said Padden. “We have also seen improvements in care. There was an increase in emergency room use in the past, and since Medical Home has been implemented, we have seen a leveling off of Emergency Room utilization and hope to see decreases in the very near future.”

For the long term, Pensacola is looking to be in the 90th percentile in quality metrics, decrease unnecessary hospitalization, bring enrollees back into the direct care system from the network, and determine how quality can be brought to the next level, explained Padden.

“We will continue to revise the Medical Home concept, adjust it, and morph Medical Home for different populations,” said Padden. “The goal is to figure out what is reasonable – how many patients a provider can provide quality care to and what staffing mix will help them to be most successful. It is a balancing act.”