Yale Health earns top marks for its focus on patient-centered care

Michelle Serlin of the Yale Health Pediatrics Department (right) meets with ne

Michelle Serlin of the Yale Health Pediatrics Department (right) meets with new parents Brandy and Cory Dionne and their twins Christian and Haley. (Photo by Michael Marsland)

Yale Health has been recognized as a model of 21st-century primary care by the National Committee for Quality Assurance (NCQA), which awarded the organization a perfect score for its accomplishments as a Patient-Centered Medical Home (PCMH).

Yale Health received the highest PCMH rating (level 3) and earned the highest possible score of 100 points, awarded across a range of standards involving all aspects of care delivery. Yale Health is one of only about 3,000 practices nationwide that has achieved any level of PCMH recognition.

"Yale Health employees have worked incredibly hard to attain this important recognition," says Paul Genecin, director of Yale Health. "At a time when our nation’s healthcare system is the subject of so much debate, the confirmation that our approach to patient-centered primary care is recognized as a model and a standard of excellence is extremely gratifying. I am very proud that the achievements of our organization have been recognized by the NCQA in this way."

The NCQA is a non-profit organization that works to improve quality in healthcare throughout the United States. Its PCMH program is specifically aimed at improving primary care.

In order to earn the recognition, Yale Health had to meet standards set by consumers and primary care professional organizations throughout the country. These standards focus on facilitating partnerships between individual patients and their personal care providers; and employing technological and other means to assure that patients get care when and where they need and want it, in a culturally and linguistically appropriate manner.

"PCMH is not a bricks and mortar place," explains Madeline Wilson, chief of internal medicine at Yale Health. "The concept of a patient-centered medical home is a way of organizing healthcare so it is centered around the needs of the patient."

"The patient-centered medical home promises to improve health and healthcare," said NCQA President Margaret E. O’Kane. "The active, ongoing relationship between a patient and a physician in medical homes fosters an all-too-rare goal in care: staying healthy and preventing illness in the first place." The PCMH recognition, she adds, "shows that Yale Health has the tools, systems, and resources to provide their patients with the right care at the right time."

Yale Health, which celebrated its 40th anniversary last year, is a full-service medical center for over 36,000 students, faculty, retirees, staff, and their dependents. The center is located at 55 Lock St., in a building that has been recognized for its sustainable design with a Leadership in Energy and Environment Design Gold Rating.

Yale Health’s PCHM recognition followed a rigorous review of its clinical operations, health informatics programming, care coordination, quality improvement, and population health activities.

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Some of the PCMH standards included ease of telephone access and ensuring patients can book appointments with their primary care clinicians as often as possible. When that is not possible, Yale Health uses a team approach.

"The relationship of the individual with his or her doctor or clinician is really central to the healthcare experience," said Michael Rigsby, Yale Health’s medical director. "But no one person can provide all of the care that anyone needs, so we rely on a team of professionals working together."

Wilson said Yale Health has also improved tracking of specialty referrals and tests as well as making sure patients are aware of how to manage chronic conditions such as hypertension and diabetes.

It often takes healthcare organizations two to three years to attain PCMH recognition, but Yale Health was able to do it in about a year because its model was already consistent with PCMH’s philosophy.

"It’s important to realize that Yale Health has been operating as a Patient-Centered Medical Home for many years," Wilson said. "We have used this recognition process to test ourselves against this national standard and to use the structure provided by the recognition process to tighten up some workflows and create some new ways of approaching things. These are all things that we planned to accomplish anyway, but this really facilitated and organized our efforts."

While the focus of the recognition is on adult primary care and pediatrics, Wilson said the process has truly been a "building-wide effort."

"We at Yale Health feel very proud of the quality of care that we have endeavored to deliver over the years," she said. "We’re proud to share with the wider Yale community the success of this model of care and the fact that the nation is endorsing a model of care that we’ve been practicing for years."

, visit the Yale Health website.