Mercy Health with another National Model in Healthcare

GRAND RAPIDS — Mercy Health’s new primary care medical practice on Grand Rapids’ west side resulted from what Bob Look calls a lot of dissatisfaction.

Patients were dissatisfied with not getting the kind of access to care they wanted. Doctors and other clinicians were dissatisfied with bottlenecks in care delivery and high patient volumes that left them frustrated and led to a high burnout rate.

In reaction to that dissatisfaction, Mercy Health launched its Physician Partners Innovative Care practice at American Seating Clark Place along Broadway Avenue, west of the Grand River.

The medical practice, which has been in the planning stages for more than two years, puts in place a facility design and care practice model that Mercy Health parent company Trinity Health intends to use as a pilot to transform primary care delivery.

“Dissatisfaction for patients and dissatisfaction for clinicians has reached a point where everybody is willing to change,” said Look, the regional director of innovation at Mercy Health, as he led a tour of the new primary care practice.

Look and others involved in creating the new medical practice hope that it leads to less stress for clinicians and a better experience for patients with a flexible model that offers cures for some of the ills that ail health care. Improved workflows will enable clinicians to handle more patients amid a nationwide shortage of physicians, Look said.

“To think that we can just continue to operate and run our business without focusing on what consumers want is not long-term strategy,” he said. “Our goal is really to assure that we had a solution for now and a solution for later.”

In terms of care, the practice brings together various disciplines — physicians, pharmacists, clinical care managers, health coaches, community health workers, behavioral health specialists and nutritionists — into a single setting to work as teams. The idea was to generate better coordination and continuity of care and create less waste, leading to improvements in the cost of delivering care.

“We can care for people much more cohesively,” said Dr. Fred Reyelts, a family doctor and co-leader of the new practice.

For example, if a patient is having problems with the medication a doctor prescribed, the pharmacist is better able to step in to solve it. Likewise, diabetic patients who need to lose weight and change their lifestyle to manage the condition can work with on-site health coaches and nutritionists.

IMPROVING FLOW

In designing the location, Mercy Health consulted with Herman Miller Inc.’s health care division, Urbaneer LLC and Lott3Metz Architecture LLC for conceptual design and refined the concepts at its innovation hub in downtown.

One area where the practice’s physical layout is different from a typical medical office is the use of consultation rooms to complement exam rooms. Consultation rooms lack the medical equipment of an exam room. The rooms are designed to have a more relaxed setting for patients meeting with their physicians to go over the results of a diagnostic test or to discuss regular blood draws to check cholesterol and glucose levels.

Using consultation rooms frees up exam rooms, improving patient flows through the practice.

Designers sought to “design space for everybody,” Look said. The goal behind the space was to drive better engagement between doctors and patients, especially people with chronic medical conditions such as diabetes, asthma or hypertension that require ongoing management. If the health care team can better interact with patients and get them to make the behavioral or lifestyle changes needed to manage their medical conditions, the resulting lower cost over time to treat them more than offsets the upfront costs of bringing the medical teams together at a single location.

“It’s cheaper to do it proactively,” said Pauline Nic, director of transformation and process excellence at Mercy Health. “The resources are wrapped around people where they need them.”

In the weeks since the office opened, practice co-leader Dr. Mary Kline already has noticed that her patients seem “happier and more engaged in their care.” That helps to build a greater rapport in the doctor-patient relationship, which can make a difference in their care, especially for people with chronic conditions connected to behavior and lifestyle.

ADDRESSING BURNOUT

In the physical layout, the space is designed to improve work flows and communication among staff members and care providers. There’s also a respite room where staff can get away for a few minutes to decompress or to exercise.

Those kinds of amenities are intended to address the high rate of burnout among medical professionals, a factor that contributes to the physician shortage.

Results of a 2017 survey by the medical news website Medscape involving more than 14,000 doctors nationwide put the burnout rate for family and internal medicine physicians at 55 percent, an increase of more than 10 percentage points since 2013 for each category. Both rank in the top five for physician burnout.

If Mercy Health can reduce the on-the-job stress and address the burnout rate of clinicians, it can ultimately lead to reduced burnout rates and improved medical outcomes for patients, Reyelts said.

“If we’re happier, we provide better care,” he said.

A NATIONAL MODEL

Elements of the model used at the new practice could begin rolling out at other Mercy Health locations around West Michigan within six months, Look said. Using the site as a skunkworks, Trinity Health eventually plans to incorporate the lessons learned in Grand Rapids at its 4,000 primary care practices in Michigan and 21 other states, he added. 

Mercy Health decided to base the practice in Grand Rapids’ west side neighborhood because it offers a good demographic mix needed for a pilot test.

“The broader the demographics, the more we have comfort that this will work,” Look said.