Jennifer Donahue
Communications Manager, Washington Chapter of the American Academy of Pediatrics
Knowing what your clinic needs to offer to best serve families is often easy. Knowing how to offer those services in a sustainable way can be much more difficult. For Dr. Jennifer Polley and her colleagues at Northwest Pediatric Center in Centralia, it was clear for many years that the families in their community needed access to care evenings and weekends, so they collaborated with other pediatric groups in town to staff a walk-in clinic at the local hospital. But as Northwest Pediatric Center grew to over 15,000 patients at 4 clinics, they realized that the best way to serve families and offer the standard of care they wanted to provide – without burning out their providers – was to extend the hours at their own clinics.
“We want our patients to have consistent care,” says Polley. “Looking at the numbers, we realized we were losing a ton of people to the walk-in clinic.” After evaluating the times that their patients were seeking care in emergency departments or urgent care clinics, Dr. Polley and her staff realized that by offering a 12pm-8pm shift on weekdays and a 3-hour Sunday evening shift, they could remain open for extended hours with their existing staff. They continue to offer Saturday hours as well.
How do they do it? It helps to start off with enough staff on hand to share the burden. At Northwest Pediatric Center they have 11 FTE physicians and the 12pm-8pm shift is just “part of the deal” at the time of hiring. They pay for Sunday evening shifts separately. “In the winter it’s hard to keep up but we have two RNS and in the winter months we triage. We don’t want to kill our providers,” says Polley.
Has it been effective? In a word: Yes. “From a business standpoint, it is amazing and for access to care it’s been fantastic,” says Polley. Families are happy to be able to see their own physicians when they need care evenings and weekends, and Dr. Polley knows they are receiving the optimal standard of care when they come into her clinics. The ultimate proof is in the numbers; the percentage of Northwest Pediatric Center patients being seen in the hospital’s urgent care clinic dropped significantly – 20% in the first year alone, while their own walk in clinic saw a 21% increase in encounters. Not only has it been the right step for patients, but from a business standpoint as Washington’s transition to value-based payment continues, a clinic’s ability to lower their patients’ rate of ED utilization will affect payment.
Dr. Polley’s advice to other clinics that want to offer extended hours: “The key is really to have buy in from your providers. It can be really hard in the winter when we are so busy, but we approach it as a team and help each other out. It’s a philosophic approach. We still need a life, but we really want to be available for our patients. We can give the best care for our patients because we know them.”