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AFSO 21: Med Group saves thousands with Just Do Its

  • Published
  • By Staff Sgt. Connie L. Bias
  • 92nd Air Refueling Wing Public Affairs
FAIRCHILD AIR FORCE BASE, Wash. --  The 92nd Medical Group has saved more than $75,000 in emergency room visit costs over the past year through a Just Do It initiative, a program associated with Air Force Smart Operations 21. Through patient education and training, and with a little help from those patients, the group is making great strides toward more efficiency with less dollars.

The secret? Teaching the base populace the difference between emergency care and urgent care.

"There are two types of care a patient can have outside the clinic: emergency care for the really serious problems, and urgent care for things that are less acute," explained retired Lt. Col. Ronald Martin, 92nd Medical Group AFSO 21 representative. "We ask people to go to urgent care for those less acute problems because the price is about one sixth the cost of an emergency room visit."

In other words, there's no reason to spend upwards of $600 dollars for a diaper rash or minor cut in the ER when an urgent care clinic can take care of such problems for an average cost of $80 to $100. For those medical issues that leave you wondering which clinic is most appropriate, the medical group has an on-call provider at 247-5561 or 247-5662 to help at any time.

"The provider is available 24-7, and we'd like people to call in if they're not sure how serious the medical problem is," said Colonel Martin, though he did stress that if a person has a true emergency, "By all means, don't waste your time calling. Call 9-1-1 and get to an emergency room ... But for those less acute issues, the provider will talk to the patient and determine what level of care is appropriate, and direct the caller to the nearest center."

This pre-visit screening process has played a major part in lowering costs; while the number of off-base medical facility visits may stay the same, every visit to urgent care saves a notable amount of money. And the number of people re-directed to urgent care by on-call providers is high; in June 2006, Fairchild's beneficiary population visited the ER 320 times, whereas in the same month this year, only 160 people checked into the ER. That's a 50-percent visit reduction that paired with a 44-percent cost cut.

According to Bill Long, Fairchild's AFSO 21 consultant, this is just the type of hard-hitting, immediate result that the Just Do It program emphasizes.

"With a Just Do It, a group identifies a problem or issue, assembles a small team, creates an action plan to improve the process and just gets it done," said Mr. Long, explaining that the other AFSO 21 process, the Rapid Improvement Event, is a more formalized process designed to improve broad-scope processes and strategies. These too are extremely useful and important (in fact, the Medical Group is currently working an RIE concentrating on some upcoming service transitions from Public Health to Primary Care Managers), but the Just Do Its allow much faster response and result times.

"That mobilizes the medical group into a continuous improvement mode, where they're always striving for better things by just implementing improvements that come up, versus waiting and prioritizing and analyzing," said Mr. Long. "It can be small or major improvements - the Medical Group has always been good at it."

That's because the Just Do It program basically puts a new name to what the medical field has always done - quality improvement.

"Healthcare civilian inspection teams require performance improvement, so we've been doing it all along," said Colonel Martin. "I think that's one thing the medical group has going for it; we're never allowed to stop quality improvement, so it just keeps going."

Keeps going is right. The group's list of recent improvements reads like the index of a success journal ... Cut profiles extending past one year by 66 percent, cut medical evaluation board processing times by almost 50 percent, increased TRICARE online registered users by 43 percent ... You get the picture. Colonel Martin pointed out, though, that successes like more urgent care use wouldn't happen without patient cooperation.

"It's really a partnership with the patients, and it's a win-win situation," he said. "The patient wins because they're not sitting in the emergency room for hours with a minor problem, and we win because we save dollars and can be better stewards of the taxpayers' money."