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Last month, when the clinical and residency components of the Family Medicine Department moved to the newly refurbished AAA building at 777 S. Clinton Avenue, it also began introducing a new approach to patient care.
As one of the main providers of high quality medical care for Rochester's underinsured and uninsured communities, Family Medicine faculty and residents log, on average, more than 55,000 patient visits each year. According to Thomas L. Campbell, M.D., Rocktaschel Professor and Chair of Family Medicine, the new location was designed to accommodate not only the continued growth of the practice, but to give faculty the opportunity to introduce new models of patient care.
"While our department desperately needed a new facility to house our very busy clinical practice, we felt the clinical practice itself also needed to be reengineered to more fully embrace the six aims of the Institute of Medicine's (IOM) Quality Chasm Report, which underscored the need for safe, effective, patient-centered, timely, efficient and equitable medical care," Campbell said. "Our new facility gives us the space, and in some cases, the equipment necessary to begin transforming the way we practice every day."
With almost 50% more space, the new Highland Family Health Center includes the practices of 20 Department of Family Medicine faculty and two dozen residents, as well as the Highland Apothecary, Cornhill Internal Medicine, Strong Behavioral Health Service and a Strong Health laboratory collection station. The Family Medicine space is divided into six suites to give the feel of a smaller practice and promote a team-based approach to care.
By the end of the year, the Department expects to have its practice fully converted to electronic health records, one of the major tenets of the IOM's report. In addition, group patient visits have been integrated into the practice, so that patients can learn more about their illness from patients with similar conditions. Currently, these group appointments are being organized for diabetic patients, with more planned on the horizon. The practice will also begin operating an open access schedule so that patients can be seen by a physician the same day they call for an appointment.
"The Department of Family Medicine is nationally renowned for its work on doctor-patient relationships, family-oriented primary care and the elimination of the disparities in health care,"Campbell said. "These changes are just one more advancement we are making to continue to provide excellent care for our patients and training for our residents. We believe it will be a model for others in the nation to follow."
Patients, their families and medical professionals can turn to a new Center for Palliative Care and Clinical Ethics to seek out expert help to cope with some of the troubling circumstances that can accompany serious illness.
The new Center brings together the Palliative Care Program, which helps enhance quality of life for seriously ill patients, and the Program in Clinical Ethics, which can play a crucial role for people facing some of medicine's thorniest questions. Doctors and scientists at the Center will study and work to improve the quality of care for all seriously ill patients, as well as train young doctors for some of the complex situations they will encounter when treating very ill patients in the future.
"There was a tremendous opportunity for collaboration and cooperation between these two programs," says Timothy Quill, M.D., a palliative care expert who heads the new Center. "This will make it easier to coordinate and improve care for patients who face very challenging problems as they cope with serious illness."
The co-director of the new Center is Jane Greenlaw, Ph.D., director of the Program in Clinical Ethics.
Both the palliative care and the ethics programs will continue as distinct programs, providing services and advice on a variety of issues. The Ethics Consultation Service is available to patients, families, and all members of a health care team who are having trouble sorting out knotty ethical issues. For example, conflict might arise about what type of care is most appropriate, perhaps around the role of advanced technology or experimental therapy in treating a patient with a life-threatening illness. The program was created more than a decade ago and is available to medical professionals and patients in several hospitals throughout the region.
The Palliative Care Program, which aims to relieve pain and suffering and to enhance the quality of life for people with serious illness, currently serves as a resource for inpatients at Strong Memorial Hospital, Highland Hospital, and Monroe Community Hospital. The service, which began in 2001, is available to anyone who is seriously ill, even if full recovery is expected eventually. The program's community-wide pain-management initiative, in collaboration with the Rochester Health Commission and Excellus Blue Cross/Blue Shield, was recently recognized nationally by the Institute of Medicine, and also is a finalist for this year's Circle of Life Award given by the American Hospital Association.
Both programs are growing: The ethics program service is making its experts available to community hospitals in the region, while palliative care consultations are now being made available to outpatients and to patients in their own homes.
"We're lucky in Rochester to have outstanding programs in both clinical ethics and in palliative care," says Quill. "Both deal with very complex clinical issues that affect patients and their families every day. We want people to know if they face an ethics conflict that isn't easily solved, or if they are in treatment and have inadequate pain and symptom management, they have a place to turn."
Center is located near the west end of the Miner Library corridor
on the first floor, 1-6305 through 1-6321, and can be reached at 275-5800
A massive letter campaign is underway throughout the Medical Center, in response to Governor George Pataki's proposed New York state budget. The budget contains crippling health care cuts to hospitals, nursing homes and home care agencies, and if adopted as it is currently proposed, Strong Memorial Hospital would lose as much as $12.3 million in Medicaid payments annually, while Highland Hospital would lose $3.6 million. Rochester's nursing homes and home care agencies would also suffer, making it even more difficult to move patients through our health care system.
Senior leadership has already worked hard to create an efficient operation, so cuts of this magnitude could mean program and staff reductions -- throughout the Medical Center and its health system. With all of Rochester's hospitals facing similar cuts—estimated at $37 million a year—it would be yet another blow to Rochester's economy.
On behalf of our patients, we must make our voices heard, to help the Rochester delegation and Governor Pataki understand how damaging these cuts are to the health care system and patient care services. During the week of February 28, tables will be set up outside the House of Six Nations cafeteria from 11:30 a.m. – 1:30 p.m. with form letters for all faculty and staff to sign. In addition, you can access sample letters online at http://capwiz.com/hanys, as well as a list of your state representatives.
Please be an active participant in a campaign to stop these devastating cuts from occurring!
A patient leaving his appointment at a University of Rochester Medical Center (URMC) clinic spotted a booth collecting money for the Red Cross' tsunami relief effort. He paused, then approached the volunteer at the booth, dropping his cab fare into the collection jar. "Those people need this more than I do," he told her. Then, he caught the bus on Crittenden Boulevard back to his home.
Over a recent, two-week period, dozens of URMC volunteers were touched by similar acts of generosity as the Medical Center and its affiliates collected $30,885.14 to aid the American Red Cross' tsunami relief efforts. Faculty and employees contributed through cash, checks and on-line donations. In addition, booths with information about the relief efforts collected cash donations at the Medical Center, Highland Hospital, Visiting Nurse Service, and Eastman Dental Center.
"So many of our staff members were looking for a way to help,
and because of the overwhelming nature of this crisis, the Medical
Center waived its non-solicitation policy," said Susan Saunders,
director of Care Management and chair of URMC's tsunami relief
committee. "It's been a pleasure to work in partnership
with the Red Cross on this effort and with the many staff and volunteers
from throughout the system who helped make this initiative successful."