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Teamwork Tames Back and Neck Pain

Seven women smiling in team photograph

Members of the Spine Center of Excellence team in the Northwest market collaborated to improve service to Medicaid members.

At the Spine Center of Excellence in the Northwest market, team members strive to connect patients to treatment as quickly as possible.

But the Level 5 team struggled when it came to providing timely access to care for Medicaid members.

Before receiving treatment, Medicaid members must undergo a state-mandated pain evaluation administered by the team’s registered nurses. The nurses’ workload, however, meant patients sometimes waited as long as 37 days to be evaluated.

To improve access to care, everyone on the team began screening Medicaid members. In 4 months, they reduced wait times from referral to consultation by 35%.

“When you’re dealing with acute or chronic pain, quicker access to treatment means happier patients,” says Kali Dailey, RN, an OFNHP Local 5017 member and the team’s labor co-lead.

Coordinating spine care

The Spine Center, based at the Sunnybrook Medical Office in Clackamas, Oregon, is part of Kaiser Permanente’s coordinated approach to spine care. Across markets, spine centers help members with neck and back pain find the right treatment programs or surgeries in an expedited way.

In the Northwest, Spine Center staff are represented by the Alliance of Health Care Unions and the Coalition of Kaiser Permanente Unions. They gather information through questionnaire calls and follow an evidence-based treatment plan for members based on their responses.

Previously, only registered nurses were responsible for completing the questionnaires. They did so during the intake call they conduct with all members to consider which treatments – including injections and surgery – are appropriate.

But the nurses’ workload meant there was a lag time between referral and intake call. Before the team overhauled its evaluation procedures, the wait time averaged more than 37 days.

For members experiencing acute or chronic pain, that’s a long time to wait for a first intervention.

“Some of these patients were feeling like they had been forgotten,” says Jodi Lippmann, the team’s licensed practical nurse and a member of SEIU Local 49.

Fast tracking patients

To connect Medicaid members to care faster, the team obtained permission from Northwest practice leaders to allow its licensed practical nurse and medical assistant to complete the questionnaires.

The team’s new “fast track” system for Medicaid members meant wait times decreased by 35% -- from 37 days to 24 days – from March through June 2021.  This far exceeded the team’s original goal to reduce the wait time to 32 days.

The revamped approach continues to pay dividends – with wait times for all Spine Center referrals continuing to drop. Market leaders have taken notice, too. They recognized the team for improving service access, holding it up as a model for others to follow.  

“Everyone on our team came together on this project,” says Sophia Le, the team’s management co-lead. “The result is better service to our patients.”

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