2018 Acclaim Award Recipient
CHRISTUS Trinity Clinic
Cultural Transformation Journey
CHRISTUS Trinity Clinic is a not-for-profit multispecialty practice founded
in 1995 and is part of CHRISTUS Health’s Northeast Texas Region, which also
includes CHRISTUS Trinity Mother Frances Health System, CHRISTUS Good Shepherd
Health System, and CHRISTUS St. Michael Health System. The group of
distinguished providers includes more than 650 physicians and advanced practice
professionals with over 41 specialties providing a world-class continuum of care
to patients in 82 locations across an area that would measure as the country's
40th largest state. Over the past two-and-a-half years, they have experienced
exponential growth, nearly doubling the number of providers, while remaining
true to their mission and serving their communities by meeting the Institute of
Medicine Aims for Improvement.
CHRISTUS Trinity Clinic provides care to nearly 200,000 patients annually
regardless of psychosocial or socioeconomic status. In addition, five rural
health clinics provide primary care services for Medicaid and Medicare patients
in rural communities. Last fiscal year, they served approximately 48,000
patients in these medically underserved areas. In 2017, they performed over
1,250,000 ambulatory clinic visits.
CHRISTUS is improving quality of care and reducing the cost of health
services while achieving and maintaining high levels of patient satisfaction and
provider engagement. AMGA’s High-Performing Health System™ (HPHS) attributes,
along with their core mission principles, guide their physicians, advance
practice providers, clinical staff, and support staff to provide the highest
quality of compassionate care.
Below are highlights of the initiatives which led to CHRISTUS Trinity Clinic
being named the 2018 Acclaim Award Recipient:
- Dashboards were created for
all departments within the system and grouped with the HPHS attributes.
- They hired an external
physician-coaching firm, which interviewed each physician leader and executive
team member in order to create a custom leadership curriculum that would best
fit the needs of their leadership team.
- Monthly meetings between
directors and managers, as well as between managers and their team members,
promote an environment of accountability related to departmental performance
- Quality reporting was
upgraded to a self-service, web-based reporting portal, and results are shared
at monthly meetings of providers and their teams.
- The system employs care
coordinators and assigns them to a primary care team of providers. At each
location, the care coordinator supports the Patient-Centered Medical Home (PCMH)
model via pre-visit planning, scheduling of appropriate preventive services, and
identifying any concerns or health problems the patient may have for his/her
upcoming physician appointment.
- Pursuit of quality is
powered by value-based contracts that cover approximately 25% of adult primary
Compensation Practices and Incentives
- To remain successful with
ever-changing physician reimbursements, CHRISTUS Trinity Clinic began modifying
their physician compensation structure to align with value-based incentives.
Efficient Provision of Services
- Their medical group
division, in conjunction with Medicare Shared Savings Program (MSSP) Track 1
ACO, has implemented claims and electronic health record data analytics to
impact the per capita cost of health care.
Organized Systems of Care
- CHRISTUS Trinity Clinic's
multidisciplinary, employed medical group is supported with a fully integrated
electronic medical record. This entire network of providers and facilities could
not operate efficiently and effectively were it not for the shared governance
structure that incorporates physician leadership in all clinical decisions and
strategy, sound financial stewardship, administration and management.
Quality Measurement and Improvement Activities
- Their Quality Committee has
excelled in fulfilling its vision statement to use the resources available to
help clinicians efficiently provide safe, evidence-based, high-quality care. As
a result, they evaluate and attempt to improve performance in many areas outside
of traditional quality metrics.
Using Technology and Evidence-Based Medicine
- The system heavily promoted
the use of a patient portal to teams and patients as a tool to achieve
patient-centered and timely care. Through the use of the patient portal,
patients are better able to be engaged in their health care and better
understand the clinical decisions made during their visits through access to
after-visit summaries of all their recent visits, lab results, vital signs and
- CHRISTUS automated a process whereby a patient’s elevated blood pressure
would trigger the EMR to include hypertension information on the after-visit
summary. These tools also assisted providers in the reduction of duplicated
testing and services, reduced medication errors through best practice advisories
when contradictions appeared, allowed up-to-date medication reconciliation and
speedy referrals, and expedited prescription ordering.