Hospitals in pursuit of excellence

Cheyenne Regional Medical Center

Cheyenne Regional Medical Center
Cheyenne, WY
222 Beds

The Problem
Cheyenne Regional Medical Center consists of 222 beds, making the facility Wyoming’s largest health care system with a total of 168 physicians and 1,850 employees. It serves a patient population characterized as follows: 22.6 percent of the patients lack health insurance, more than 20 percent of the patients smoke and 24.3 percent of the adults are obese.

The Solution
Cheyenne Regional created the Cheyenne Health and Wellness Center in 2005 in South Cheyenne. The health and wellness center partners with local community organizations including businesses, schools and child care facilities to provide general primary medical care, dental/vision services, flu shots/immu¬nizations, diagnostic testing/screening, well-child visits, in-house pharmacy, translation services (English/Spanish), health education, family planning, pregnancy testing and referral, work/school physicals and case management. The Cheyenne Health and Wellness Center serves more than 5,000 patients annually, and 70 percent of patients have family income below 100 percent of the federal poverty level. Wanting to engage more proactively with patients with chronic disease, the Cheyenne Health and Wellness Center created Wyoming’s first patient-centered medical home with the aim to improve access to care, help patients manage their symptoms, reduce acute events and improve patients’ health outcomes.

The Result
In year two, the patient-centered medical home has shown significant improvement for patients struggling with access to health care services and with high incidence of chronic disease, including:
            Overall, patient population size increased by 17.5 percent; over 5,000 patients served to-date. 
            Breast cancer screening was improved to 41 percent (from 13 percent in 2011).
            Pneumococcal vaccination for the age target population improved to 19 percent (from10 percent in 2011).Female patients receiving a Pap test increased to 68 percent (from 19 percent in 2011).
             BMI is now captured and recorded for 100 percent of the patients at the time of their visit.
             The average cost per clinic visit decreased by 20.84 percent.

Lessons Learned
As the Cheyenne Health and Wellness Center evolved, the partners found it necessary to address quality improvement issues to streamline operations such as patient tracking and monitoring, clinical management and reporting.

Cheyenne Health and Wellness Center has implemented a series of Plan-Do-Study-Act cycles of quality improvement to streamline the operations, the clinical management and the quality reporting processes in support of the patient-centered medical home transformation work. As a result, the team has successfully implemented chronic disease management programs, developed a streamlined process of medical referrals, increased access to care including same-day appointment availability and doubled the number of successful prescription assistance applications. The clinic had significantly reduced operating costs and increased revenues.

The safety-net patient-centered medical home  is evolving into a more formal learning model, which includes the transformation of process and culture.

Contact Information
Phyllis Simpson Sherard, PhD
Administrator
(307) 633-2914
Phyllis.Sherard@crmcwy.org

This case study was originally featured in the HPOE guide: "The Role of Small and Rural Hospitals and Care Systems in Effective Population Health Partnerships," published June, 2013.