Finding and Engaging Primary Care Practices

1. Finding and Engaging Primary Care Practices

2. Importance of Primary Care Involvement • Cities for Life has recognized the centrality of primary care in diabetes management. • It’s not enough for communities to offer a rich set of resources that promote diabetes management 24/7. Patients must be guided to the availability of these resources and helped to find those which might best meet their needs.

3. Importance of Primary Care Involvement • Cities for Life uses patient navigators – trained non-professionals who then help patients consider and access resources that may be helpful to them. • Primary care practices refer patients to patient navigators. • The following slide shows a diagram of the interactions between primary care practices, a practice-based research network coordinating center, patient navigators and community resources.

5. Recruiting Practices • Engage a local Coordinating Center. For this role, consider working with a practice-based research network (PBRN). • A local PBRN knows their practices and the practices know and trust their local network. • Members of a PBRN may be interested in participating in the Cities for LifeSteering Committee and serving as the initial interface between the participating practices and the patient navigators.

6. 10 Essential Steps to Effectively Engaging Physicians • We recommend the coordinating center follow the “10 Essential Steps to Effectively Engaging Physicians,” by Dr. Howard Beckman (available at http://www.cfmc.org/files/ACUploads/StrategiestoEngagePhysicians_051412_FINAL.pdf) • The following steps are essential to effectively engaging physicians: • Set a tone of collaboration – Make the time convenient for the clinician; go to his/her practice. Open the conversation with, “I appreciate your visiting with us today.” • Explain the purpose of the project. “We are looking for physicians who want more resources for their patients who have or are at risk for type 2 diabetes. My visit here today is tell you about the available community resources and explain our patient navigation process.” • Be non-judgmental, allowing the clinician to become part of the solution. “We’ve heard that many clinicians wish they had more time and solutions to offer patients, but they simply don’t have the staff or resources. This project can help you lead patients to resources simply by referring them to a patient navigator.” • Present ONLY enough data to inform the discussion and explain why you are talking to him or her. • Listen carefully to his or her responses. Demonstrate you want to understand without judging.

7. 10 Essential Steps to Effectively Engaging Physicians (cont’d) • Engage other staff that might be present. “What do you hear from patients as you work with them?” • Offer praise whenever possible. “It seems like you are really trying to offer patients the information they need.” • Encourage staff to consider solutions to problems identified so the physician won’t have to be the solution to each problem. “Can you think of ways to respond to a patient’s needs before the doctor is involved? Have you talked to staff in other practices?” • Conclude by asking if the clinician would refer patients to the navigators, and whether the clinician would consider joining your Community Action Team. • Send a follow up thank you note summarizing the results of the meeting.

8. Working with Practices • The Coordinating Center gathers input from community partners and leads the effort to identify eligible and interested practices in targeted neighborhoods. • The Coordinating Center enrolls practices and promotes quality improvement activities within the practices. • The Coordinating Center and the patient navigators work with practices to establish effective referral and tracking systems for patients.

9. Working with Practices • Use materials developed by Cities for Life to help clinicians and staff members become comfortable approaching patients: • Talking points for providers (why participate, addressing patient refusals) • Posters • Pamphlets • Brochures for the waiting room