Tiffiny Journot-Collins reached out to an elderly patient to schedule his Medicare Annual Wellness Visit, and she discovered he had some frustrations.
Tiffiny knew what to do.
“Making sure patients feel heard is important,” she says. “I’m not just calling so you will see your doctor, I want you to know that I hear you, and I’m going to help you out however I can. Sometimes it’s little things.”
For the elderly gentleman, the little thing was the prescription pick-up alert on his phone. Now resolved, he knows what to expect when filling out his prescriptions, thanks to Tiffiny’s calm and helpful explanation. And now he’s scheduled for his next wellness appointment too.
“I received an email from one of the clinic practice managers yesterday regarding an interaction one of my health promotion specialists had with a patient,” Tiffiny’s manager, Keri Thompson, shared. “She wanted to recognize Tiffiny for how she handled an upset patient and the excellent customer service that made the patient feel valued and heard. I feel her praise truly captured the amazing human that Tiffiny is. And, when I shared the email with Tiffiny, the response she sent back to me was so heartwarming. Tiffiny is an excellent member of this team and department, and she truly embodies CHC’s mission.”
Tiffiny works as a Health Promotion Specialist within the Population Health Team. She and the other specialists reach out to patients to encourage them to complete their wellness visits and screenings, discuss risks to their health, and figure out ways to overcome any barriers that might prevent them from getting needed care.
“Imagine that was someone calling your grandpa, grandma, or your mom or your dad, I want to make sure they get the care they need,” Tiffiny says. “I think every person deserves that.”
What is Population Health at CHC/SEK?
The Population Health Department works to enhance patient health, improve the health of populations, reduce the cost of care, and create efficiencies in CHC/SEK’s system of care.
Health Promotion Specialists call patients to discuss preventative care they may be due for, such as wellness visits and cancer screenings. They schedule thousands of appointments each year. In the last year, the Population Health Department has scheduled over 12,500 appointments! Over 8,500 were for Well Child Checks and Medicare Annual Wellness Visits.
Health Promotion Specialists also make calls to complete a health risk assessment before Medicare Annual Wellness Visits. The calls are a great opportunity to identify safety concerns, barriers to care, and needs like food or safe housing. The specialists are not confined to time constraints like in the primary care setting, so they can offer more time to listen to patients. Doing these calls beforehand also allows them to connect patients to resources quickly instead of waiting for needs to be addressed at their appointment. A couple of days can mean a lot when someone doesn’t have access to food.
Our comprehensive care extends to the post-hospitalization period, too. Our Transition of Care nurses, as part of the Population Health team, follow up with patients who have had a recent stay in a hospital or a visit to an emergency department. They help ensure patients are connected to their primary care provider and any health needs are met following their hospital visit. In the last year, these four nurses scheduled almost 1,000 Hospital and Emergency Department Follow-up appointments.
Lastly, Population Health assists the primary care teams by helping address the acute needs of patients through the Nurse Triage position. The triage nurse takes inbound calls for patients from all service locations. She provides timely assistance to patients and helps them get the right care, at the right place, at the right time. This can help decrease unnecessary emergency department utilization or ensure that patients who are very sick can get the care they need sooner. In the last year, the triage line received over 1,500 calls.
Learn more about CHC/SEK here.