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Air Force medical group saves thousands with AFSO 21

by Staff Sgt. Connie L. Bias
92nd Air Refueling Wing Public Affairs

9/4/2007 - FAIRCHILD AIR FORCE BASE, Wash. (AFPN)  -- Members of the Fairchild Air Force Base medical group saved more than $75,000 in emergency room visit costs over the past year through a just-do-it initiative, a program associated with Air Force Smart Operations for the 21st century. 

Through patient education and training, the 92nd Medical Group staff is making great strides toward more efficiency with less dollars.

The secret? Teaching the base populace the difference between emergency care and urgent care.

"There are two types of care a patient can have outside the clinic: Emergency care for the really serious problems, and urgent care for things that are less acute," said retired Lt. Col. Ronald Martin, the 92nd Medical Group AFSO 21 representative. "We ask people to go to (an) urgent care (clinic) for those less acute problems because the price is about one sixth the cost of an emergency room visit." 

The cost of a visit to an ER for a diaper rash or minor cut can run up to $600, but an urgent care clinic can take care of similar problems for an average cost of $80 to $100. 

For those medical issues that leave you wondering which clinic is most appropriate, the medical group has an on-call provider to help at any time.

"The provider is available 24-7, and we'd like people to call in if they're not sure how serious the medical problem is," Colonel Martin said. If a person has a true emergency, "By all means, don't waste your time calling. Call 911 and get to an emergency room. But for those less acute issues, the provider will talk to the patient and determine what level of care is appropriate, and direct the caller to the nearest center."

The previsit screening process has played a major part in lowering costs for the medical group. While the number of off-base medical facility visits may stay the same, every visit to an urgent care clinic versus the ER saves money. 

The number of people redirected to an urgent care clinic by on-call providers is high. In June 2006, Fairchild AFB's beneficiary population visited the ER 320 times, whereas in the same month this year, only 160 people checked into the ER. That's a 50 percent visit reduction, paired with a 44 percent cost cut. 

This is just the type of hard-hitting, immediate result that the just-do-it program emphasizes, said Bill Long, Fairchild AFB's AFSO 21 consultant. 

The just-do-it initiative is one of two AFSO21 programs used by the medical group.
The other, the Rapid Improvement Event, is a more formalized process designed to improve broad-scope processes and strategies. 

The medical group staff is currently working an RIE concentrating on some upcoming service transitions from public health to primary care managers, but just-do-it allows a much faster response and result times, Mr. Long said.

"With just-do-it , a group identifies a problem or issue, assembles a small team, creates an action plan to improve the process, and just gets it done," Mr. Long said. "That mobilizes the medical group into a continuous improvement mode, where they're always striving for better things by just implementing improvements that come up, versus waiting and prioritizing and analyzing." 

That's because the just-do-it program basically puts a new name to what the medical field has always done -- quality improvement, he said.

"Health care civilian inspection teams require performance improvement, so we've been doing it all along," Colonel Martin said. "I think that's one thing the medical group has going for it; we're never allowed to stop quality improvement, so it just keeps going."

The group's list of recent improvements reads like the index of a success journal -- cut profiles extending past one year by 66 percent, cut medical evaluation board processing times by almost 50 percent, increased Tricare online registered users by 43 percent. 

Successes like more urgent care clinic use wouldn't happen without patient cooperation, Colonel Martin said.

"It's really a partnership with the patients, and it's a win-win situation," he said. "The patient wins because they're not sitting in the emergency room for hours with a minor problem, and we win because we save dollars and can be better stewards of the taxpayers' money."

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