The Yakima Farm Workers Clinic (YVFWC) at www.yvfwc.com in 15 months has made progress towards transforming all of their 14 eligible sites to operate as Patient Centered Medical Homes (PCMH) and gain level 3 PCMH recognition.
Guided by practice coaches and PCMH experts from Arcadia Healthcare Solutions, YVFWCs ultimate objective is to implement sustainable change and necessary workflows, staffing models, and day-to-day operations in order to function as a PCMH.
YVFWC was established as a non-profit organization in 1978 to provide healthcare for migrant and seasonal farm workers. Today, YVFWC with locations throughout the state of Washington and Oregon provides services without regard to an individual’s ability to pay. A sliding-fee scale is available for those without health insurance.
The list of services includes medical and dental care, behavioral healthcare and counseling, pharmacy services, community health services and nutritional services, plus there are education and employment training programs.
Many of the communities served by YVFWC have significant populations of farm workers and low income families. To meet the needs of the people living in the communities, about two-thirds of staff members are bilingual and bicultural with many of the staff from families that earn their living from migrant or seasonal farm work.
According to the National Center for Farmworker Health (NCFH) at www.ncfh.org, the trend is for many health centers and doctor’s offices to become PCMHs and work as a team. According to NCFH explaining how the PCMH works, a patient named Mr. Mendoza fainted at work. His coworkers rushed him to the ER where the doctors ran tests and found that he was diabetic
He then went to his local health center now a Patient Centered Medical Home and works with a healthcare team to better manage his diabetes. Before he was ready to go to the health center, Mr. Mendoza and his wife went to a class on diabetes. Soon after the class, his doctor received a note electronically that he had completed the class.
His healthcare team consists of:
- An interpreter able to share health information in his language and help him communicate with his healthcare team
- The patient navigator to help him with his appointments and referrals
- The doctor that treats and leads Mr. Mendoza’s healthcare
- His wife who supports and helps him manage his diabetes at home
- The diabetes educator to teach him how to take care of himself
At the end of his visit, Mr. Mendoza was able to log into his patient portal to look at all of his health information including laboratory tests. He was also able to schedule future appointments, and have his prescriptions sent directly to his pharmacy.
YVFWC has found that in spite of the challenges and the level of complexity associated with a transformational effort of this magnitude, YVFWC is already beginning to see measureable signs of improvement.
There have been improvements in the quality of care and outcomes, staff members are driving standardization across the network, and there is consistency, reliability, and understanding of reporting across the organization. However, there is still a significant amount of work to be done by YVFWC Health and Arcadia staff to keep the momentum moving forward during the process.