Mr. Evan Steffens

Evan Steffens, R.N., M.S.

That relatively straightforward, if unusual, team structure yields a number of benefits, said Evan Steffens, R.N., director of clinical and quality systems for the practice network, which is affiliated with Premier Health Partners.Chief among them is that team members come to know their patients well enough to avoid the time-consuming triage and time-wasting task shuffling that can occur when patients call a large practice.

"You get tremendous efficiency by having people responsible for a smaller piece of the pie," Steffens said.
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Moving from a formerly centralized model to dedicated practice teams has been no small feat, acknowledges Steffens, who, before joining Primary Care Networks, helped lead the transition to a decentralized structure at Seattle-based Group Health Cooperative.
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They like being part of their own little company, and there is more accountability," Steffens said, noting the marked drop in call-in rates."People are more likely to show up when they know their team is depending on them."

The shorter visit time, from about 65 minutes in 2000 to an average of 40 minutes this year, is responsible in part for the significant financial improvement Primary Care Networks is experiencing.But the reduced salary overhead - there's less overtime and less need to cover employees who call in sick now - has contributed to the improved bottom line as well, according to Steffens.

The new team structure also has been well-received by physicians, primarily because it simplifies their workday and makes it easier to identify and remedy problems when they occur."The [physician] response has been very positive for the most part," Steffens said.

--Evan Steffens, Primary Care Networks of Premier Health Partners (20 minutes)

Mr. Evan Steffens, RN, MS Director, Clinical and Quality Systems, Primary Care Networks, Premier Health SystemsNMHCC - Speakers
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Mr. Evan Steffens, RN, MS

Director, Clinical and Quality Systems, Primary Care Networks, Premier Health Systems
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Evan Steffens is currently the Director of Clinical and Quality Systems for Primary Care Networks of Premier Health Partners in Dayton, Ohio.The physician network consists of the practices of 103 primary care physicians located in a large geographical area around the city of Dayton, Ohio.In her capacity as Director, she is responsible for developing, implementing and maintaining all clinical and quality initiatives for the network physicians.Recent projects include major chronic disease initiatives for the improvement of the management of cardiac disease, hypertension and diabetes as well as preventive strategies.Additionally, Evan has been instrumental in the implementation of the concepts of office design and improved efficiency including open access scheduling, use of disease registries and the use of practice teams.For the past two years, Evan has been working closely with the Tri-River Healthcare Initiative to develop and implement a physician bonus plan which incorporates the concepts of improved chronic disease management, information technology implementation and customer satisfaction.Evan is a advance practice nurse with many years of both inpatient clinical delivery as well as outpatient primary care management.

"The employer/plan/physician relationship is often adversarial, so the partnership represents a new way of looking at healthcare," says Evan Steffens, director of clinical and quality services for Premier Health Partners.Although she says it has taken a hands-on effort to get physician buy-in, "we are all at the same table trying to problem-solve."

Evan Steffens, RN, MS, director of Clinical and Quality Systems, Premier Health Partners Primary Care Physicians Network, presented the "Diabetes Innovation Tool Kit" - a comprehensive diabetes improvement initiative - at the NCHC's national conference in Washington, D.C., in May.The program also will be featured in a Journal of the American Medical Association (JAMA) article in the fall.

"The tool kit," explains Steffens, "consists of a variety of materials that physicians keep in their exam rooms so they are quickly available when seeing their diabetic patients."

"But our team also worked closely with the physicians to get their feedback and continually improve the process," says Steffens.

Secretary: Evan Steffens, RN, MS