Bangor Beacon Community: Establishing Best Practices in Health Care

Catherine J. Bruno | May 24, 2011

Governance – it’s been the Achilles heel of more than one multi-stakeholder health information organization. As a collaborative partnership including hospitals, a primary care association, and other health care provider organizations, the Bangor Beacon Community realized early on that our success depended in large part on a solid governance strategy that linked the goals of the Beacon Community Program and the broader stakeholder community.

From the outset, we established a leadership committee, the first element of our strategy, to provide overall strategic direction for the community and to align our objectives with state policy. The group, which meets quarterly, is comprised of leaders from our partners, plus such organizations as the Maine State Coordinator for Health Information Technology and the Maine Centers for Disease Control.

At the heart of our community is the Clinical Leadership Team, the second element of our strategy, which consists of clinical leaders from partner organizations along with research and evaluation leaders and program staff. The clinical team meets monthly and approves and monitors all of the clinical measures, interventions, and goals of the Bangor Beacon Community. A smaller Clinical Transformation Improvement Committee, a third element, made up of the physician and care management leaders from the community’s primary care practices, reviews the results monthly and develops action plans to improve clinical performance. This approach ensures that we have buy-in across the continuum of care as we develop strategies that best serve our patients’ needs.

These successes extend beyond the conference room – they’re paying real dividends in the clinical setting, where they matter most. On a daily basis, I hear about patients whose chronic conditions are improving because of the practices developed by our Clinical Leadership and Transformation teams. Their stories are real, tangible proof that strategies which began at the most senior levels of leadership have a real impact on the quality of life of our patients.

For instance, there is David. The past eight years have been very difficult for David and his family as he has struggled with both diabetes and congestive heart failure. He had been spending nearly every other month in the hospital, but thanks to his care manager, Joanne, David is spending more time at home.

Joanne teaches David a number of strategies to empower him to better care for his disease. The improvements he’s made through diet and exercise have led to some real changes. Since they’ve been working together for the last four months, he’s had no admissions into the hospital.

Joanne says that working with her patients is now easier than it used to be because of the addition of electronic health records (EHR), “With the EHR, I have all the information I need right at my fingertips.” Regardless of whom David sees for care – a physician, specialist, or a care manager – any diagnoses, treatments, laboratory tests, or medications are listed in his EHR.

With resource support of the Beacon Community Program, improved health outcomes are achieved by strengthening the role of care managers who can leverage EHRs to deliver timely and targeted patient support. With the formation of the Bangor Beacon Program, the community has initiated the Care Manager Forum where care managers like Joanne can come together in monthly meetings. All of our community partners have agreed to make available their care manager teams to participate in these meetings where they receive training, discuss barriers, and share best practices that support patients and providers irrespective of their health system affiliation. The core team of care managers is a shared resource among community organizations, and it helps us achieve one of our primary goals. That is, to reduce avoidable hospital admissions and emergency department visits by patients with diabetes, chronic obstructive pulmonary disease, congestive heart failure, and asthma.

Nearly a year into the Beacon grant, we’ve identified a number of effective governance practices. First, we broadly include stakeholders. Invitations to most of our groups are open as long as there is interest and engagement. Second, we communicate frequently in a number of ways, including monthly status reports, regular meetings, a collaborative web space, and the incorporation of social media outlets such as Facebook, Twitter, and YouTube. And finally, we are transparent and collaborative and include our partners in all levels of governance including identifying ways to realize health care delivery efficiencies through shared resources.

As the executive sponsor of the Bangor Beacon Community, I’m fortunate to work with a group of engaged and active leaders. All of us are grateful for the opportunity the Beacon Community Program has provided to the citizens of Bangor and the State of Maine, and we hope that the best practices we’ve established will help guide other organizations in their mission to improve health and health care in the communities they serve.

Check out a short film about the Bangor Beacon Community by visiting: http://www.youtube.com/watch?v=QbXCoyGaJJ0&feature=channel_video_title.