It is with enthusiasm that I welcome you to the first edition of The UT Healthier Way, our new monthly e-newsletter for our employees that will serve as a resource to providing information and updates about UT Health Physicians.

Nearly one year ago, we recommitted ourselves to the “UT Healthier Way,” which encapsulates our philosophy of placing patients at the center of all of our efforts. Our patients may come to us in discomfort and most always with concerns, anxiety and questions. Our patients expect answers, advice, respect, compassion and hope. It is our obligation, and is indicative of the UT Healthier Way to serve our patients as their most trusted health partner, always ensuring to make every patient encounter a positive one.

The UT Healthier Way newsletter will share accomplishments, offer opportunities for learning and growth, and report the life-changing breakthroughs our colleagues within UT Health San Antonio develop. It is my intent that the newsletter not only serves to provide you with useful information for your day-to-day responsibilities but that its articles and videos also cultivate your passion for providing exceptional patient-centered care. Our goal is to inform, inspire and engage for the benefit of those we serve.

In San Antonio, UT Health Physicians has nearly 800 physicians, over 200 advanced practice providers and over 1,000 nurses and care team members. Our clinical sites are becoming busier and we are concentrating on improving access to the increasing number of patients who seek our care and expertise. As our practice continues to grow, the UT Healthier Way will help us stay connected, aligned in our mission, and committed to our patients.

UT Health Physicians provides a level of expert care and a patient experience that is found nowhere else.  Patients choose us for more than the clinical expertise we offer… it is the way we deliver that care.  It is a pleasure to work with dedicated professionals who unite and collaborate to provide outstanding care.  YOU make a difference in our patients’ lives and I thank you for your dedication.

Sincerely,

Carlos A. Rosende, M.D., F.A.C.S.

Executive Director, UT Health Physicians

Executive Vice Dean for Clinical Affairs, Joe R. & Teresa Lozano Long School of Medicine

UT Health San Antonio

Here is your monthly update from the UT Health Physicians operations team: 

Learning and implementing best practices in operations for UT Health Physicians can prevent mistakes, maintain a consistent flow of business to better meet patient demands, and keep our clinical practice profitable and productive. Below are a few updates of interest to our employees.

UT Health San Antonio Spirit Week is Nov. 13-16. Join us for a week of celebration as we work together to continually build our culture of excellence! Learn more about Spirit Week 2017.

The holiday schedule for November has all practices closed for the Thanksgiving Holiday, Thursday and Friday, November 23-24. Normal hours resume on Monday, November 27th. We are so thankful for you and wish you a happy Thanksgiving!

New hand sanitizer standards will soon be implemented to help improve safety and prevent illness. Gojo Company was selected to provide new automatic dispenser technology for Purell foam hand sanitizer in the hallways and in treatment areas. More  information coming soon on installation dates. Contact Nancy Mendicino for questions.

Diabetes services now available at UT Health Physicians on the 3rd floor of the Medical Arts & Research Center. Dr. Ralph DeFronzo, Dr. Lisa Gorn and Anna Velasco-Neaves are accepting new patients Mon. through Fri. 8 am - 4 pm. Patients who need care for pre-diabetes, type 1 and type 2 diabetes can be seen and take advantage of complete diabetes care for nutrition and patient education, monitoring devices and insulin therapy. 

The Glenn Biggs Institute for Alzheimer’s & Neurodegenerative Diseases now available for patients. Part of our comprehensive Neurology care at UT Health Physicians, care for these patients is now available on the 8th floor of the Medical Arts & Research Center. Please welcome Dr. Alicia Parker to UT Health Physicians. For information and referrals please call (210) 450-9700.

Pediatric Neurology at UT Health Physicians is now open on the 8th floor of the Medical Arts & Research Center. Please welcome Dr. Kelly Averill (joined us on 10/25/17) and Dr. Sidney Atkinson. For referrals, please contact (210) 450-7337 or fax (210) 450-2121.  

UT Health Physicians Pediatric Allergy services will soon be opening on the 6th floor of the Medical Arts & Research Center next to ENT. We look forward to welcoming Dr. Edward Brooks and Dr. Jesus Guajardo. For referrals please contact (210) 450-7337 or fax (210) 450-2121. 

Practice-to-Practice scheduling has begun pilot in Primary Care at the Medical Arts & Research Center. We are now scheduling patients for Ob/Gyn, Gen Surgery or Urology. The patient leaves their primary care provider with an appointment with one of our specialists. So far, this has been a significant patient satisfier! For questions, please contact Casey Peterson.

If you would like more information or have any questions, please reach out to your practice operations team: Casey Peterson, Senior Director of Practice Operations and Jeanette Hernandez, Director of Practice Operations.

Healthcare providers are subject to broad and ongoing changes in regulations for how we provide care, how we document care provided to patients, and how we get paid for the services we provide. The impact to UT Health Physicians is no exception. Our practice has experienced sweeping federal and state changes that have radically changed our environment. For us to continue to excel in meeting our mission in this increasingly complex and competitive industry, it is crucial that we have alignment and clarity throughout every level of our complex organization.

What does that really mean? Ultimately, what we must do is to build a working environment and culture around how to best perform and achieve our mission in an industry that is heavily regulated and continually changing, which is very hard to do for any organization and in particular an academic health center like UT Health San Antonio.

One of the best practices to achieve success in managing change and improving culture is to have a shared philosophy and clear understanding of expectations, goals, values, structure and what is needed to better perform and respond to change timelier. To help simplify our process and approach, we have developed what we’re calling the “UT Health Continuous Improvement System.” To demonstrate what this means in a way that may be more easily understood, we’ve created a graphic – a pyramid – that reflects how we align our approach to change, why and how we are making the change, and to benefit whom in a more integrated way. The UT Health Continuous Improvement System pyramid, shown below, serves as a visual concept to help simplify knowledge of who we serve, who we are and how we will differentiate ourselves through the UT Healthier Way.

Patients are our priority. They are always at the top of our mind and likewise, are placed at the pinnacle of our pyramid. We serve patients through a dedicated mission, vision and core values. The next layer of the pyramid demonstrates ways we will grow and show our value to patients and payors alike.

And ultimately we will execute strategies to achieve our goals through leadership development, IT, financial management, team development, Lean principles, and the philosophy of relationship-centered care. The pyramid also shows us how what it will take for us to drive successful population health management programs and support the demand to achieve value-based performance.

The UT Health Continuous Improvement System, laid out in the graphic below, will entail a series of educational experiences for our employees designed to improve our patient capacity.  To date, we have developed several rigorous, evidence-based training programs that focus on enhancing our ability to manage populations and better serve patients with higher quality outcomes.

The UT Health Continuous Improvement System concept is a critical transformation strategy that is designed to introduce our teams to concepts of population health but also to go beyond by providing the opportunity for individual clinics and units to develop meaningful, team-based care relationships. 

We will continue to educate all at UT Health Physicians on this concept and will highlight and detail aspects of our efforts to continually improve our practice with the ultimate goal of providing the highest quality outcomes for patients in the most efficient way we can.

“The fundamental task of management is to make people capable of joint performance through common goals, common values, the right structure, and the training and development they need to perform and to respond to change.” – Peter Drucker

Timely access to medical care is a key to wellness yet remains a national challenge with variability by region, specialty, and insurer.  The importance of timeliness was highlighted as one of the fundamental aims for health care in the Institute of Medicine’s (IOM) 2001 report, Crossing the Quality Chasm.  A more recent report from the IOM, Transforming Health Care Scheduling and Access:  Getting to Now, further emphasized the goal of a patient-centric health care system where patients obtain appointments when they need them and with whom they need them.

In furthering its mission of Making Lives Better, UT Health has long worked to streamline patient access starting with its Patients First initiative several years ago.  In 2016, a leadership team from UT Health toured the Emory Clinic in Atlanta to study access.  This led to the formation of the Access Committee (AC)* under the direction of Dr. Ronald Stewart and more recently, a subcommittee, the Access Taskforce (ATF)**, to carry forward the recommendations of its parent committee and to accelerate operations in regard to patient access. 

The overarching goals of the Committee and the Taskforce are to improve access so that 65% of new patients receive appointments with primary care within seven days and with subspecialists within fourteen days.

Early interventions of the Access Committee including Early Arrival, in which patients are instructed to arrive 15 minutes early to improve clinic flow; Fast Pass, in which patients are given opportunities via MyChart messaging to schedule appointments; and Clinic-to-Clinic (C2C) scheduling in which Primary Care schedules patients directly into selected subspecialty clinics are beginning to bear fruit.  Early Arrival has assisted clinics to remain on time, and Fast Pass and C2C have seen the streamlined booking of several patients.

In addition to fostering these initiatives, the ATF has undertaken a global look at the process of Access at UT Health from a systems engineering perspective with a goal of maximizing the congruence of Demand (the volume of patients needing appointments) with Supply (the number of appointment openings) while maximizing Capacity (the efficient use of resources).  Each of these aspects, demand, supply, and capacity, are requiring the development and utilization of new tools for measurement. 

Among the more than 40 line-item recommendations developed to date by the ATF, those that have been implemented include a review of scheduling best practices with practice staff, daily phone huddles with all UT Health practices, a web-based access tool to determine appointment availability, Subgroup Scheduling, and the development of new graphics and modified dashboards. 

In addition, small teams of practice staff members (Access Teams “A-Teams”) are beginning to examine each others’ clinics to identify those that have developed novel, exceptional workflows and processes that can benefit the entire organization. 

The work of the AC and ATF have greatly benefitted from the concerted support and effort of all clinical Department Chairs, Medical Directors, Practice Managers and Practice Operations.  In time, UT Health will see the day when clinic schedulers use the date given by patients when asked, When would you like to be seen? as the actual appointment date.

Daniel A. Johnson, MD

Chair, Access Taskforce

*Access Committee (AC):  Deborah Conway, MD; Pamela Glasscock; Carlos Jaen, MD, PhD; Nydia Kent; Stephen R. Krauss, MD; Meeghan Lautner; Laura Monroe; Diana Morrison; Patrick Nguyen, MD; Brian Reeves, MD; and Ronald Stewart, MD (Committee Chair).

**Access Task Force (ATF):  Timothy Barker; Marc F. Deschaine; Glenn Gross, MD; Pamela Glasscock; Kristen Hansman; Brandon Hartman; Jeanette Hernandez; Daniel A. Johnson, MD; Kenyatta Lee, MD; Casey Peterson; Carlos Rosende, MD, FACS; and Gorden Whiting.

Do you know about the employee discounts for UT Doctors?  UT employees and retirees with UT SELECT medical insurance can save on copays and other fees when they use UT Health Physicians. 

Do you need to see a doctor?  Make an appointment today with UT Health Physicians through our special UT Select appointment number:  210-450-9090. 

Learn more at: UTHealthcare.org/UTSELECT

The care we provide at UT Health Physicians endures long after an appointment ends. A patient's opinion on how they were treated and the care they received are remembered always and shared time and time again. The good stories our patients share about our practice establish an expectation and a reputation each of us is called to uphold. Here are recent comments directly from our patients.

"I like going to the doctor because she was very good to me.  They were very respectable and they treated me with respect and that's good.  She's a very good doctor.  I would go there again and send my family there.  Thank you."

"I've only been to this 1 appointment there.  I was really pleased with the very, very good listening skills, very good listeners, very much trying to help me trying to help set up a treatment plan for me, and I will understand more about it later but very good, very nice.  Thank you."

"My experience was amazing and I wouldn't have changed anything. I received a warm greeting from Becca at the front desk and even when she was assisting me and someone came up behind me, she smiled and said they would be with her in just a moment which I appreciated! Dr. Corley was compassionate and listened to all my concerns and questions. Outstanding job! thank you!"

"Dr. Zayac is wonderful and the office staff is courteous and professional. I have recommended Dr. Zayac and this facility to friends and will continue to do so.

"Just keep on being proactive caring medical professionals"

"Dr. Bolfing is the best Doctor I have ever had. He's is very knowledgeable, compassionate and supportive. You can tell he cares about his patient. He actively listens, addresses all my concerns and provides easy to understand explanations."

"The provider was very kind… was patient ask, answered a lot of questions, and made sure I understand everything going on before letting me leave the office."

"Mark Deschain is very professional, very knowledgeable, and he really makes me feel, he makes me, not be in pain after I see him thank you."

"Dr. Zargonis is… a very caring, and a generous man.  He listened to me… you know, with complete care and he was just a, a super super… individual… he cared for me, and… all his staff was really really, really excellent. "

UT Health providers make a difference in our community every day. This month, they were featured in the media for addressing the spike in HIV, the Santikos Suite opening at the Medical Arts & Research Center, studying the effect of insulin resistance on the heart, and much more. 

Santikos Suite aids study of Alzheimer’s, other diseases - Dr. Pamela Otto

Insulin resistance underlies CV risk factors - Dr. Ralph DeFronzo

Will Bexar County Be the First in Texas to Legalize Needle Exchange? - Dr. Delia Bullock

Before the Next Outbreak - Dr. Jan Patterson

Zebra fish help UT Health researcher find treatments for childhood cancers - Aaron Sugalski

Evening Dose of Long-Acting ADHD Med Closer to Release - Dr. Steven Pliszka

San Antonio leaders set targets for reversing increase in HIV - Dr. Barbara Taylor

Local doctors developing new pill to battle recurrent breast cancer - Dr. Virginia Kaklamani

UT Health San Antonio Military Caregiving Telehealth Initiative-  Dr. Dawn Velligan

For more news visit the UT Health San Antonio Newsroom >>

Here are the newest health champions joining UT Health Physicians. Please welcome them!

Cecilia Aguilar, Coding Support, Dolores Aguirre, Cardiology, Rosa Aleman, Urology, Rebecca A. Arredondo, Primary Care, Tyler Barreto, Administration, Kinley D. Beck, Ophthalmology, Ana M. Bermea, Coding Support, Candace E. Blanks, Ophthalmology Coding, Cassandra L. Boswell, Dermatology, Mayra P. De La Garza, Psychiatry, Cheryl Y. Digges, Primary Care , Anna Luisa C. Garza, Neurology Alzheimer's and Neurodegenerative Diseases, Kristina M. Gonzalez, Cardiology, Samantha M. Liddeke, Primary Care, Luis Lopez, Student - Paramedic, Lisa M. Menjares, Otolaryngology, Diana M. Pena,  Neurology Alzheimer's and Neurodegenerative Diseases, Reginald Regan, Urology, Amalie G. Resendez, Urology, Carolina Solis-Herrera, Diabetes, Federico Tozzi, Surgery, Joel Tsevat, Hospital Medicine, Debra J. Zamora, Ophthalmology