Stillwater Medical Group
Stillwater Medical Group
Located in central-eastern Minnesota and western Wisconsin, Stillwater
Medical Group is a multi-specialty group practice that is a member of
Lakeview Health System. The 98 health care providers in the group
perform 210,000 patient visits each year at the group's three clinical
sites. Staff and leaders at Stillwater Medical Group have experience with
shared decision-making. Since 2007 they have been working with the
Institute for Clinical Systems Improvement (ICSI) and HealthPartners, Inc.
ICSI is an independent, non-profit collaboration of 58 medical group
members, sponsored by six Minnesota health plans and other health
care providers in Minnesota. The goals of ICSI include championing the
cause of health care quality in Minnesota and serving as a catalyst for
improvement by creating a collaborative environment for providers,
health plans, employers, and patients to solve system-wide problems
together. HealthPartners is a non-profit, Minnesota-based integrated
care delivery system, and health maintenance organization, (HMO).
HealthPartners HMO works collaboratively with health care leaders
across the state to advance the implementation of shared decision making
and quality of care initiatives.
Fellowship Study, A Larger Scale Project
After participating in a study with HealthPartners on the use of decision aids for the treatment of uterine fibroids, Stillwater Medical Group implemented a process for distributing decision aids and providing care support for patients with breast or prostate cancer. The group first distributed decision aids for breast cancer treatment decisions, developing a process for integrating the aids into their established breast care program. The team then identified a need for prostate cancer decision aids and implemented a similar system-wide process for distribution and care coordination. This process includes care coordination and decision making support from the time of diagnosis. Prior to the initial consultation with the specialist, patients meet with a nurse care coordinator to assess knowledge of disease, go over pathology results, and review treatment options. Care coordinators go through the decision aid with the patient and request that the patient reviews the materials before he or she returns to the specialist for medical care planning. The team provides support and coordination of care throughout treatment based on individual patient needs.
System-Wide Goals
With the goal of system-wide implementation of shared decision-making for other conditions, staff and clinicians from Stillwater Medical Group decided to join the demonstration project sponsored by the Foundation for Informed Medical Decision Making. Project leaders have identified benign prostatic hyperplasia (BPH) as the topic for shared decision-making implementation during the demonstration project. The process will follow the process previously established by the team for shared decision-making regarding breast and prostate cancer treatment. The primary care provider or the urologist will refer patients with a diagnosis of BPH to the nurse care coordinator. The nurse will conduct a learning assessment, present materials, answer questions, and offer support. The patient will be asked t review the materials before they return to the urologist or primary care provider for treatment options and medical care planning. The team plans to add shared decision-making support for diabetes, back pain, and other conditions in the future. For more information about this implementation project, please contact Joyce Kramer, Cancer Care Coordinator at jkramer@lakeview.org or Nita Michels, Director of Quality Improvement at nmichels@lakeview.org.