Founded in 1914, the UNITE HERE Health Center resides in Manhattan's Chelsea neighborhood, and provides healthcare services to more than 14,000 patients, 85 percent of whom are employed by Union of Needletrades, Industrial and Textile Employees (UNITE) or the Hotel Employees and Restaurant Employees Union (HERE). In order to uphold its mission, UNITE realized it needed to reinvent its systems and re-evaluate its organizational culture and the center's CEO and Medical Director, Dr. Karen Nelson, was motivated to build a patient-centered system of care that would meet the needs of today's working families. PCDC offered the strategies, tools and guidance to enable a successful transformation.

At the inception of the Practice Redesign project, UNITE's patient wait-times for appointments had stretched to over two hours -- a simple flu shot required a half day off from work and patients typically waited more than two weeks to be seen by a doctor.

Dr. Nelson and PCDC staff gathered a multi-disciplinary project team that would oversee the year-long process. With hands-on support from PCDC, the project team began by collecting data to understand how the work flow affected both patients and staff.

"We look at how to operate a health center effectively, whether it's cutting wait time during appointments, offering same day appointments with your own doctor or using electronic medical records to streamline information sharing. These are all essential tools to deliver excellent care," said Ronda Kotelchuck, PCDC's Executive Director.

Once the team collected and analyzed the data, they began to address the root causes of problems by changing longstanding office and clinical procedures. PCDC staff met with them on a weekly basis to offer guidance and keep them on task.

At first, the process met with some resistance. Staff members were concerned that the proposed changes would compromise the quality of care. As they reviewed the data and examined the PCDC model, the resistance slowly melted. The weekly schedule was changed to accommodate same day appointments. Support staff members were trained to be effective patient care associates. Patient care became the focus of every employee's job.

"The staff now understands what it means to be patient-centered. The idea is to get patients the care they need when they need it," said Dr. Karen Nelson.