Translating ‘See-and-Treat’ to primary care: opening the gates does not cause a flood

Abstract

Abstract Objective To explore how the See-and-Treat concept can be applied in primary care and its effect on volume and productivity. Design An explanatory single-case study design with a mixed methods approach and presented according to the SQUIRE 2.0 guidelines. Setting A publicly-funded, private primary care provider within the Stockholm County, which caters to a diverse patient population in terms of ethnicity, religion, socioeconomic status and care needs. Participants CEO, center manager, four physicians, two licensed practical nurses, one medical secretary and one lab assistant. Intervention A See-and-Treat unit was established to offer same-day service for acute unplanned visits. Standardized patient symptom forms were created that allowed patients to self-triage and then enter into a streamlined care process consisting of a quick diagnostic lab and a physician visit. Main Outcome Measures Volume, productivity, staff perceptions and patient satisfaction were measured through data on number and type of contacts per 1000 listed patients, visits per physician, observations, interviews and a questionnaire. Results A significant decrease in the acute and total number of visits, a continued trend of diminishing telephone contacts, and a non-significant increase in physician productivity. Patients were very satisfied, and staff perceived an improved quality of care. Conclusions See-and-Treat appears to be a viable approach for a specific primary care patient segment interested in acute same-day-service. Opening up access and standardizing care made it possible to efficiently address these needs and engage patients.