Primary Link Coordinator Armani’ O’Neal coordinates follow-up care for patients by phone. This approach allows the program to be expanded easily to remote locations.

Providence Regional Medical Center Everett has partnered with Project Access Northwest to help its low-income, uninsured and Medicaid patients find appropriate follow-up care with primary care providers upon discharge from the hospital

When a patient is discharged from the hospital, pursuing follow-up care with a primary provider within five days greatly improves recovery and long-term health outcomes. Having a primary care home also reduces patient  readmission rates and emergency department visits. That’s why Providence Regional Medical Center Everett reached out to Project Access Northwest late last year to help provide these same positive outcomes for its low-income, uninsured and Medicaid patients, who may struggle to find care. Following a six-month planning period, the new Hospital Inpatient Discharge Program was launched on June 1.

Primary Link Coordinators contact the patients by telephone prior to their inpatient hospital discharge and work to schedule convenient primary care follow-up appointments for them with Community Health Center of Snohomish County, Sea Mar Community Health Centers, International Community Health Centers, Molina Medical in Everett or Providence Medical Group, among others. This program works with both the Colby and Pacific hospital campuses in Everett. Once these initial appointments are scheduled, patients receive reminder calls and care from the primary care provider.

“We’re excited to see our Primary Link concept expanded to new sites, in new ways,” says Sallie Neillie, executive director of Project Access Northwest (2006–June 2017). “So far, the numbers we’re tracking are encouraging; we’re making appointments, and patients are getting the follow-up care they need. I think this is a model that can be adapted to meet the needs of any hospital system.”

The Hospital Inpatient Discharge Program operates six days a week. We are carefully tracking patient data to assess the program’s impact.