Presentation on theme: "Partnership for Child Health Jacksonville, FL 2011"— Presentation transcript:
1 Partnership for Child Health Jacksonville, FL 2011 Quality ImprovementPartnership for Child HealthJacksonville, FL2011
2 What is Quality? Institute of Medicine Definition of Quality The degree to which health services forindividuals and populations increase thelikelihood of desired health outcomes andare consistent with current professionalknowledge.
3 A Medical Home framework… ...and the degree to which practice philosophy, standards and activities lay the foundation to providing care that is:Patient-centeredAccessibleContinuousCoordinatedComprehensiveCompassionateCulturally effective
4 What is Quality Improvement? Very simply, Quality Improvement (QI) is a method of continuously examining processes and making them more effective.
5 An ongoing process…. … or formally through QI is a career-long journey,whether informally…… or formally throughpractice-based structuredQI processMaintenance ofCertification - AmericanBoard of Pediatrics
6 Why is QI Important? Improve patient health Improve patient experience Increase practice efficienciesReduce expensesPay-for-performanceTransparency in quality and outcomes
7 Key Components QI Identifying areas of potential improvement Defining clear objectives (Aim Statements)Structured QI processMeasuring and tracking progressEffective team work
8 Aim Statement What are you trying to accomplish? Answers the first question:What are you trying to accomplish?
9 Aim statement - SMART SPECIFIC MEASURABLE ACTION-ORIENTED A written statement of the accomplishments expected from team’s improvement effort -SPECIFICMEASURABLEACTION-ORIENTEDREALISTIC and RELEVANTTIMELY
10 Aim Statements: which one is the best? We will learn how to implement a medical home quality improvement process at our practice.All members of the medical home team will learn about QI by participating in the AAP EQIPP Medical Home learning moduleBy 1/30/11, all of the medical home team members will have completed the “QI Basics” portion of the AAP EQIPP Medical Home learning module.
11 Another exampleWe will offer opportunities for families to provide feedback about their child’s visit.We will give an office visit questionnaire to all families at the end of their child’s visit.By February 15, 2011 we will have designed a family feedback survey and a data collection and reporting process. By March 15, we will have be offering the survey (to be completed at the visit or mailed in from home) to 100% families at the end of their child's visit.
12 Structured QI Process The Improvement Model - What are we trying to accomplish?How will we know that a change is an improvement?What changes can we make that will result in improvement?
14 PDSA- Plan Do Study Act Analyze theprocess; determine what changes would most improve it; establish a plan for making improvement; predict resultsDoPut your change into motion on a small scale or trial basis; collect dataActIf the change isworking, implement it on a larger scale. If not, refine it orreject it and beginthe cycle againStudyCheck to see whether the change is working; compare to prediction
15 PDSA: cycles for testing Increase your belief that the change will result in improvementOpportunity for “failures” without impacting performanceDocument how much improvement can be expected from the changeLearn how to adapt the change to conditions in the local environmentEvaluate costs and side-effects of the changeMinimize resistance upon implementation
16 Our take on QI Keep it simple, don’t try to change overnight Talk to the experts (colleagues, nurses, other staff, families)Remember – you can’t improve what you can’t (or don’t) measure
17 Measurement for Quality Improvement Measurement begins with identifying potential improvement areas.Measuring tells a team if the changes they make are making a difference.The team needs just enough data to tell if the change is making an improvement. Should speed improvement, not slow it down.“Measurement” is not the goal.
18 Medical Home Measurement tools Medical Home IndexMedical Home Family Index
19 B-building blocks and progress summaryE- improvement activities, data collection andprogress tacking
20 Medical Home Measurement tools …are based on the premise that medical home is an evolutionary process rather than a fully realized status for most practice settings.The tools quantify "medical homeness" and measure a primary care practice's progress in this ongoing process.
21 Measurement - and Pursuit of Recognized Standards NCQA Physician Practice Connections® - Patient-Centered Medical HomeTMWeb-based data collection tool that provides a framework for QI strategies to achieve NCQA “Medical Home Recognition”NCQA Recognition is the basis for efforts to transform payment systems and enhance compensation from public and private payers.
22 Effective Team WorkTeams harness the knowledge, skills, experience and perspectives of different individuals to make lasting improvements.American Academy of Family Physicians
23 Before you assemble your QI team…. … you must create an infrastructure within your practice that will support the team's work.American Academy of Family Physicians
24 Physician leadership is key! Be a QI champion and actively support your team. Without demonstrated endorsement from practice leaders, teams will flounder.American Academy of Family Physicians
25 Utilize external resources to help you get your teams started. Identify the key people to help keep the QI momentum going, such as an office manager facilitator .Cultivate a spirit of QI within your practice that encourages everyone to improve the quality of services and programs continuously.Utilize external resources to help you get your teams started.Develop staff members' skills in research, data collection and analysis.American Academy of Family Physicians
26 Recruiting members. ….To work efficiently, QI teams need diversity: people with different skills, experience, knowledge and viewpoints.Staff members who are directly involved with the process under study should be represented on the team.American Academy of Family Physicians
27 Running effective QI meetings requires… pre-planning by team leader and team facilitatorclearly established goals (agenda)group idea generationassigned responsibility and time allotted for each agenda itemRefer to tools available on:EQIPP (enrollment required) (http://www.eqipp.org/)Building Your Medical Home toolkit (http://www.pediatricmedhome.org/qib/)A Team Approach to Quality Improvement (http://www.aafp.org/fpm/990400fm/25.html)American Academy of Family Physicians
28 Where can our practice team learn more about Medical Home Quality Improvement?
30 What is EQIPP?AAP EQIPP courses are designed to help you learn how to identify and close the gaps in your practice using practical QI tools.By using EQIPP, you will collect data to measure your current level of care at baseline as you work to improve care through Plan, Do, Study, Act (PDSA) cycles.Course DescriptionUsing the learning EQIPPment provided in this program, by the end of the EQIPP Medical Home for Pediatric Primary Care course, you will be able to: - Collect and analyze baseline data to establish a starting point for improvement. - Identify one or more performance gaps in one or more key activities of the medical home. - Create an improvement plan for closing the performance gap(s) in which you: *Identify a specific aim; *Generate ideas for change; and *Consider potential barriers. - Implement change(s) designed to close gap(s). - Collect and analyze follow-up data to measure the results of your improvement efforts. - Create additional improvement plans and repeat the change-improvement cycle until you reach your maximum potential of being a high quality, effective medical home.Activity DetailsCredit Types: CME Credit Amount: 32.0 Credits Release Date: 2010-Oct-28 Expiration Date: 2013-Oct-28 Registration Required: Yes Cost: $ System Requirements:
31 The AAP now offers –Medical Home for Pediatric Primary Care
33 With EQIPP online courses, you can: learn to document improved quality care on a continuous basisearn CME creditmeet MOC (American Board of Pediatrics Maintenance of Certification)Part 4: Performance in Practice requirementsall at once.
34 EQIPP guides you through: online work to review content presentation, research linked information, and participate in activitiesoffline work to introduce and implement performance improvement within your own practice
35 Course Home tab -Provides course goals and objectivesLists Key Clinical ActivitiesLinks to key areas within the course (Helpful Links)User can: 1. Browse available content2. View demo3. Complete QI BasicsDescribe what QI is and why it is important;List benefits of applying QI principles in practice;Form an effective team to direct QI efforts in practice;Apply the model for improvement to plan, test, and implement changes that result in measurable improvements; andRecognize that QI requires multiple tests of change and changes to office habits, processes, and systems.
36 Improvement Activities Enter Baseline DataAnalyze ResultsAims & ChangesCreate Improvement PlanEnter Follow Up Data
40 Now what? P P P Step # 4. Implement a quality improvement process Step # 1. Educate and engage all physicians and practice staffStep # 2. Identify the children with special health care needs in the practiceStep # 3. Unite the medical home team and assess the current medical home qualities of the practicePPStep # 4.Implement a quality improvement process
41 Support for Your Practice Practices participating in the Medical Home Implementation Project receive:Reimbursement of EQIPP enrollment feeat AAP Member rate of $199 for one physician in your practice if enrolled by January 31, 2011. Upcoming Webinar about EQIPP provided by the AAP and Center for Medical Home Improvement (February 28, 2011)Ongoing technical support offered by Partnership for Child Health medical home support staff.