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Partnership for Child Health Jacksonville, FL 2011.

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Presentation on theme: "Partnership for Child Health Jacksonville, FL 2011."— Presentation transcript:

1 Partnership for Child Health Jacksonville, FL 2011

2  Institute of Medicine Definition of Quality The degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.

3 ...and the degree to which practice philosophy, standards and activities lay the foundation to providing care that is:  Patient-centered  Accessible  Continuous  Coordinated  Comprehensive  Compassionate  Culturally effective

4  Very simply, Quality Improvement (QI) is a method of continuously examining processes and making them more effective.

5  QI is a career-long journey, whether informally… … or formally through o practice-based structured QI process o Maintenance of Certification - American Board of Pediatrics An ongoing process….

6  Improve patient health  Improve patient experience  Increase practice efficiencies  Reduce expenses  Pay-for-performance  Transparency in quality and outcomes

7  Identifying areas of potential improvement  Defining clear objectives (Aim Statements)  Structured QI process  Measuring and tracking progress  Effective team work Key Components QI

8 Answers the first question: What are you trying to accomplish?

9  A written statement of the accomplishments expected from team’s improvement effort - ◦ S PECIFIC ◦ M EASURABLE ◦ A CTION-ORIENTED ◦ R EALISTIC and RELEVANT ◦ T IMELY

10  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 module  By 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 We 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, 2011 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 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? Structured QI Process The Improvement Model -

13 PDSA: Plan  Do  Study  Act

14 Plan Analyze the process; determine what changes would most improve it; establish a plan for making improvement; predict results Do Put your change into motion on a small scale or trial basis; collect data Study Check to see whether the change is working; compare to prediction Act If the change is working, implement it on a larger scale. If not, refine it or reject it and begin the cycle again

15 Increase your belief that the change will result in improvement Opportunity for “failures” without impacting performance Document how much improvement can be expected from the change Learn how to adapt the change to conditions in the local environment Evaluate costs and side-effects of the change Minimize resistance upon implementation

16  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 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 Index  Medical Home Family Index

19  B -building blocks and progress summary  E - improvement activities, data collection and progress tacking

20  …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 NCQA Physician Practice Connections® - Patient-Centered Medical Home TM  Web-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. Measurement - and Pursuit of Recognized Standards

22  Teams harness the knowledge, skills, experience and perspectives of different individuals to make lasting improvements. Effective Team Work American Academy of Family Physicians

23 … you must create an infrastructure within your practice that will support the team's work. Before you assemble your QI team…. American Academy of Family Physicians

24  Be a QI champion and actively support your team. Without demonstrated endorsement from practice leaders, teams will flounder. American Academy of Family Physicians Physician leadership is key!

25 American Academy of Family Physicians  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.

26  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. Recruiting members. …. American Academy of Family Physicians

27  pre-planning by team leader and team facilitator  clearly established goals (agenda)  group idea generation  assigned responsibility and time allotted for each agenda item Refer to tools available on: ◦ EQIPP ( enrollment required) ( ◦ Building Your Medical Home toolkit ( ◦ A Team Approach to Quality Improvement ( Running effective QI meetings requires… American Academy of Family Physicians

28 Where can our practice team learn more about Medical Home Quality Improvement?

29 Medical Home QI Training

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.

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 basis  earn CME credit  meet MOC (American Board of Pediatrics Maintenance of Certification) Part 4: Performance in Practice requirements all at once.

34  EQIPP guides you through:  online work to review content presentation, research linked information, and participate in activities  offline work to introduce and implement performance improvement within your own practice




38 Useful Tools!


40 Step # 1. Educate and engage all physicians and practice staff Step # 2. Identify the children with special health care needs in the practice Step # 3. Unite the medical home team and assess the current medical home qualities of the practice Step # 4. Implement a quality improvement process

41 Practices participating in the Medical Home Implementation Project receive: - Reimbursement of EQIPP enrollment fee at AAP Member rate of $199 for one physician in your practice if enrolled by January 31, 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.

42 Website: Melana Smith, RN (904) , ext 325

43 One Step at a Time….

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