Presentation is loading. Please wait.

Presentation is loading. Please wait.

Boston Children’s Hospital Heart Center

Published bySabrina Beasley Modified over 6 years ago

Similar presentations

Presentation on theme: "Boston Children’s Hospital Heart Center"— Presentation transcript:

1 Boston Children’s Hospital Heart Center
ACPC Quality Network Pilot Experience: Counseling for Elevated Body Mass Index Lauren Hartwell, MPH Candidate Quality Improvement Consultant, Cardiology

2 Overview Change Strategies Project Timeline Challenges Lessons Learned
Ongoing Efforts

3 QNet Quality Improvement Pilot Elevated BMI Project Team
Site Administrator: Susan Saleeb MD Data Collection & Analysis: Lauren Hartwell MPH(c) BMI Pilot Physician Lead: Sarah De Ferranti MD MPH BMI Pilot Team: Sarah Atwood RN Kevin Friedman MD Ronald Lacro MD Jennifer Bachman CPNP, MSN, RN David Fulton MD Jami Levine MD Caroline Brantley MS, RD, LDN Naomi Gauthier MD Laura Mansfield MD David Brown MD Skylar Griggs RD Renee Margossian MD Steven Colan MD Michelle Gurvitz MD Mary Mullen MD, PhD Lauren Danforth BSN, RN David Harrild MD, PhD Jane Newburger MD, MPH Sarah De Ferranti MD MPH Lauren Hartwell MPH(c) Terry Saia PNP Jesse Esch MD Mariam Irshad MPH Susan Saleeb MD Jeremy Fox MD Kathy Jenkins MD, MPH Tajinder Pal Singh MD Highlight diversity of team - includes 2 nurses, 2 nurse practitioners, 2 dieticians, 2 departmental QI experts, and 19 physicians 3

4 QNet Quality Improvement Pilot Strategies for Improving BMI Counseling
Change Strategies Analyzed available medical record system for opportunities to flag elevated BMI Existing entries in “Problem List” Electronic linking of education sheets Automatic EMR calculation and permanent storing of percentiles Working on electronic red flag for elevated BMI 4

5 QNet Quality Improvement Pilot Strategies for Improving BMI Counseling
Change Strategies, continued Developed new BMI patient/family education sheet with insights from: Preventive cardiology group Nutritionists Nurses Parent focus group Partnering with new Cardiac Rehabilitation Program 5

6 QNet Quality Improvement Pilot Strategies for Improving BMI Counseling
Change Strategies, continued Recruited RN support to identify eligible patients Alert physician of need for counseling Distribute counseling materials Assist in documentation of counseling – IT change 6

7 QNet Quality Improvement Pilot Strategies for Improving BMI Counseling
Change Strategies, continued Encouraged physicians/NPs to document counseling in multiple ways: Select from “Problem List” Use Autotext statements Enter in discussion section of letter Document referral to local or Heart Center nutritionist 7

8 QNet Quality Improvement Pilot Elevated BMI Project Timeline
Recruited physicians, nurses, and dieticians Disseminated metric details, MOC timeline & requirements Kick-off meeting of working group Reviewed baseline data Reviewed nutrition education handouts Brainstormed changes Recruited IT to facilitate EMR changes Developed new BMI education sheet – distributed to clinics to cardiologists to raise awareness Refined BMI education sheet through parent focus group Developed and refined staff education Engagement through broad contact Jan/Feb 2017 Mar 2017 Apr/May 2017 Jun/Jul 2017

9 QNet Quality Improvement Pilot Elevated BMI Project Timeline
Reviewed Q data – initial assessment post-intervention Involvement of fellows through education Targeted education to RNs, NPs, and CAs in clinic Discussed best practices for weight management counseling Submitted BMI education form for hospital-wide use Seeking BMI prevalence data on CHD and other patients Continuing education to nursing staff BMI screening tips distributed to nursing staff BMI education sheet approved for hospital use Aug 2017 Sep 2017 Oct 2017

10 Education Sheets for Elevated BMI Counseling
10

11 QNet Quality Improvement Pilot Counseling for Elevated BMI
Challenges Large department (> 70 cardiologists) Spreading the word Small core group involved in QI Numerous subspecialists and sub-subspecialists Maintaining interest Change is slow - - message stagnates , postings ineffective Message fatigue Inboxes overburdened 11

12 QNet Quality Improvement Pilot Counseling for Elevated BMI
Challenges (continued) Variable Buy-In Single encounter patients Patients with active issues – recent procedure, etc. “Job of the pediatrician” Counseling is “ineffective” Easy to measure counseling, hard to measure effect Metric fatigue (meaningful use, etc.) Metric may need some exclusions Trisomy 21, other syndromes Acute care issues 12

13 QNet Quality Improvement Pilot Counseling for Elevated BMI
Lessons Learned Sharing vetted counseling material is appreciated (true for both BMI and TOF) Sharing data is powerful Center performance over time Comparison to national mean MOC helps a lot!!! 13

14 BCH Heart Center QNet Results Counseling for Elevated BMI
14

15 QNet Quality Improvement Pilot Counseling for Elevated BMI
Ongoing Efforts Automated flag for elevated BMI – RED Ongoing cardiology staff and fellow education Future Cardiology Grand Rounds, Fellows clinics Disseminating best practices for counseling Applying metric to adult cardiac patients Particular efforts to target CHD patients Ongoing review of elevated BMI prevalence data Integration into Cardiac Fitness Program 15

16 Thank You!

Download ppt "Boston Children’s Hospital Heart Center"

Similar presentations

Paul J. Nietert, PhD Ruth G. Jenkins, MS Andrea M. Wessell, PharmD

Paul J. Nietert, PhD Ruth G. Jenkins, MS Andrea M. Wessell, PharmD
1 Healthier Generation Benefit: Supporting the Assessment, Prevention, and Treatment of Childhood Obesity Liz Martin, MS, CHES Director of Population Health.

1 Healthier Generation Benefit: Supporting the Assessment, Prevention, and Treatment of Childhood Obesity Liz Martin, MS, CHES Director of Population Health.
Quality Improvement/ Quality Assurance Amelia Broussard, PhD, RN, MPH Christopher Gibbs, JD, MPH.

Quality Improvement/ Quality Assurance Amelia Broussard, PhD, RN, MPH Christopher Gibbs, JD, MPH.
Using EMR Templates to Measure Quality of Care for Children with ADHD and Obesity Jeanne Van Cleave, MD Timothy G. Ferris, MD, MPH September 26, 2007.

Using EMR Templates to Measure Quality of Care for Children with ADHD and Obesity Jeanne Van Cleave, MD Timothy G. Ferris, MD, MPH September 26, 2007.
March - April 2003 Boston Children’s Hospital e Standardization and Automatic Extraction of Quality Measures in an Ambulatory EMR Denni McColm, CIO,

March - April 2003 Boston Children’s Hospital e Standardization and Automatic Extraction of Quality Measures in an Ambulatory EMR Denni McColm, CIO,
Boston Children’s Hospital: Our Journey to Smarter Infusion Pumps Jennifer Taylor, M. Ed, BSN, RN, CPN; Brenda Dodson, Pharm.D... Introduction and Background:

Boston Children’s Hospital: Our Journey to Smarter Infusion Pumps Jennifer Taylor, M. Ed, BSN, RN, CPN; Brenda Dodson, Pharm.D... Introduction and Background:
Brief Profile Proposal for Healthy Weight R2 Content Profile 2015/16 Yr 9 presented to the Quality, Research & Public Health (QRPH) Planning Committee.

Brief Profile Proposal for Healthy Weight R2 Content Profile 2015/16 Yr 9 presented to the Quality, Research & Public Health (QRPH) Planning Committee.
New Opportunity for Network Value: Using Health IT to Improve Transitions of Care 600 East Superior Street, Suite 404 I Duluth, MN 55802 I Ph. 800.997.6685.

New Opportunity for Network Value: Using Health IT to Improve Transitions of Care 600 East Superior Street, Suite 404 I Duluth, MN I Ph
Team Membership Stephanie Detterline, MD Mary E. Altier, MSN, RN Clinical Departments: Emergency Medical Services, General Medicine, Cardiac Services Hospital.

Team Membership Stephanie Detterline, MD Mary E. Altier, MSN, RN Clinical Departments: Emergency Medical Services, General Medicine, Cardiac Services Hospital.
Kylia Crane, RDN, LD Nutrition Coordinator Georgia Chapter- American Academy of Pediatrics 404-881-5093 WIC and Georgia Chapter of the.

Kylia Crane, RDN, LD Nutrition Coordinator Georgia Chapter- American Academy of Pediatrics WIC and Georgia Chapter of the.
Rosana P. Arruda MS.,RD.,LD. Houston Department of Health and Human Services (HDHHS) - WIC LA 26 Amalia Guardiola, MD. Community and General Pediatrics.

Rosana P. Arruda MS.,RD.,LD. Houston Department of Health and Human Services (HDHHS) - WIC LA 26 Amalia Guardiola, MD. Community and General Pediatrics.
Update from NIH/HHS: Healthy People 2020 Nutrition and Weight Status Focus Area Van S. Hubbard, M.D., Ph.D. Rear Admiral, U.S. Public Health Service NIH.

Update from NIH/HHS: Healthy People 2020 Nutrition and Weight Status Focus Area Van S. Hubbard, M.D., Ph.D. Rear Admiral, U.S. Public Health Service NIH.
Can Bright Futures Be Implemented in a Busy Clinical Setting? Lessons Learned from the Preventive Services Improvement Project: A National Collaborative.

Can Bright Futures Be Implemented in a Busy Clinical Setting? Lessons Learned from the Preventive Services Improvement Project: A National Collaborative.
Transitioning from Children’s to Adult Hospital Inpatient Settings Sarah Ahrens, MD Ryan Coller, MD, MPH Jody Belling, RN, MS.

Transitioning from Children’s to Adult Hospital Inpatient Settings Sarah Ahrens, MD Ryan Coller, MD, MPH Jody Belling, RN, MS.
The Comprehensive Perinatal Services Program

The Comprehensive Perinatal Services Program
You’re a Member of the Advancing Excellence (AE) Campaign: Now What? How to Enter, Track, and Trend your Data Debra Bakerjian, PhD, RN, FNP Chair, Clinical.

You’re a Member of the Advancing Excellence (AE) Campaign: Now What? How to Enter, Track, and Trend your Data Debra Bakerjian, PhD, RN, FNP Chair, Clinical.
HEART FAILURE TEAM MEMBERSHIP

HEART FAILURE TEAM MEMBERSHIP
Workflow Improvement and Increased MD Satisfaction After Integration of Sign-out into the EMR Jon Bernstein MD, PhD 1,2 Dan Imler, MD 1,2 Christopher Longhurst.

Workflow Improvement and Increased MD Satisfaction After Integration of Sign-out into the EMR Jon Bernstein MD, PhD 1,2 Dan Imler, MD 1,2 Christopher Longhurst.
An EHR isn’t Enough: Information Exchange for Meaningful Use June 18, 2010 Tri-State REC Kickoff Michele Fronckiewicz Executive Director Child Health Administrative.

An EHR isn’t Enough: Information Exchange for Meaningful Use June 18, 2010 Tri-State REC Kickoff Michele Fronckiewicz Executive Director Child Health Administrative.
HL7 Child Health Work Group Update HL7 EHR-Public Health Task Force Andy Spooner, MD CMIO, Cincinnati Children’s Hospital & Medical Center Co Chair, HL7.

HL7 Child Health Work Group Update HL7 EHR-Public Health Task Force Andy Spooner, MD CMIO, Cincinnati Children’s Hospital & Medical Center Co Chair, HL7.

Similar presentations

Ads by Google