1. Engaging Staff with Meaningful Data to Drive Quality Improvement
Getting data is an IT/staffing/logistics issue
Using data to drive quality improvement is an leadership issue “the hard part.”
Lander Cooney, CEO
Community Health Partners, Inc.

2. Community Health Partners, Inc.
FQHC started in 1997, rural/frontier, ~120 employees
Medical, dental, behavioral health, pharmacy, and educational programming
Served 12,400 patients for over 43,000 visits in 2011
Tell a little history. Serving two county area with a poulation close to 100,000 people. . . Larger than the state of Connecticut. 2

3. Community Health Partners, Inc.
Participated in DM, CVD, Depression, ARMC, Oral Health, Self-Management Support, Patient Safety Collaboratives
Live on NextGen EHR since April 2009
Received NCQA PCMH recognition January 2012

4. PCMH Change Concepts Empanelment Engaged Leadership
Continuous and Team-Based Healing Relationships
Quality Improvement
Patient-Centered Interactions
Enhanced Access
Care Coordination
Organized Evidence-Based Care
(Safety Net Medical Home Initiative –
Don’t need to tell this group about these concepts. . . There are two obvious connections but really measurement helps us make progress in all areas. . .
Panel size, new patients by site and provider, average # visits per year per patient by site
PCMH – A, staff engagement, baldrige response, presentations, community partnerships
Continuity
EVERYTHING, we even measure how many PDSAs are going at once. .
Goals set, panel management, did we ask langugage preference?
3rd next, FOC
Should track referrals, labs, missed opportunities for follow up
See QI – timely A1c or PHQ. . .

5. It starts with Mission, Vision, Values (MVV)
Mission: To enhance community health and wellbeing.
Strategic goal areas: Access, Quality Improvement, Finance, Engagement, Addressing Root Causes of Poor Health, and Partnerships.
Vision: 100% access, zero disparity
Values:
Customer/Patient-centered, excellence, optimism, empathy, respect, efficiency, clear communication, collaboration, flexibility, equity, education, transparency
Tell a little history. Serving two county area with a poulation close to 100,000 people. . . Larger than the state of Connecticut.

6. History of Measurement at CHP
The Technical Story…….
Balanced Scorecard
Strategic Plan
PECS
EMR

7. History of Measurement at CHP
The Engagement Story…….
Asked what does engagement really mean?
Link strategic plan to daily work
In response to Are We Making Progress? Baldrige Gap Survey ( ....and research

8. CHP’s approach
Assume employees WANT to do great work, it’s my job to engage them in it
Align everyone with the mission and strategic objectives
Share data regularly and in a timely manner, transparently, specific to the team doing the work
Give everyone the tools to do improvement work
Recognize, spread, and sustain. . .

9. Assume employees WANT to do great work
Patient centered = employee centered
Hire well – values match
Start with a simple question:

10. Align everyone with the mission, vision, and strategic objectives

11. Drivers

12. Share data regularly, transparently, and specifically

13. Specificity matters . . .

14. in highlighting positive deviants . . .
Tracking patient plan printing. .
Identified by Medical director in May of 2010 as a new measure we’d be tracking – meaningful use, PCMH, good practice
Took providers a while to figure out how to make it part of workflow.
Explain elements of graph – site line, org line, median
ONE provider in Livingston figured it out – I know this because I see all individual lines but also because MM went on vacation in sept of 2010
Also see dip in march 2011 when EMR went down. . .

15. and breaking down big issues.

16. Transparency (with care) motivates.

17. Some thoughts on timeliness and frequency. . .
Good enough measures
Formal vs. informal measures
Use run charts to show change over time.
Think about when and how often
Share data when people have the context to digest and then DO something about it.

18. Give everyone the tools to improve
Communication and teamwork
Facilitative leadership
Run Charts 101
Meetings & time to analyze data and create a plan
PDSA
Lean

19. Recognize, spread, and sustain change
Visual management
Embed data everywhere
Walk the walk
Intranet
PCMH steering committee
Inter-site teams
Summits and Fed-Ex Days

20. Recognize, spread, and sustain change

21. PCMH - A

22. Questions?

23. Thank you! Lander Cooney cooneyl@chphealth.org 406-823-6316 CHP Health
Special thanks to CHP’s founding CEO,
Laurie Francis, RN, MPH
(and you can contact her with questions too )
CHP Health