1. Pursuing High Value Healthcare Optimizing Laboratory Testing Webinar #5 May 7, 2015 1

2. Agenda Welcome Team Status Reports o Progress/Activities Since Learning Session Data Team Updates  Current data and reports  Discussion  Phase 2 of Collaborative ● Next Steps  Action Period  Learning Session #4 DHMC- June 4, 2015 2

3. Our First Collaborative: Global Aim We aim to reduce harm to patients and conserve system resources by optimizing the use of laboratory tests for patients cared for in our region’s hospitals. We will use a collaborative approach considering the best medical evidence and quality improvement science. It begins with an evaluation of current test ordering profiles and patterns followed by an organized plan to optimize testing and ends with a plan to sustain these practices. By doing this we expect to reduce cost and improve satisfaction and quality of care for patients and the health system. It is important to work on this now because as health care professionals we can play an important role in health care reform by designing more patient-centered, efficient and high value inpatient care. 3

4. Quality Improvement Process Assessment Theme Global Aim Specific Aim Change Ideas Measure(s) PDSA SDSA 1 2 3 1 2 3 Success Measure Global Aim Modified from Quality By Design, A Clinical Microsystems Approach Nelson, Batalden and Godfrey© Trustees of Dartmouth College Step 1- Form Team Step 2- Get Baseline Data Step 3- Create Global Aim Step 4- Create Specific Aim Step 5 –Determine Cause and Effects Step 6- Brainstorm Change Ideas Step 7 –Determine Process Measures Step 8- Test Your Changes 4 We are here!

6. Team Progress Reports RRMC Brattleboro NVRH Bennington Porter DHMC CVMC UVMMC New Team Members? Meeting Frequency? Data Findings? Identified Improvement Opportunities? Test of Change/PDSA Cycles? PDSA Outcomes? 4

7. Data Update Data Definitions Resource Sample of current monthly data reports Discussion What’s Next?

8. Phase 2 of Collaborative Work with current data base Deeper dive based on organization specific findings Deeper dive based on group findings ?

9. 9 Learning Session 1 Oct. 22 8:30 to 3:30 Learning Session 1 Oct. 22 8:30 to 3:30 Learning Session 4 Jun. 4 DHMC 8:30 to 3:30 Learning Session 4 Jun. 4 DHMC 8:30 to 3:30 Learning Session 2 Feb. 12 UVM 8:30 to 3:30 Learning Session 2 Feb. 12 UVM 8:30 to 3:30 Kick-Off Week 1 Sept 11, 2PM Kick-Off Week 1 Sept 11, 2PM Learning Session 3 Apr. 2 CVH 8:30 to 3:30 Learning Session 3 Apr. 2 CVH 8:30 to 3:30 Pre-work 5-6 weeks Pre-work 5-6 weeks Conference Call / Webinar Nov 6, 2PM Conference Call / Webinar Dec 4, 2PM Conference Call / Webinar Jan. 8, 2PM Conference Call / Webinar Mar 5, 2PM Conference Call / Webinar May 7, 2PM Continuous Coaching/Faculty Support Collaborative Timeline

10. Next Steps Action Period  Continue to Review and submit data  Determine change ideas  Design tests of change  Trial tests of change  Evaluate Results Support  Set up a time for Faculty to join a Team Mtg. Next Learning Session June 4, 8:00 to 3:30 DHMC 14