Transcript Slide 1

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“We don’t have a health care
delivery system in this
country. We have an
expensive plethora of
uncoordinated, unlinked,
economically segregated,
operationally limited micro
systems, each performing in
ways that too often create
suboptimal performance both
for the overall health care
infrastructure and for
individual patients”.
Our Problem To Solve
George Halvorson, Author of
Health Care Reform Now!:
A Prescription for
Change.
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The Formula
Providers
Health
Information
Technology
Continuous
Quality
Improvement
Structure and Process
Incorporating Evidence-Based Standards
of Care
Meaningful
Use
Outcome
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An ongoing effort to
provide services that
meet or exceed customer
expectations through a
structured, systematic
process for creating
organizational
participation in planning
and implementing quality
improvements based on
meaningful use of data
that results in improved
outcomes.
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Providing ongoing feedback improves patient outcomes,
health center operations and systems by encouraging
continuous adjustments of programs, policies and activities.
Collecting information about how things are done and the
results helps to understand how health center initiatives
develop and disseminate lessons others can profit from.
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Involving all members of the health system, people who
haven’t had a voice gain the opportunity to better understand
and contribute.
Finally, effective quality programs helps hold everyone
accountable to health center expected outcomes and to the
grant makers who provide funding.
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An organizational culture
centered in Quality
is a MUST.
Involvement of People:
Service Providers, Executive
Management, Managers,
Supervisors, Staff,
Contractors, Board Members,
Everyone!!!!!!
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Who are the members?
What are the roles and responsibilities?
What is the meeting format? (who staffs,
minute-taking, participation requirements,
confidentiality, etc.)
Where does the Committee report?
When does the Committee meet?
How long do committee members serve?
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Safe: Avoid injuries to patients from the care that is intended
to help them.
Effective: Match care to science; avoid overuse of ineffective
care and underuse of effective care.
Patient-Centered: Honor the individual and respect choice.
Timely: Reduce waiting for both patients and those who give
care.
Efficient: Reduce waste.
Equitable: Close racial and ethnic gaps in health status.
Source: Crossing the Quality Chasm: A New Health System for the 21st
Century. Institute of Medicine. 2001
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What are we trying
to accomplish?
What change can
we make that will
result in
improvement?
How will we know
a change is an
improvement?
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QM Program Description
QM Work Plan
Provider Credentialing and Privileging
Peer Review Process
Assessing Organizational Satisfaction (Employee, Provider and
Patient)
Complaint Management
Incident Management
Infection Prevention and Control Management
Medical Record Standards
Medical Record Review Process
Confidentiality and Privacy of Personal Health Information
Use of Clinical Protocols
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Meeting Community Health Center HRSA QA/QI
Program Requirements.
The QA/QI program must:
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Include clinical services and management
Maintain the confidentiality of patient records
Include a Clinical Director whose focus of
responsibility is to support the QA/QI program and
the provision of high quality patient care.
Include periodic assessment of the utilization and
quality of services provided or proposed to be
provided.
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Key Components:
I. Overview
II. Quality Program Structure
III. Quality Improvement Methodology
IV. Communication and Coordination
V. Confidentiality and Privacy of Information
VI. Program Review Process (Timeframes)
VII. Health Care and Business Plan
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Personnel
Data Management
Data Processing, Analysis
and Reporting
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Analyze and
Synthesize Findings
Interpret
the Findings
Make Judgments
/Recommendations
Share
the Results
Identify Program
Performance Standards
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If you don’t know your destination … you won’t
know which way you are heading.
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Systematically identifying
patterns in the information
gathered and deciding
how to organize, classify,
interrelate, compare, and
display it.
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Captivating –Focuses on things that
are timely and meaningful.
Credible – This is for real – Datadriven performance based on sound
methodology and performance
standards.
Continuous – Displays results over
time with summary of findings.
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Satisfaction with Case Management
2004
2005
2006
100%
90%
97.73%
Goal: 90%
100.00%
93.33%
80%
93.18%
94.03%
87.10%
70%
60%
50%
40%
30%
20%
10%
0%
Helpfulness of Staff
Needs were Met
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DEMING’S Model:
Plan: Analyze the process, determine what
changes would most improve the process,
and establish a plan for making the
improvement;
Do: Put your change into motion;
Study: Check to see whether the change
is working;
Act: If the change is working, implement it
on a larger scale. If the change is not
working, refine it or reject it and begin the
cycle again.
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The solution(s) most likely to be successful should
be implemented.
It is often preferable to do this on a small scale to
see if the change(s) will work.
Make the data collection easy enough and the time
frames short enough so that data collection can be
repeated frequently to allow for trending of
changes over time.
Allow enough time to improve performance.
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Study the data in order to
determine:
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What were the findings?
Did the improvement
action(s) effect a change?
What were the positive
and negative effects?
What are the potential
causes contributing to
these effects?
What could have been
done better?
What would we change
and do differently?
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Act on what you learned.
Continue to make improvements in the process by
going through the cycle again, starting at Plan.
Don’t forget a good outcome starts with a good
process.
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Health Outcomes
System and Environmental Change
Actions
Learning
Reactions
Participation
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Improves outcomes for consumers
Improves consumer satisfaction
Improves workforce retention and satisfaction
Increases use of preventive interventions
Increases best practices/innovation
Foundation for performance based incentives
Reduces waste
Reduces rework
Reduces errors
Saves resources
Reduces liability
Improves processes for persons served/other stakeholders
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