Transcript Document

Maine Chronic Disease
Improvement Collaborative (CDIC)
IMPROVING DIABETES AND HYPERTENSION
NOVEMBER 2014 – JUNE 2015 PILOT
Launch Webinar: November 7, 2015: 8 – 10 AM
(866) 740-1260 ; 1120970#
www.readytalk.com #1120970
Rhonda Selvin, NP
Associate Medical Director, Maine Quality Counts
Joanne O’Neil Lafferty, M.Ed.
Quality Improvement Specialist, Maine Quality Counts
Agenda
 Welcome and Introductions (45 minutes)
 Quality Counts Staff
 Practice Teams
 Project Overview (45 mins)
 Setting the Stage
 Collaborative Model
 Benefits of Participation
 Collaborative Overview
 Next Steps
Q&A
Maine Quality Counts Staff & Faculty
CDIC Participating Teams
Naples Family Practice
York Family Practice
Midcoast Brunswick Family Practice
Capeheart Community Health Center (PCHC)
Pines Presque Isle
Welcome
 Your name and role (all team members)
 A little bit about your team (improvement
initiatives involved in, etc.)
 One thing your practice is most proud of
 One thing you want to learn from the
collaborative
 Six word sentence that describes your teams’
feelings going into this
Why Now?
National Front
Local Front
 32% of mortalities in
Chronic disease is the
number one cause of
death.
Maine in 2010
 Diabetes rates have
risen from 6% to 8.7%
in 10 years
 92,000 adult residents
living with diabetes
Why Maine?
 Strong primary care leadership
 Active participation by Maine practices in
Medical Home & Health Home, others…
 Rural communities increase isolation and
the need for support for chronic disease
patients
 Your readiness & willingness!
About the Project
 Funder: Maine Centered for Disease Control (CDC)

1305: State Public Health Actions to Prevent & Control Diabetes, Heart Disease &
Obesity
 Project Partners:

Maine Quality Counts: project leadership, practice coaching, PCMH expertise

Maine CDC: grantee and partner

Partnership for Health: evaluation partner
Stakeholder group … strong and growing!

Including:
 MMC Diabetes Collaborative
 Maine Cardiovascular
Health Council
 Medical Care Development/Public Health
 HealthCentric Advisors Quality Improvement Organization (QIO)
 Area Agencies on Aging
 Maine Nurse Practitioner Association
 Primary care practice and Specialty provider groups
Our Goals
 Expand
knowledge on
evidence based, safe,
cost effective care
 Implement/spread
best practices and
algorithms across the
state
 Improve quality, cost
and safety
 Teach and spread
science of quality
improvement
Leading Improvement
 Patients/families
 Health
 Provider
support
 Leadership
 Teams
 Relationships
 Data
CDIC
Collaborative Model
JOANNE O’NEIL LAFFERTY, M.ED.
MAINE QUALITY COUNTS,
QUALITY IMPROVEMENT SPECIALIST
Benefits of Participation
 Dedicated,
on-site improvement coaching support
 Learning sessions—all teach all learn
 Case conference calls with clinical experts
 Virtual learning communities—”share seamlessly and
steal shamelessly”
 Maintenance of Certification & CME available
(contact Joanne for information)
Benefits of Participation
Dedicated, on-site improvement coaching support
A dedicated improvement coach on-site to support you with the program
requirements 2 times a month at a time convenient for you
 Assess
current state and support ongoing improvement
work
 Optimize registry to inform improvement
 Support data collection and reporting
 Develop team meeting and improvement skills
Benefits of Participation
Building In-person & virtual Learning Communities




Most of the learning will be virtual, allowing you to stay in your office
Share & network across the state
Access to clinical and quality improvement experts
Access to best practices, tools & templates
November December January
Launch
Webinar

Learning
Session 1
February
March
April
May
June
CaseConference
Call
Practicebased SelfStudy
CaseConference
Call
Learning
Session 3
2/26/15
3/19/15
Anytime
5/21/15
(Optional)
6/18/15
9AM – 3PM
12:15 – 1:15
this month
12:15 – 1:15
9AM – 3PM
CaseConference
Call
Practicebased SelfStudy
Learning
Session 2
1/15/15
Anytime
this month
A chance to learn, share and spread best practices
11/7/14
12/4/14
8AM10AM
9 AM – 3 PM 12:15 – 1:15
Benefits of Participation
Additional Benefits of Participation
 An
easy way to achieve Maintenance of Certification
(optional)
 CME
available (optional) for your staff
CDIC Aims 2014-2015
By July, 2015, the CDIC participants will aim to redesign their practices
to:
 Improve blood pressure control of hypertensive patients
so that 65% of hypertensive patients have BP<140/90 mm
Hg.
 Improve HbA1c control of diabetic patients so that 80% of
diabetic patients whose most recent HbA1c level is <9.0%
during the measurement year.
How might we meet that Aim?
Drivers for Improving Chronic Care
Family of Measures
 Outcome measure
Overall measure of success
Voice of customer or clinical outcome
 Process measures
How work gets done
More sensitive to change
Come and go as work changes
Our Measures
Note:
Will vary based on MOC participation
Outcome Measures:
 HTN BP Control (<140/90) (NQF 18) and/or LDL <100 (NQF 0074)
 DM A1c Control (>9%) (NQF 59) and/or a1c <8% (NQF 0575)
Process Measures:
Registry Use
Population Management
Pre-Visit Planning
Self-Management Plan
Referral
Others…
Balancing and Structural:
Systems Assessment
Staffing
Patient Satisfaction
Time
Others??
CDIC Evaluation
Federally required evaluation.
 Partnerships For Health is based in Augusta and has been
awarded the evaluation contract.
 Two components of the evaluation – performance measures
and qualitative evaluation.
Qualitative evaluation
Performance measures:
1 - 45 minute interview with an
Approximately 6 measures
administrative leader / manager
Need to be reported beginning/end
1 - 1 hour focus group with staff
Partnerships For Health will be
3 - 45 minute individual interviews
available to assist with data
with patients
collection
Balancing…
Is there any other part of the system that might
be influenced by your changes?
Patient
Satisfaction
Length of Visit
Finances
Staff Satisfaction
Structural
 Staffing
(turn over)
 Educated Care Team
How have we learned that we can accelerate
change and increase improvements in healthcare?
Aim
Measure
Change Idea
Changes Tied to Aim/Measures
Measures
Aims
Change Ideas
Next Steps
Meet your QI Support! (Onsite)
1.
2.
3.
BUILD your team
ASSESS your systems and registry
CLARIFY your needs for support
1.
2.
3.
4.
4.
5.
Measure collection
Registry optimization
Workflow optimization
Others…
BRAINSTORM Aims and improvement opportunities
ORIENT team to resources
How Ready are You?
On a scale of 1 (low) – 10 (high)
1.
We have are excited to meet with QI Specialist and get
started!
2.
We can easily pull measures that tell each team how they are
doing with Diabetes and Hypertension patients!
3.
We have tested things in the past that seem to have gone
well!
4.
Our team can work with our QI Specialist 2x/month
5.
Here’s where we think we might start:
__________________________________
Contacts
 Joanne O’Neil Lafferty, M.Ed.
[email protected]
 Rhonda Selvin, NP
[email protected]
•
General CDIC Mailbox
[email protected]
Questions?