a meaningful quality improvement program that meets …...general indicator checklist 1-hx =...
TRANSCRIPT
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A Meaningful Quality Improvement Program that meets AAAHC Guidelines
Beth Brown MS, ANPConnie Hume-Rodman MD
ACHA May 30, 2012
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I’ll be happy to give you innovative thinking. What are the guidelines?
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Objectives
AAAHC criteria - 3 broad areas
How Oregon State’s program meets criteria QI study examples
Using EMR in our process
Peer Review program
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Student Health ServicesLive well. Learn well. Be well.
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AAAHC Compliance3 – Year Cycle
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AAAHC GuidelinesBroad – Based Program
Clinical issues Cost of care Patient outcomes Administrative
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Written Policy & Plan
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Mission
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Volunteer Committee
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Includes one physician
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Goals and Objectives
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Objectives 2010- 2013 Benchmark studiesNational clinical guidelinesAAAHC accreditation3 studies minimum
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Goals 2011-2012
Complete outstanding studies Perform pertinent
studies & re-studies Continue prescription
writing error study
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Goals 2011-2012Types of Studies
Patient outcome Cost of care Student learningAdministrativeNational
benchmark
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Goals 2011-2012Peer Review
Clinician Physical Therapy Nursing SANE
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Student Satisfaction Surveys-Internal/External-Focused
-Urgent Care
-LGBT
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Sources of Studies
Peer Review Incident Reports Health & Safety
Committee
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Studies from Individual Departments
Lab Pharmacy Physical TherapyMedical Records Clinicians Nursing Administration
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Studies of Clinical Health Concerns
Prevalent diseases/injuries Concussion Depression
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Internal benchmarking
Student Satisfaction Surveys
Student Learning Surveys Influenza Like IllnessNursing Advice LinePlan B Billing/Insurance
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Link with risk management program Incident Reports Occupational Health
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Annual Evaluation
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Reporting
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AAAHC Guidelines10 Elements of QI Study Reports
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Purpose and Description of Study Assessment of issue Reason for selecting Impact of topic
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Goal of Study
What results are satisfactory? Guidelines or benchmarks used.
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Study Methods
Data collected Data collection
process/tools
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Findings
Data analysis Comparison of data against goal
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Interventions and Recommendations
“As you can see we have thought carefully about ways of improving staff productivity.”
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Evaluation and Conclusion
Goal reached?Re-study? Inform staff
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AAAHC GuidelinesBenchmarking
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Relevant Performance Measures
National Clinical Guidelines
Metabolic Syndrome Hypertension Concussion Depression
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System for Data Collection and Analysis
ACHA Pap and STI Survey ACHA Clinical Benchmarking
Re-studies:• Ottawa Rules • Flu Shot Rates• Peak Flows for Asthma• Depression
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Measuring Changes in PerformanceRe-studies and Peer Review
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Using Local, State or National Standards
NCHA Survey- Gardasil vaccination rates
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Incorporating Benchmarks Using EMR to improve quality
Centor Criteria Ottawa ankle rules Depression
-PHQ-9 Concussion
-SCAT 2 Animal Bite Reporting
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Reporting Benchmark Results
Annual Report Shared Drive Department Meetings
-ACHA Benchmarks
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“First, I want to give you an overview of what I will tell you over and over again during the entire presentation.”
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AAAHC Accreditation Requirements
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Peer Review Purpose
FEEDBACK
Individual
Supervisors
Collective Practice
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Procedure
Quarterly
Fall & Spring-General-Diagnosis
Winter-Screening
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Process
Random assignment
NP/PA
MD/DO DO/MD
PA/NP
Forms
Comments
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Then and
now…
Courtesy of OSU Archives P57:7675
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Changes
Tabulating Data
Modifying forms
Using EMR
“Regime change is never easy, dear.”
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Tabulating Data
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General Indicator Checklist 1-Hx = Adequate history recorded.2-PE = Adequate physical exam recorded.3-Dx = Assessment and diagnosis supported by history/physical.4-Tx = Treatment plan consistent with assessment and diagnosis. 5a-ED = Appropriate pt education discussed and recorded…5b-Verb.Tx = Patient indicates or verbalizes understanding of treatment.6-Rx = Appropriate meds prescribed and recorded.7a- F/U Adv. = Follow up advice given and occurred if recommended.7b-Verb.F/U = Patient indicates or verbalizes understanding of when to
return8-Consult = Appropriate and timely consultation if indicated.9-Tests = Diagnostic and therapeutic procedures are clinically necessary.10-F/u tests = Timely follow up of findings/test results. 11-Med.List = Medication list was updated and confirmed. 12-Allergies = Allergies or NKDA noted on Allergy section.13a-Med.Hx = All significant problems noted on the Medical History.13b-Prob.List = All significant problems noted on the Problem List.14-Rev.Hx = Past Medical History reviewed within the past year.15-Lock = Was chart note locked within 2 working days of visit?
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Modifying forms
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Separate Screening & General Indicators
Incorporate AAAHC indicators
Edit Indicator Checklist
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Alcohol (Audit-C)
Depression
(PHQ-9)
Tobacco
BMI > 30
Screening Peer Review
Checklist
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Using EMR
.
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“We think you may be suffering from information underload.”
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YOU DID IT!
• Thank you•