c3 kelly mendes - qi in a prototype community: improving attachment rates in the cowichan valley
TRANSCRIPT
QI in a Prototype Community: Improving Attachment Rates in the Cowichan Valley
Presented by:
Valerie Nicol, Executive Lead CVDFP Kelly Mendes, Quality Improvement Advisor, Impact BC
February 28, 2013
The Cowichan Division of Family Practice (CVDFP)
• The CVDFP has been created to provide support to the people and family physicians of the Cowichan region.
• As a Patient Attachment Initiative Prototype Community, we will provide leadership in healthcare innovations, in collaboration with our community.
About the CVDFP:
• Population: 82,871• 90 GP members• 12% of population is Aboriginal
What are we Trying to Improve?
• 5% (4,143) Unattached Patients
• 40% (33,148) Poorly Attached Patients
Attachment Goals
Mar 2011 –
Maternity Clinic, FPHSP attaching patients
Feb 2013
1389+ Pts attached via CMC, FPHSP, New GP recruitment and GP Support
2015 –
All patients who want a GP have one
Data Collection Process
Circle of Care Modelling
Process
GP Interviews
Pt. Attachment Survey
GP Survey
Community Health Centre – “Warmland Health Services”
Primary Internal Features
• On site services• For unattached
patients only
Integrated services
• For unattached patients
• Also available to support patients with a GP
Outreach Services
• Part of the clinic• Provided in
outlying communities
Features of the health centre were
organized into three groupings
“Warmland Health
Services”
The synergistic effect of taking a mixed approach…
… enables the community to develop an overall vision and then implement portions of the vision as funding and resources allow
Attachment Initiatives
Provincial Attachment
Working Group
Family Practice Hospital Support Program
Cowichan Maternity Clinic
Aboriginal Health Working Group
Chronic Pain Working Group
Warmland Health Services:
Unattached Pt Services
End of Life/Palliative Care Working Group
CVDFP Attachment
Working Group
Current Initiatives:
Proposed Initiatives:
Practice Coaching
The Improvement Framework
Impact BC’s Role
Family Practice Hospital Support
Program
Cowichan Maternity Clinic
Aboriginal Health Working Group
Chronic Pain Working Group
CVDFP Attachment Working Group
Project Charters
Prepare Monthly Reports
QI Learning &
Innovation Reporting Structure
Impact BC(Quality Improvement
Advisor)
Data Collection Plan
Proces
s Measures
• # of unattached pts seen in walk-in clinics
• # of unattached pts seen in ED
Outcome
Measures
• # of unattached patients
• # of GPs taking unattached pts
Balancing Measures
• # of ED visits/yr (attached/unattached)
Measures
How will we know a change is an Improvement?Attachment via Existing Programs to Dec 31, 2012:
• 222 Patients Attached
Hospital Support Program
• 63 Patients Attached
Locum Coordinator
Program
• Locum became full service GP in area
• 500+ patients attached
Division Support
• April 2012 – GP suddenly unable to practice - CVDFP matches 600+ pts to division members
1,389+Patients Attached
Next Steps…..
• Addition of Practice Coaching initiative to support Attachment by increasing EMR optimization and office efficiencies
• Re-engaging stakeholders• Patient / Provider satisfaction surveys• Continue collection of measures, learnings,
tests of change to inform CVDFP of progress in these initiatives
Contact Info:
Valerie Nicol,Executive Lead CVDFP [email protected]
Kelly Mendes, Quality Improvement AdvisorImpact BC [email protected]