Advanced Access; What s it All About?
|
|
- Preston Howard
- 6 years ago
- Views:
Transcription
1 Advanced Access; What s it All About? CATHERINE TANTAU TANTAU & ASSOCIATES POB 179, 111CHICAGO PARK CALIFORNIA CT@TANTAUASSOCIATES.COM 1
2 Objectives Begin to understand the best work currently being done to dramatically improve appointment access and continuity for patients. Learn what research has told us for years about the value of Continuity between patients and PCP s. Recognize where you are on the access continuum and how to distinguish between Traditional, Open and Advanced Access models. Understand why access is a pillar of the Medical Home model and why it s not about just working harder. 2
3 Every system is perfectly designed to get the results it gets. 3
4 4
5 Academics Weigh in Key Elements of a Medical Home Barbara Starfield, 2004 Accessible Person focused Comprehensive Coordinated Barbara Starfield, MD, MPH Director, Primary Care Policy Center Distinguished Professor, John Hopkins University Schools of Public Health and Medicine 5
6 NCQA PCMH Standards Standard 1: Access and Communication Standard 2: Patient Tracking and Registry Functions Standard 3: Care Management Standard 4: Patient Self-Management Support Standard 5: Electronic Prescribing Standard 6: Test Tracking Standard 7: Referral Tracking Standard 8: Performance Reporting and Improvement Standard 9: Advanced Electronic Communications
7 I had to think about this for awhile before I jumped in. I realized everything in medicine has changed steadily constantly looking for better ways to diagnose and treat patients. But, office flow has stayed the same for 50 years. It is about time we pay attention to it. Patrick Macken M.D., Luther Middlefort Waiting list of 4 months for 26 years eliminated in four months 50% now booked same day, 50% next day Phone abandoned rate reduced from 20% to <1% Protocols to refill common meds Anticipate need for x-rays, complete pre-visit 7
8 Minor changes in flow can help greatly with a very busy schedule Steve Smith M.D., Olympia Washington 3 rd next available 15 days to 5 days in 4 months Reduced appointment types from 7 to 3 Start on time Chart preparation the day before Pre-history form Huddles 8
9 I have seen that it works in other places so we have adapted the principles in our service. Marc Lowe M.D., Urology, Group Health Cooperative Achieved access goals in 5 months. Phone abandoned rate reduced 25% to 5% Late and missing encounter forms reduced from 151 per month to 0 in four months Standardized exam rooms and stocking lists Patient clinic discharge form allows MA/LPN to complete visit and fill out majority of paperwork 9
10 What if. you could offer your patients an appointment with the physician or provider of their choice at a time that was convenient for them? 10
11 Access An access problem is a delay problem An access problem is a system property 11
12 Constraints Demand from pts Request for primary service constraint Access to that service constraint Delivery of that service constraint Access to specialty service 12
13 The longer patients/families wait, The harder we work. New Patient Calls (1/wk/MD) Switchboard Established Patient Calls (Most) PCP Receptionist (4) # Admin. - Q & A - Page Pedi MA - Assist patient Hold Busy N.A. Answer Appt. req. recept Note: - No triage on phone - Occas. triage walk in + - Book it w/pcp - Overflow MD if walk in when avail min. -- hours or lost Bounce to others when PCP recept. fall Q & A Sick? Not sure Mesg. To MD MD calls patient Q & A Check insur. & confirm on 2 systems new patients longer - Next avail. w/pcp + - Book it - Add on sooner - Occas. Msg to MD or 30" - hrs. Advise Appt. Emerg. - ED Note: Always see pts. Admin. to resolve - non PCP - 1st available 13
14 Advanced Access AA is No delays for an appointment. CONTINUITY for patients and providers. Doing today s work today AA is Not Holding appts in anticipation of same day urgent demand. A Walk in Clinic or Urgent Care Clinic. 100% open schedule each day Telling pts to all back tomorrow 14
15 Advanced Access is the ability of a practice to Offer patients/families an appointment with the provider of their choice at a time that is convenient for them. 15
16 Start with an Aim The Gold Standard Primary Care: Offer an appointment today for any problem (urgent or routine) with the PCP or teammate in the absence of the PCP.* Specialty Care Offer an appt this week for any problem (urgent or routine) with the specialist of record or teammate in the absence of the specialist of record. WHY??? Tantau & Associates.com 16
17 Feeling overwhelmed? 17
18 Gold Standard: Why Today???? Constant tension between medical definition of Urgent and patient definition. Nice for pts. Transformative for the practice Work doesn t pile up Room to grow practice TODAY. Competitive advantage 18
19 Gold Standard: Why Continuity? Poor Continuity More hospitalizations Longer Length of Stay More referrals to specialists More prescriptions More ER visits More testing, studies Increased Demand More costs for everyone Lousy access 19
20 4/17/2002 4/24/2002 5/1/2002 5/8/2002 5/15/2002 5/22/2002 5/29/2002 6/5/2002 6/12/2002 6/19/2002 6/26/2002 7/3/2002 7/10/2002 7/17/2002 7/24/2002 7/31/2002 8/7/2002 8/14/2002 8/21/2002 8/28/2002 9/4/2002 9/11/2002 9/18/2002 3rd NEXT AVAILABLE PHYSICAL Carillion Medical Group Team HARCUS LEWIS PRINCE STAMBAUGH YOUNG ZIMMER
21 Delay the Anchor Measure What s a 3rd Next Available? 21
22 Anchor Measure for Access Tool #1: How to Measure Delay for 3 rd next available appt. Delay for a Routine Appointment for each Provider Number of calendar days to third next available routine appointment. Pick appt type or length most delayed (physical?) to track Or, measure Long appts and Short appts. If that is more meaningful to you. 3 rd Next Available a reliable reflection of system s availability. 1st or 2nd appt likely due to cancellation or random event. Use your scheduling system; computerized or manual. Count number of days from today to the day when 3 rd next appointment is available. Measure for each Provider. Measure same day and time each week 7:30 Monday morning is good. Plot the number of calendar days to the third 3 rd next available appointment, each week An example of a Delay run chart.. 22
23 10/4/99 10/18/99 11/1/99 11/15/99 11/29/99 12/13/99 12/27/99 1/10/00 1/24/00 2/7/00 2/21/00 3/6/00 3/20/00 4/3/00 4/17/00 5/1/00 Days Delay for a Physical Exam 3rd Next Avail. Appt. for PE Appt. with PCP
24 5/31/05 6/30/05 7/31/05 8/31/05 9/30/05 10/31/05 11/30/05 12/31/05 1/31/06 2/28/06 A different time, a different place, a very different group, same access aim, similar results NUMBER OF CALENDAR DAYS UNTIL 3RD APPT PEDI OB/GYN I MED Source: Providence CHC s, Rhode Island 24
25 Capitol Hill CHC Providence, Rhode Island Decrease No Show rate CHHC NO SHOW RATE % 30.0% 25.0% 20.0% 15.0% 10.0% 5.0% 0.0% PEDI OB/GYN I MED APRIL MAY JUNE JULY AUGUST SEPT OCTOBER NOVEMBER DECEMBER JANUARY FEBRUARY MARCH APRIL MAY JUNE JULY Aug Sept Oct Nov Dec 25
26 26
27 YKHC Physical Therapy Reduction in Delays for Appointments Stopped serial Booking of returns Third next appointment -PT No. of Days RH KH HJ /27/05 11/16/05 12/07/05 12/19/05 01/13/06 01/18/06 01/27/06 02/06/06 (*)3/7/ /17/06 03/29/06 Date 27
28 Critical Access Design Elements 1. Continuity / familiarity 2. Appointment capacity 3. Demand and Supply equilibrium 28
29 Range (Max_Min) %VG/EX 1. Continuity Satisfaction Ratings 90 Comparison of Provider Ratings (Qs 56-65) by Demographics Ethnicity Gender Age Educ Health Status Care Type # of Visits Tenure Range PCP Familiar Stranger Am Africian Hispani White Chines Filipino Japane Other Indian Am. c e se Asian Other Male Female < LT 12 H School Post- Sec. College Grad G. Sch. Poor Fair Good V. Good Excelle Prevent Routine Contin Emerg Urgent nt ive uing ency LT Range PCP Familiar Stranger
30 Gold Standard: Why Continuity? Poor Continuity More hospitalizations Longer Length of Stay More referrals to specialists More prescriptions More ER visits More test, studies Increase Demand More costs for everyone 30
31 2. Capacity 45% 40% 35% 30% 25% 20% 15% 10% 5% 0% % Open Next Four Weeks Sep-99 O ct-99 Nov-99 Dec-99 Jan-00 Dr. S Dr. T Dr. V 31
32 3. Demand and Supply Equilibrium Demand Evidence of a stable reservoir??? DELAY Supply Costs: No Shows, Triage, Rework, Call backs, Messages, Testing, Rx s 32
33 Access Continuum Traditional Model Carve Out Model Advanced Access Model 33
34 Traditional Model Saturated schedules Triage & rework use expensive resources (MD and RN) Multiple appointment types Urgent, Routine juggled Capacity: Overbook and over there Continuity: delayed 34
35 Open Access; Carve Out Model Marv Smoller,MD Predict demand for Urgent appts based on history. Reserve space for Urgent demand (carve out) Routines delayed; no space for intermediate care Continuity: fair to poor Capacity: Future filled or held 35
36 Carve Out Model Flaws Call back Black market Self destruct Do some of today s work today 36
37 Advanced Access Paradigm shift: No distinction between Urgent & Routine Evidence of stable reservoir Backlog eliminated (good vs. bad) Continuity: System property Primary Care panels Specialty care Case loads Capacity: Future is open Pull vs push 37
38 Advanced Access Today and the future are open and available for booking appts. Yesterday we did yesterday s work. Last week we did last week s work. Last month we did last month s work. Today we do today s work. We don t need to freeze, restrict, hold appts. We us tools to predict daily appt demand. 38
39 Advanced Access Fears: Saturated schedules Demand is insatiable Panel size Pitfalls: Panel size Supply side variation Do today s work today. 39
40 Traditional and Carve-outs In order to protect today, we push work to tomorrow. Vs Advanced Access In order to protect tomorrow, we pull work into today. 40
41 Results of Advanced Access Reduced delays for appointments Decreased Urgent Care and ED visits Improved continuity for patients and physicians Improved clinical outcomes Enhanced compliance with guidelines Growth opportunities and financials Increased patient, physician and staff satisfaction. 41
42 Nov 9-13 Dec 7-11 Jan 4-8 Feb 1-5 Mar 1-5 Mar 29-Apr 2 April 26-Apr 30 May 31-June 4 June 28 - Jul 2 Aug 2-6 Aug 30-Sept 3 Sept 27-Oct 1 Oct Nov Dec 20-24*** Jan Feb Mar Apr Delay for Appointments Before Advanced Access Wisconsin Group 1 Days to 3rd Next Available Appointment After Advanced Access Target Level 42
43 Days til 3rd Available Routine Appointment 43
44 Jul-99 Aug-99 Sep-99 Oct-99 Nov-99 Dec-99 Jan-00 Feb-00 Mar-00 Apr-00 May-00 Jun-00 Jul-00 Aug-00 Sep-00 Oct-00 Nov-00 Dec-00 Appointment Availability Family Medicine Clinic Average Percentage of Appointments Open at 8:00 a.m. 60% 50% 48% 46% 49% 51% 56% 40% 37% 40% 42% 30% 28% 33% 35% 29% 20% 18% 10% 7% 10% 7% 0% 4% 44
45 Emergency Department Visits ER Visits per 1000 Patients in Panel Group Mar-99 Apr-99 May-99 Jun-99 Jul-99 Aug-99 Sep-99 Oct-99 Nov-99 Dec-99 Group 1 Wisconsin Group 45
46 Patient / Provider Continuity Family Medicine Patient / Provider Continuity 90% 80% 70% 60% 75% 66% 77% 70% 60% 60% 66% 75% 69% 65% 69% 70% 77% 50% 53% 40% 36% 30% 20% 17% 24% 10% 14% 0% Jul-99 Sep-99 Nov-99 Jan-00 Mar-00 May-00 Jul-00 Sep-00 Nov-00 Jan-01 46
47 Lipids Colorectal BP - diag. Tetanus Influenza Pneumovax Breast Ca Cervical Ca Tobacco Use Tobacco users advice % of serv. Complete Improved Clinical Outcomes 120% Q 110% 100% 90% 80% 88% 1999 Q4 97% 94% 97% 96% 88% 86% 98% 99% 86% 93% 70% 60% 50% 40% 30% 1998 Q4 20% 10% 0% Interventions: 1998 Q Q Q1 Lipids 59% 92% 88% Colorectal 50% 74% 97% BP - diag. 88% 100% 94% Tetanus 50% 80% 97% Influenza 52% 100% 96% Health prompt Pneumovax 65% 92% 88% Breast Ca 69% 70% 86% Cervical Ca 76% 95% 98% Continuity Tobacco Use 70% 97% 99% Tobacco users advice 93% 90% 86% % of serv. Complete 60% 87% 93% 47 Advanced Access
48 Visits Change in Visit Utilization April March 1997 Sacramento 250, Visits 194, ,000 Visit Rate 170, , ,000 Impaneled Members 86,896 83,867 (-8.3 %) , Initiated Second Generation End Year 1 End Year 2 4/95 to 3/96 4/96 to 3/97 Year Primary Care Visits Avg. # Impaneled Visits / Impaneled Member
49 Over and Under Appointments 49
50 Improved Finances Average per month over 1 year Office Visits per Physician Decrease of 11.9% April 98-March 99 April 99-March April 98-March 99 April 99-March 00 Work RVU per Physician Increase of 6.8%
51 Improved Finances Average per month over 1 year $200,000 $190,000 $180,000 $170,000 $160,000 $150,000 $16,500 $16,000 $15,500 $15,000 $14,500 $14,000 $13,500 $167,560 April 98-March 99 $14,654 $196,521 April 99-March 00 $16,054 April 98-March 99 April 99-March 00 Net Revenue per Month Increase of 17.3% Net Income per Month Increase of 9.6% 51
52 Getting Started.. 52
53 High Leverage Changes for Access Improvement Balance demand and supply daily Reduce backlog Decrease appointment types Develop contingency plans Reduce demand for visits Optimize the Care Team 53
54 Advanced Access Sequencing Steps Foundation Steps Set Access Aim Gold Standard Empanel pts to PCP in Primary Care Measure delay 3 rd next available routine appt Measure Continuity with PCP Measure Appt Demand, Supply, Actual Match Demand, Supply, daily and weekly Action Steps Reduce Backlog Simplify appt types/times Contingency planning Reduce Demand for visits Optimize the Care Team At every step Track, display, discuss data weekly. Celebrate successes and failures! 54
55 XXXX Last Chance? What s next???????? 55
56 References Tantau, Catherine, Accessing Patient Centered Care Using the Advanced Access Model, Journal of Ambulatory Care Management, Winter, 2009 Managing the Unexpected, Karl E. Weick and Kathleen M. Sutcliffe, University of Michigan Business School, 2001 Kilo, C.M., Triffletti, P., Tantau, C., & Murray, M. (2000). Improving access to clinical offices. The Journal of Medical Practice Management, 16(3):126:132. Tantau, Catherine. Same-Day Appointments Create Capacity, Increase Access. Executive Solutions for Healthcare Management, February Tantau, Catherine, Murray, M., Sept Same-day appointments: Exploding the access paradigm. Family Practice Management, 7(8): Retrieved January 15, 2004: huttp:// Raddish M, Horn S, Sharkey P. Continuity of Care: Is it Cost Effective? American Journal of Managed Care. 1999:5: Jon O. Neher, MD; Gary Kelsberg, MD; Drew Oliveira, MD, Improving Continuity by Increasing Clinic Frequency in a Residency Setting, Family Medicine Journal, Vol.33, no. 10 p 751, November - December 2001 John W. Saultz, Jennifer Lochner, Interpersonal Continuity of Care and Care Outcomes: A Critical Review, Ann Fam Med 2005;3: DOI: /afm
Advanced Access: How To Make it Work, Part I -Appt Demand and Supply Forecasting -Backlog Reduction
Advanced Access: How To Make it Work, Part I -Appt Demand and Supply Forecasting -Backlog Reduction Catherine Tantau, BSN, MPA President, Tantau & Associates Tantau & Associates P.O. Box 179 Chicago Park,
More informationM1 Advanced Access: How To Make it Work Part I. Catherine Tantau, BSN, MPA President, Tantau & Associates. Objectives Part I
M1 Advanced Access: How To Make it Work Part I Catherine Tantau, BSN, MPA President, Tantau & Associates IHI International Summit March 15, 2015 Tantau & Associates P.O. Box 179 Chicago Park, California
More informationPresbyterian Healthcare Services Care Management
Presbyterian Healthcare Services Care Management Kathy M. Garcia RN, BSN Director of Nursing, Primary Care Service Line November 2012 Future Healthcare Challenges Increasing number of patients Decreasing
More informationAurora will expand its geographic coverage within Wisconsin to achieve its mission to: Aurora Health Care 1991 Strategic Plan
Objectives To describe the 20-year evolution of Aurora Medical Group within Aurora Health Care To identify the cultural characteristics necessary to improve patient access from the patient s perspective
More informationCHC-A Continuity Dashboard. All Sites Continuity - Asthma. 2nd Qtr-03. 2nd Qtr-04. 2nd Qtr-06. 4th Qtr-03. 4th Qtr-06. 3rd Qtr-04.
PPC1: ACCESS AND COMMUNICATION Element B: Access and Communication Results Item 1: Visits with assigned PCP Continuity data is reviewed each month at our Office Redesign Committee (ORDC). The data is collected
More informationPatient Care: Case Study in EHR Implementation. With Help From Monkeys, Mice, and Penguins. Tom Goodwin, MHA MIT Medical Cambridge, MA March 2007
Using Information Technology to Drive Patient Care: Case Study in EHR Implementation With Help From Monkeys, Mice, and Penguins Tom Goodwin, MHA MIT Medical Cambridge, MA March 2007 MIT Medical Staff 122
More informationOregon Medical Group Team Medicine 3 April 2014
Oregon Medical Group Team Medicine 3 April 2014 Joshua P. Kimball Chief Operating Officer Oregon Medical Group Oregon Medical Group Oregon Medical Group is a physician owned, primary care heavy, multispecialty
More informationManaging Risk Through Population Health Initiatives
Managing Risk Through Health Initiatives Vicki DeBaca, DNS, RN Vice President, Health & Provider Services Sharp Rees-Stealy Medical Centers 1 Sharp Rees-Stealy Medical Centers San Diego s Multi-Specialty
More informationPATIENT CARE SERVICES REPORT Submitted to the Joint Conference Committee, August 2016
Report Contents: PATIENT CARE SERVICES REPORT Submitted to the Joint Conference Committee, August By: Terry Dentoni, MSN, RN, CNL, SFGH Chief Nursing Officer 1. Professional Nursing..1 2. Emergency Department
More informationPatient-centered care - from buzz word to meaningful reality. Current Health Care System
Patient-centered care - from buzz word to meaningful reality Katie Coleman, MSPH David K. McCulloch MD Current Health Care System Traditionally, this is the only part of the health care system that is
More informationDepartments to Improve. February Chad Faiella RN, Terri Martin RN. 1 Process Excellence
Coordination of Multiple Departments to Improve ED Throughput February 2011 Chad Faiella RN, Terri Martin RN 1 Agenda OhioHealth information Grant Medical Center facts Bed assignment process Key takeaways
More informationNHS Performance Statistics
NHS Performance Statistics Published: 8 th March 218 Geography: England Official Statistics This monthly release aims to provide users with an overview of NHS performance statistics in key areas. Official
More informationmeaningful reality Katie Coleman, MSPH
Patient-centered care - from buzz word to meaningful reality Katie Coleman, MSPH David K. McCulloch MD Current Health Care System T diti ll thi i th l Traditionally, this is the only part of the health
More informationNHS performance statistics
NHS performance statistics Published: 8 th February 218 Geography: England Official Statistics This monthly release aims to provide users with an overview of NHS performance statistics in key areas. Official
More informationNHS performance statistics
NHS performance statistics Published: 14 th December 217 Geography: England Official Statistics This monthly release aims to provide users with an overview of NHS performance statistics in key areas. Official
More informationPATIENT CARE SERVICES REPORT Submitted to the Joint Conference Committee, March 2018
Report Contents: PATIENT CARE SERVICES REPORT Submitted to the Joint Conference Committee, March By: Terry Dentoni, MSN, RN, CNL - ZSFG Chief Nursing Officer 1. Professional Nursing......1-2 2. Emergency
More informationPACT: The VA s Medical Home
A5/B5 This presenter has nothing to disclose PACT: The VA s Medical Home What is working to change a big system Mike Davies, MD Director VA Systems Redesign Rich Stark, MD Director VA Primary Care Operations
More informationAdvanced Access Overview
Advanced Access Overview By Elizabeth W. Woodcock, MBA, FACMPE, CPC Creating timely access for patients is on the agenda for many medical practices. Why? Because improved access means happier patients
More informationPATIENT CARE SERVICES REPORT Submitted to the Joint Conference Committee, November 2017
Report Contents: PATIENT CARE SERVICES REPORT Submitted to the Joint Conference Committee, November By: Terry Dentoni, MSN, RN, CNL - ZSFG Chief Nursing Officer 1. Professional Nursing.....1 2. Emergency
More informationHypertension Best Practices Symposium Sponsored by AMGA and Daiichi Sankyo, Inc.
Hypertension Best Practices Symposium Sponsored by AMGA and Daiichi Sankyo, Inc. October 13-15, 15, 2010 Scottsdale, AZ Kaiser Permanente of the Mid-Atlantic States (KPMAS) 1 KPMAS Medical Group Profile
More informationPatient-Centered Connected Care 2015 Recognition Program Overview. All materials 2016, National Committee for Quality Assurance
Patient-Centered Connected Care 2015 Recognition Program Overview All materials 2016, National Committee for Quality Assurance Learning Objectives Introduction to Patient-Centered Connected Care and Eligibility
More informationFinding Progress on Timely Access Issues
Finding Progress on Timely Access Issues Bill Barcellona SVP for Government Affairs, CAPG L. Gordon Moore, MD Senior Medical Director, 3M Health Data Science Group Dan Southard Deputy Director, Office
More informationFrom Big Data to Big Knowledge Optimizing Medication Management
From Big Data to Big Knowledge Optimizing Medication Management Session 157, March 7, 2018 Dave Webster, RPh MSBA, Associate Director of Pharmacy Operations, URMC Strong Maria Schutt, EdD, Director Education
More informationC.O.R.E. MISSION STATEMENT
C.O.R.E. MISSION STATEMENT Comprehensive Opiate Recovery Experience RECOVERY WITH RESPECT Improving the lives of individuals through comprehensive opiate replacement services C.O.R.E. MEDICAL CLINIC IS
More informationTransforming Health Care with Health IT
Transforming Health Care with Health IT Meaningful Use Stage 2 and Beyond Mat Kendall, Director of the Office of Provider Adoption Support (OPAS) March 19 th 2014 The Big Picture Better Healthcare Better
More informationdiabetes care and quality improvement in our practice
The Multidisciplinary Team: The key to successful planned diabetes care and quality improvement in our practice Robb Malone, PharmD UNC General Internal Medicine January 20, 2009 Objectives Review the
More informationPresentation Outline
Chronic Disease Toolkits: Spreading Quality Outcomes Simply Gerald H. Angoff, MD, FACC, MBA Steve Sarette, BA Presentation Outline It Introduction ti Setting the scene Quality Improvement Project Details
More informationImproving Pain Center Processes utilizing a Lean Team Approach
Improving Pain Center Processes utilizing a Lean Team Approach Organization Name: St. Joseph Medical Center Type: Acute Care Hospital Contact Person: Sue Mitchell Title: Nurse Mgr Pain Mgmt Center E-Mail:
More information2017 HIMSS DAVIES APPLICANT
2017 HIMSS DAVIES APPLICANT Introduction of NOMS Team Members Melissa Thomas IT Project Director Joshua Frederick, CPA, MT Chief Executive Officer Jennifer Hohman, MD Executive Vice President, NOMS Healthcare
More informationDesigning Reliable Value-based Systems of Care for Chronic Disease and Prevention
Designing Reliable Value-based Systems of Care for Chronic Disease and Prevention Frederick J. Bloom, Jr. MD MMM President, Guthrie Medical Group 1/23/15 Where We Want to Be 1. Affordable coverage for
More informationCountywide Emergency Department Ambulance Patient Transfer of Care Report Performance Report
Countywide Emergency Department 9-1-1 Ambulance Patient Transfer of Care Report Performance Report Prepared by: Contra Costa Emergency Medical Services Visit us at www.cccems.org 2/11/2016 Contra Costa
More informationThe PCMH St Joseph s Experience
The PCMH St Joseph s Experience Priya Radhakrishnan, MD Roshni Kundranda, MD, MSPH Binh Doung, DO Jenni Schroeder, RN, BSN ACP Regional Meeting Tucson, 2013 Disclosure No financial conflicts of interest
More informationAlaska Psychiatric Institute. Admissions & Demographic Annual Report
Alaska Psychiatric Institute Admissions & Demographic Annual Report (As of 8/2/27) 1 Total Admissions FY, FY4, FY, FY, FY7 18 1 Number Of 14 12 1 8 FY FY4 FY FY FY7 4 2 FY Admissions - 1,227 FY Admisions
More informationFrom Reactive to Proactive: Creating a Population Management Platform
Session D9 / E9 From Reactive to Proactive: Creating a Population Management Platform Richard Gitomer, MD Director, Brigham and Women s Primary Care Center of Excellence Vice Chair, Primary Care, Dept.
More informationREASSESSING THE BED COORDINATOR S ROLE SHADY GROVE ADVENTIST HOSPITAL
Publication Year: 2008 REASSESSING THE BED COORDINATOR S ROLE SHADY GROVE ADVENTIST HOSPITAL Summary: Creation of Bed Coordinator position to improve patient flow throughout the entire hospital Hospital:
More informationAchieving Operational Excellence with an EHR a CIO s Perspective
Achieving Operational Excellence with an EHR a CIO s Perspective Phyllis Schuck, SPHR CIO of Pinehurst Surgical HIT Session 6.02 Thursday, March 29, 2007 Pinehurst Surgical Organization Overview Founded
More informationDriving the value of health care through integration. Kaiser Permanente All Rights Reserved.
Driving the value of health care through integration February 13, 2012 Kaiser Permanente 2010-2011. All Rights Reserved. 1 Today s agenda How Kaiser Permanente is transforming care How we re updating our
More informationLean Healthcare Outcomes: Delivering Results
Presenters Lean Healthcare Outcomes: Delivering Results John Duggan Director of Real Estate Operations & Retail Subsidiaries Reliant Medical Group, Worcester, MA C01: October 2nd, 2012 Marc Margulies AIA,
More information9/15/2017 THROUGHPUT. IT S NOT JUST AN EMERGENCY DEPARTMENT ISSUE LEARNING OBJECTIVES
THROUGHPUT. IT S NOT JUST AN EMERGENCY DEPARTMENT ISSUE D O N N A C R I M M I N S - B O N N E L L, B S N, M H S M, C P H Q, L S S G B LEARNING OBJECTIVES 1) Define who is affected by inefficiency in throughput
More informationExecutive Summary: Davies Ambulatory Award Community Health Organization (CHO)
Davies Ambulatory Award Community Health Organization (CHO) Name of Applicant Organization: Community Health Centers, Inc. Organization s Address: 110 S. Woodland St. Winter Garden, Florida 34787 Submitter
More informationExecutive Director s Report: Customer Experience Update
Executive Director s Report: Customer Experience Update Board of Directors Meeting, November 12, 215 Seconds Calls Service Center Performance 2, 18, 16, 14, 12, 1, 8, 6, 4, 2, Calls Offered Jan 215 Sept
More informationHeart Failure Order Sets. Standardizing Care for the Heart Failure Patient 2012
Heart Failure Order Sets Standardizing Care for the Heart Failure Patient 2012 Objectives: Standardize care for all heart failure patients in Legacy Base Practice on American Heart Association Guidelines
More informationTransforming Healthcare Delivery, the Challenges for Behavioral Health
Transforming Healthcare Delivery, the Challenges for Behavioral Health Presented by: M.T.M. Services, LLC P. O. Box 1027, Holly Springs, NC 27540 Phone: 919-434-3709 Fax: 919-773-8141 E-mail: mtmserve@aol.com
More informationThe Reduction of Seclusion & Restraint in the University of Michigan Psychiatric Emergency Services with the Introduction of 24/7 Nurse Staffing
The Reduction of Seclusion & Restraint in the University of Michigan Psychiatric Emergency Services with the Introduction of 24/7 Nurse Staffing Sharon P. Stetz MSN Marvella M. Muzik, MS PMHNP, BC Objectives
More informationUsing Data for Proactive Patient Population Management
Using Data for Proactive Patient Population Management Kate Lichtenberg, DO, MPH, FAAFP October 16, 2013 Topics Review population based care Understand the use of registries Harnessing the power of EHRs
More informationTitle. SF Health Network Telephone Communication Program. Subtitle. Antenor Arenas Director, Centralized Call Center
SF Health Network Telephone Communication Program December 15, 2015 Antenor Arenas Director, Centralized Call Center Title Anna Robert, RN, DrPH Director of Care Coordination Subtitle 1 Overview Organizational
More informationImproving Clinical Flow ECHO Collaborative Change Package
Primary Drivers (driver diagram) Change Concepts Change Ideas Examples, Tips, and Resources Engaged Leadership Develop culture for transformation Use walk-arounds and attendance at team meetings to talk
More informationJulie Kelley, MSW, MPH Program Chief, Mental Heath/Psychiatry Contra Costa Regional Medical Center Martinez, CA
Julie Kelley, MSW, MPH Program Chief, Mental Heath/Psychiatry Contra Costa Regional Medical Center Martinez, CA Patients and Families as Care Partners April 20, 2011 Little about us Contra Costa Regional
More informationImprove the Efficiency and Service of the Emergency Room at North Side Hospital
Improve the Efficiency and Service of the Emergency Room at North Side Hospital John Melton, VP and CEO Washington County Operations meltonjw@msha.com Kerry Vermillion, CFO Washington County Operations
More informationCountywide Emergency Department Ambulance Patient Transfer of Care Report Performance Report
Countywide Emergency Department 9-1-1 Ambulance Patient Transfer of Care Report Performance Report Prepared by: Contra Costa Emergency Medical Services Visit us at www.cccems.org 2/28/2017 Patient Transfer
More informationInfluence of Patient Flow on Quality Care
Influence of Patient Flow on Quality Care Patients Waiting on Trolleys for an Inpatient Bed Patients who are Medically Fit to be discharged and cared for at Home with Support or in a Nursing Home or District
More informationQuality Management Report 2017 Q2
Quality Management Report 2017 Q2 Quality Management Program CMS STAR Ratings Member Satisfaction (CAHPS & HOS) HEDIS Risk Adjustment DHS Member Incident Reporting Member Satisfaction Surveys Pay for Performance
More informationJourney in managing practice variation in Diabetes and Hypertension (Part 2/2)
Journey in managing practice variation in Diabetes and Hypertension (Part 2/2) For Part 1 of this presentation, go to http://rightcare.berkeley.edu/sacramento-university-of-best-practices Parag Agnihotri,
More informationSTATISTICAL PRESS NOTICE MONTHLY CRITICAL CARE BEDS AND CANCELLED URGENT OPERATIONS DATA, ENGLAND March 2018
STATISTICAL PRESS NOTICE MONTHLY CRITICAL CARE BEDS AND CANCELLED URGENT OPERATIONS DATA, ENGLAND March 2018 Main Findings March 2018: Critical Care Beds There were 4,064 adult critical care beds available
More informationUniversity of Michigan Health System Program and Operations Analysis. Analysis of Pre-Operation Process for UMHS Surgical Oncology Patients
University of Michigan Health System Program and Operations Analysis Analysis of Pre-Operation Process for UMHS Surgical Oncology Patients Final Report Draft To: Roxanne Cross, Nurse Practitioner, UMHS
More informationHPV Vaccination Quality Improvement: Physician Perspective
HPV Vaccination Quality Improvement: Physician Perspective Discussion of efforts to raise HPV vaccine coverage using quality improvement from a physician s perspective Alix Casler, M.D., F.A.A.P. Chief
More informationMinnesota Perspective: Fairview Health Services. National Accountable Care Organization Congress October 25, 2010
Minnesota Perspective: Fairview Health Services National Accountable Care Organization Congress October 25, 2010 Fairview Overview Not-for-profit organization established in 1906 Partner with the University
More informationUsing Lean Principles to Decrease Outpatient Registration Wait Times. It s a Journey not a Destination
Using Lean Principles to Decrease Wait Times It s a Journey not a Destination 533 Bed Acute Care System 461 Beds at AnMed Health Medical Center 72 Beds at AnMed Health Women s and Children's Hospital 45
More informationStandard Reporting Template
Standard Reporting Template NHS England (Wessex) 2014/15 Patient Participation Enhanced Service Reporting Template Practice Name: Practice Code: Shanklin Medical Centre J84010 Signed on behalf of practice:
More informationMaking the Medical Home Work/Teamwork in Primary Care. Amy Mullins, MD Trinity Clinic Whitehouse
Making the Medical Home Work/Teamwork in Primary Care Amy Mullins, MD Trinity Clinic Whitehouse Objectives Objectives Include: 1. Learn how to build your office team. 2. Understand various ways to use
More informationAPPENDIX 2 NCQA PCMH 2011 AND CMS STAGE 1 MEANINGFUL USE REQUIREMENTS
Appendix 2 NCQA PCMH 2011 and CMS Stage 1 Meaningful Use Requirements 2-1 APPENDIX 2 NCQA PCMH 2011 AND CMS STAGE 1 MEANINGFUL USE REQUIREMENTS CMS Meaningful Use Requirements* All Providers Must Meet
More informationNational Trends Winter 2016
National Trends Winter 216 About the National Trends data This report presents a unique and real-time view of trends within temporary nursing including bank and agency usage. The data used has been drawn
More informationFrom Implementation to Optimization: Moving Beyond Operations
From Implementation to Optimization: Moving Beyond Operations Session 260, March 8, 2018 Scott Aikey, Sr. Director, Core Clinical Applications Children s Hospital of Philadelphia 1 Conflict of Interest
More informationCOMMITTEE REPORTS TO THE BOARD
Item # 9 F i COMMITTEE REPORTS TO THE BOARD To From South East LHIN Board Members Quality Committee Reviewed by Quality Committee Committee Members of the Committee were given the opportunity to review
More informationCorporate Services Employment Report: January Employment by Staff Group. Jan 2018 (Jan 2017 figure: 1,462) Overall 1,
Corporate Services Employment Report: January Employment by Staff Group Jan (Jan 20 figure: 1,462) Jan % Overall 1,520 +58 +4.0% 8 Management (VIII+) 403 +52 4.8% Clerical & Supervisory (III to VII) 907
More informationPart 2: PCMH 2014 Standards
Part 2: PCMH 2014 Standards Heather Russo, CCE PCMH Consultant September 15, 2015 Advancing Healthcare Improving Health For Practices Recognized at Level 2 or Level 3 under the 2011 Standards Your Guide
More informationPANELS AND PANEL EQUITY
PANELS AND PANEL EQUITY Our patients are very clear about what they want: the opportunity to choose a primary care provider access to that PCP when they choose a quality healthcare experience a good value
More informationLean Six Sigma DMAIC Project (Example)
Lean Six Sigma DMAIC Project (Example) Green Belt Project Objective: To Reduce Clinic Cycle Time (Intake & Service Delivery) Last Updated: 1 15 14 Team: The Speeders Tom Jones (Team Leader) Steve Martin
More informationOntario Shores Journey to EMRAM Stage 7. October 21, 2015
Ontario Shores Journey to EMRAM Stage 7 October 21, 2015 ICE BREAKER Agenda System overview & pervasiveness of use Review Clinical Practice Guideline implementation Discuss Patient Portal implementation
More informationAppendix 4 CMS Stage 1 Meaningful Use Requirements Summary Tables 4-1 APPENDIX 4 CMS STAGE 1 MEANINGFUL USE REQUIREMENTS SUMMARY
Appendix 4 CMS Stage 1 Meaningful Use Requirements Summary Tables 4-1 APPENDIX 4 CMS STAGE 1 MEANINGFUL USE REQUIREMENTS SUMMARY 1. Use CPOE (computerized physician order entry) for medication orders directly
More informationEXECUTIVE SUMMARY. Introduction. Methods
EXECUTIVE SUMMARY Introduction University of Michigan (UM) General Pediatrics offers health services to patients through nine outpatient clinics located throughout South Eastern Michigan. These clinics
More informationUniversity of Cincinnati Patient Centered Medical Home Leadership Decisions
University of Cincinnati Patient Centered Medical Home Leadership Decisions Eric J. Warm M.D., F.A.C.P. Program Director, Internal Medicine Associate Professor of Medicine University of Cincinnati College
More informationLaguna Honda Lean Transformation. Laguna Honda Strategic Performance Management November 2017
Laguna Honda Lean Transformation Laguna Honda Strategic Performance Management November 2017 Background MAKE IT BETTER 4. 1. Performance Improvement FIX IT Do the work and make it happen 3. Create best
More informationPractice Transformation: Patient Centered Medical Home Overview
Practice Transformation: Patient Centered Medical Home Overview Megan A. Housley, MBA Business Development Director Kentucky Regional Extension Center The Triple Aim Population Health TRIPLE AIM Per Capita
More informationABCD of Access Solutions Support Programme
ABCD of Access Solutions Support Programme SCIMP/SNUG Conference 20-21 September 2016 Dillon Sykes Managing Director Agenda Section Section Name 1. The struggle to meet patient demand 2. ABCD of Access
More informationMark Stagen Founder/CEO Emerald Health Services
The Value Proposition of Nurse Staffing September 2011 Mark Stagen Founder/CEO Emerald Health Services Agenda Nurse Staffing Industry Update Improving revenue trends in healthcare staffing 100% Percentage
More informationFebruary 2007 ACP, AAFP, AAP, AOA joint statement
Patient Centered Medical Home in a Safety Net Community Health Clinic: The T Transformation f i off Eastside Adult Clinic Nicole Joseph, MD Denver Health GIM Grand G dr Rounds d February 7, 2012 OBJECTIVES
More informationThe Virtual Connection: Electronic Visits. Joseph E. Scherger, MD, MPH National Medical Home Summit March 3, 2009
The Virtual Connection: Electronic Visits Joseph E. Scherger, MD, MPH National Medical Home Summit March 3, 2009 The Holy Grail of Health Care 2009 Cost Reduction Quality Improvement Service Improvement
More informationSaskatchewan. Drug. Information. Service
Saskatchewan Drug Information Service Regina Qu Appelle Health Region Contract On-Call Drug Information Service Annual Report 2009-2010 College of Pharmacy and Nutrition, University of Saskatchewan 110
More informationAyrshire and Arran NHS Board
Paper 12 Ayrshire and Arran NHS Board Monday 9 October 2017 Planned Care Performance Report Author: Fraser Doris, Performance Information Analyst Sponsoring Director: Liz Moore, Director for Acute Services
More informationInfluence of Patient Flow on Quality Care
Influence of Patient Flow on Quality Care Patients Waiting on Trolleys for an Inpatient Bed Patients who are Medically Fit to be discharged and cared for at Home with Support or in a Nursing Home or District
More informationOperations report. August 12, 2016
Operations report August 12, 216 1 HFSC at a glance: 216 compared to 215 Total Average TAT Requests Received Total Average Process Time 5% 33% 39% Total average TAT include all sections averaged from the
More informationUCLA Newborn Screening Symposium 2018
UCLA Newborn Screening Symposium 2018 Facility Feedback HEPP Reports and Graphs How to Best Utilize These Reports for Optimal Outcomes Timeliness in Specimen Collection and Transit TRF Completion Early/Missing
More informationSaskatchewan. Drug. Information. Service
Saskatchewan Drug Information Service Regina Qu Appelle Health Region Contract On-Call Drug Information Service Annual Report 2010 2011 College of Pharmacy and Nutrition 110 Science Place, Saskatoon SK
More informationThe Role of Medication Management in a Patient-Centered Medical Home
The Role of Medication Management in a Patient-Centered Medical Home David W. Moen, MD Medical Director Care Model Innovation Fairview Health Services Disclosures The faculty reported the following financial
More informationQuality and Efficiency Support Team (QuEST) Directorate for Health Workforce and Performance
Quality and Efficiency Support Team (QuEST) Directorate for Health Workforce and Performance A Whole System Approach to Patient Flow for Scotland Our Quality Improvement Approach Jane Murkin Programme
More informationPPI Deprescribing: Ascension
PPI Deprescribing: Ascension Tonya Thomas, PharmD Clinical Pharmacist Saint Thomas West Hospital Nashville, TN, USA #derx2018 Session resources will be available at deprescribing.org/resources Learning
More informationOperational Excellence: Lean
Operational Excellence: Better Service By Working Smarter Lean Lean is a production practice that considers the expenditure of resources for any goal other than the creation of value for the end customer
More informationSTEMI ALERT! Craig M. Hudak, MD, FACC,FACP 24 January 2015
STEMI ALERT! Craig M. Hudak, MD, FACC,FACP 24 January 2015 STEMI Overview ST segment Elevated Myocardial Infarction Patient Outcome Goals: Save myocardium Reduce CHF Reduce arrhythmias Improve quality
More informationExecutive Summary MEDICARE FEE-FOR-SERVICE (FFS) HOSPITAL READMISSIONS: QUARTER 4 (Q4) 2012 Q STATE OF CALIFORNIA
MEDICARE FEE-FOR-SERVICE (FFS) HOSPITAL READMISSIONS: QUARTER 4 (Q4) 2012 Q3 2013 Executive Summary STATE OF CALIFORNIA The Centers for Medicare & Medicaid Services (CMS) has tasked Health Services Advisory
More informationWashington State LTSS System, History and Vision
Washington State LTSS System, History and Vision Bea Rector, Director, Home and Services Aging and Long Term Support Administration Washington State Department of Social and Health Services For Northwest
More informationCOLLABORATIVE PRACTICE SUCCESSES IN PRIMARY CARE
COLLABORATIVE PRACTICE SUCCESSES IN PRIMARY CARE KPhA Annual Meeting September 7, 2014 Tiffany R. Shin, PharmD, BCACP Lyndsey N. Hogg, PharmD, BCACP Objectives Describe basic concepts of collaborative
More informationImplementing Medicaid Value-Based Purchasing Initiatives with Federally Qualified Health Centers
Implementing Medicaid Value-Based Purchasing Initiatives with Federally Qualified Health Centers Beth Waldman, JD, MPH June 14, 2016 Presentation Overview 1. Brief overview of payment reform strategies
More informationPatient-Centered Medical Home (PCMH) & Patient-Centered Specialty Practice (PCSP)
Patient-Centered Medical Home (PCMH) & Patient-Centered Specialty Practice (PCSP) Foundation for a Better Health Care System Presenter Jeanette Ikan, M.D., MHAI Objectives: Definition and benefits of PCMH,
More informationWorkflow. Optimisation. hereweare.org.uk. hereweare.org.uk
Workflow Optimisation Dr. Paul Deffley & Jaivir Pall Clinical Lead & Commercial Lead About Here Not-for-profit social enterprise Membership organisation (our members are local GPs, Practice Managers, Practice
More informationAdministrative Update: How to Implement Discharge Pharmacy Services (DPS) Objectives
Administrative Update: How to Implement Discharge Pharmacy Services (DPS) Morgan Pendleton, PharmD, BCOP Hematology/Oncology Clinical Pharmacist Wake Forest Baptist Health Objectives Evaluate the need
More informationSt Paul s Way Medical Centre. Patient Participation Group Event September 2013
St Paul s Way Medical Centre Patient Participation Group Event September 2013 Welcome and introductions Dr Joe Hall Lead GP Dr Emma Murphy Lead GP Luthfur Rahman Patient Advisor Rukshana Parvez - Receptionist
More informationKentucky Sepsis Summit. August 2016
1 Kentucky Sepsis Summit August 2016 St. Elizabeth Healthcare About Us: - 7 facilities & over 1200 licensed beds - Serving the NKY/Cincinnati Region in: - Orthopedic Care - Heart and Vascular Institute
More informationMaimonides Medical Center Makes a Quantum Leap with Advanced Computerized Patient Record Technology
Maimonides Medical Center Makes a Quantum Leap with Advanced Computerized Patient Record Technology Healthcare Information and Management Systems Society Electronic Poster Session CPR System Planning The
More informationHIMSS Nicholas E. Davies Award of Excellence Case Study Nebraska Medicine October 10, 2017
HIMSS Nicholas E. Davies Award of Excellence Case Study Nebraska Medicine October 10, 2017 Nebraska Medicine $1.2 billion academic health system 8,000 employees More than 1,000 affiliated physicians Primary
More information