A Meaningful Quality Improvement Program that meets AAAHC Guidelines. Beth Brown MS, ANP Connie Hume-Rodman MD ACHA May 30, 2012
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1 A Meaningful Quality Improvement Program that meets AAAHC Guidelines Beth Brown MS, ANP Connie Hume-Rodman MD ACHA May 30,
2 I ll be happy to give you innovative thinking. What are the guidelines? 2
3 Objectives AAAHC criteria - 3 broad areas How Oregon State s program meets criteria QI study examples Using EMR in our process Peer Review program
4 Student Health Services Live well. Learn well. Be well.
5 AAAHC Compliance 3 Year Cycle
6 AAAHC Guidelines Broad Based Program Clinical issues Cost of care Patient outcomes Administrative
7 Written Policy & Plan
8 Mission 8
9 Volunteer Committee
10 Includes one physician
11 Goals and Objectives
12 Objectives Benchmark studies National clinical guidelines AAAHC accreditation 3 studies minimum
13 Goals Complete outstanding studies Perform pertinent studies & re-studies Continue prescription writing error study
14 Goals Patient outcome Cost of care Student learning Administrative National benchmark Types of Studies
15 Goals Peer Review Clinician Physical Therapy Nursing SANE
16 Student Satisfaction Surveys -Internal/External -Focused -Urgent Care -LGBT
17 Sources of Studies Peer Review Incident Reports Health & Safety Committee
18 Studies from Individual Departments Lab Pharmacy Physical Therapy Medical Records Clinicians Nursing Administration
19 Studies of Clinical Health Concerns Prevalent diseases/injuries Concussion Depression
20 Internal benchmarking Student Satisfaction Surveys Student Learning Surveys Influenza Like Illness Nursing Advice Line Plan B Billing/Insurance
21 Link with risk management program Incident Reports Occupational Health
22 Annual Evaluation
23 Reporting
24 AAAHC Guidelines 10 Elements of QI Study Reports 24
25 Purpose and Description of Study Assessment of issue Reason for selecting Impact of topic
26 Goal of Study What results are satisfactory? Guidelines or benchmarks used.
27 Study Methods Data collected Data collection process/tools
28 Findings Data analysis Comparison of data against goal
29 Interventions and Recommendations As you can see we have thought carefully about ways of improving staff productivity.
30 Evaluation and Conclusion Goal reached? Re-study? Inform staff
31 AAAHC Guidelines Benchmarking
32 Relevant Performance Measures National Clinical Guidelines Metabolic Syndrome Hypertension Concussion Depression
33 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
34 Measuring Changes in Performance Re-studies and Peer Review
35 Using Local, State or National Standards NCHA Survey - Gardasil vaccination rates
36 Incorporating Benchmarks Using EMR to improve quality Centor Criteria Ottawa ankle rules Depression -PHQ-9 Concussion -SCAT 2 Animal Bite Reporting
37 Reporting Benchmark Results Annual Report Shared Drive Department Meetings -ACHA Benchmarks
38 First, I want to give you an overview of what I will tell you over and over again during the entire presentation.
39 AAAHC Accreditation Requirements
40 Peer Review Purpose FEEDBACK Individual Supervisors Collective Practice
41 Procedure Quarterly Fall & Spring -General -Diagnosis Winter -Screening
42 Process Random assignment NP/PA MD/DO DO/MD PA/NP Forms Comments
43 Courtesy of OSU Archives P57:7675 Then and now
44 Changes Tabulating Data Modifying forms Using EMR Regime change is never easy, dear.
45 Tabulating Data
46 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 return 8-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?
47
48
49 Modifying forms
50 Separate Screening & General Indicators Incorporate AAAHC indicators Edit Indicator Checklist
51 Alcohol (Audit-C) Screening Peer Depressi on (PHQ-9) Review Checklist Tobacc o BMI > 30
52
53 . Using EMR
54
55
56
57 We think you may be suffering from information underload.
58 YOU DID IT! Thank you
59 Oregon State University in
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