Closed Loop Referral Communications

Transcription

1 Closed Loop Referral Communications Session 223, March 8, 2018, 11:30 AM Kristen Wohlford, Regional Director Practice Operations, Mission Health Bridget Schmidt, Ambulatory Nursing Informatics, Mission Health 1

2 Kristen Wohlford, MHA Bridget Schmidt, B.S., R.N. Conflict of Interest Have no real or apparent conflicts of interest to report 2

3 Agenda Mission Health overview Referral Management Project overview DMAIC Approach Project Vision Prior State of Referral Management Initial Analysis Ideal Future State Implementation New Tools End User Communication Project Wins Future Optimization 3

4 Learning Objectives Identify what triggered the initiation of the referral management project Describe 3 challenges faced by referral coordinators with the previous workflow Assess 3 ways the new process has remediated the challenges identified with prior current state Define Closing the Loop as it pertains to the referral management workflow Identify the vision for future state reporting 4

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6 Mission Health System EMR History Cerner PowerChart Client since Hospitals live on full Cerner suite Cerner PowerChart Ambulatory (PCA) Client since Practices live on PowerChart Ambulatory 7 Waves of Implementation Primary Care, Internal Medicine, OB/Women s, Pediatrics/Genetics, Surgery/Orthopedics, Neurology, Vascular/Interventional Radiology/Vein, Infectious Disease, Weight Management, Oncology, Employee Health, MyCareNow/Urgent Care, Cardiology 6

7 Mission Health System Ambulatory Providers County Provider Type Total Physician Macon Mitchell Yancey Jackson Burke McDowell Buncombe Transylvania Graham Haywood Grand Total AP

8 Mission Health Systems Closed Loop Referral Process 8

9 Overview of Referral Management Project Why? Pattern of Patient Safety Event logged related to a Referral RL logged related to delay in referrals RL is a patient risk management software tool Minimal, inconsistent tracking workflow and tool No transparency into referral management Staff and providers frustrated with process 9

10 DMAIC Approach Define Measure Analyze Improve Control 10

11 Referral Management Project Vision The project purpose, in accordance with Mission Health System s BIG(GER) AIM of Patient Quality/Safety, is to: Improve the efficiency and effectiveness of the patient referral process Standardize the referral workflow process across practices Insure patients receive necessary services and referring providers receive pertinent patient information Monitor Key Process Indicators related to referrals 11

12 Prior State of Referral Management Analysis showed 41 steps from order placement to closing the loop 47 call outs of re-work, inefficiencies, problems, no standard process 12

13 Prior State Workflow 13

14 Prior State Workflow Continued 14

15 Prior State Workflow Continued 15

16 Prior State Workflow Continued 16

17 Initial Analysis - Waste and breakdowns in communication between practices - Duplicate documentation in multiple systems - Unknown volume, patterns and performance associated with referrals - Inconsistent processes across practices - Training gaps 17

18 Ideal Future State Tracking Tool sortable to support monitoring Discrete data Reportable Utilize shared chart Set standards around processing Referrals 18

19 Implementation Sprints EMR Alert Notifications Retrospective Referral Clean Up Update and modify encounter selection window in PCA 19

20 New Referral Management Tools Innovative use of current Cerner Tools New Referral Orders build with Order Entry Format (OEF) updates New Custom Referral Management MPage Custom Rules for automation closing the loop Reporting New Custom Referral PowerForm Playbook for standard workflow Direct Message Provider letter SOP for referral management 20

21 New Referral Management Tools New Order Entry Format for Consult Requests Previous Order details: New Order Details: 21

22 Referral Management Tools Consult PowerForm Previous form for consults: 22

23 Referral Management Tools New Consult PowerForm New Referral PowerForm shared by ordering (sending) and consulting (receiving) offices, when both are on PCA Each of the 3 parts will be discussed on the next slides 23

24 Referral Management Tools New Consult PowerForm 24

25 Referral Management Tools New Consult PowerForm 25

26 Referral Management Tools New Consult PowerForm 26

27 Referral Management Tools Ambulatory Referral Worklist New worklist viewable to ordering and consulting offices (both on PCA); Updates are real-time 27

28 Referral Management Project End User Communication Training Plan Roadshows Super User Communications Newsletter Blasts Operations Meeting Communication Command Center 28

29 Referral Management Project Wins New referral workflow Summary page allows Referral Coordinators to manage and track their referrals within the EMR and is viewable in real-time by consulting clinics on PCA Reduced process from 41 Steps to less than 15 steps Immediate increase in Referral Coordinator job satisfaction 29

30 Referral Management Project Wins Automation to eliminate the repetitive manual work required to close the referral loop for practices Over the first 4 weeks after implementation, an Average of 153 referrals were SYSTEM closed per week. With an estimated savings of 9 min/ Referral with the new process, that equates to 23 human hours saved each week. 30

31 Referral Management Future Optimization Vision for future state Reporting Mission Clinic Vital Signs (MCVS) Volume of referrals Internal and External Referral Patterns and Needs, Throughput Key Process Indicators Time from Ordered to Sent Time from Ordered to Scheduled Time from Ordered to Completed 31

32 Project Recognition 32

33 Questions? 33