Overview of The Joint Commission s Primary Care Medical Home (PCMH) Certification
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1 Overview of The Joint Commission s Primary Care Medical Home (PCMH) Certification Joyce Webb, RN, MBA Project Director, Standards and Survey Methods Program Lead, The Joint Commission s PCMH Initiative AHC PCMH Update
2 Objectives: 1. Describe the Joint Commission s PCMH model 2. Provide an overview of the PCMH standards 3. Describe the PCMH on-site survey 4. Discuss the Top 10 Most Challenging PCMH standards 5. Discuss PCMH implementation resources AHC PCMH Update
3 Research for core concepts Patient-Centered Primary Care Collaborative Joint Principles of Patient-Centered Medical Home (AAFP,AAP,ACP,AOA) Agency for Healthcare Research & Quality (AHRQ) Veterans Health Administration Commonwealth Fund/Qualis Health CMS - Meaningful Use Blue Cross Blue Shield of Michigan Minnesota Dept. of Health/Human Services Institute of Medicine Center for Medical Home Improvement National Partnership for Women & Families AHC PCMH Update
4 The Joint Commission s PCMH Model Based on the Agency for Healthcare Research and Quality s (AHRQ) definition of a medical home. a medical home is a model of primary health care that has specific core functions and attributes AHC PCMH Update
5 AHRQ Model for Medical Home AHC PCMH Update
6 The Joint Commission s Primary Care Medical Home Model Team-based approach Primary Care Clinician Interdisciplinary team 5 Operational Characteristics AHC PCMH Update
7 PCMH - Operational Characteristics 1. Patient-Centeredness 2. Comprehensive Care 3. Coordinated Care 4. Superb Access to Care 5. System-Based Approach to Quality and Safety AHC PCMH Update
8 PCMH model Core concepts 5 Operational Characteristics Transformation PCMH Standards & Survey Process AHC PCMH Update
9 The Joint Commission s Primary Care Medical Home (PCMH) Standards AHC PCMH Update
10 Accreditation standards already address: Ethics, Rights, & Responsibilities (RI) Leadership, Oversight (LD) Performance Improvement (PI) Provision of Care, Treatment, & Services (PC) Qualified and competent staff & LIPs (HR) So what s different? AHC PCMH Update
11 Special PCMH Header: For organizations that elect The Joint Commission Primary Care Home option: AHC PCMH Update
12 Patient-Centeredness: Patient-selected primary care clinician (PCC) PC EPs 16 / RI EP7 Patient info about the PCMH s services & how it functions RI EPs 1-3, 5&6 Working in partnership with patient PC EPs 9 &11 Assessment of patient s health literacy needs PC EP 30 Appointment reminders PC EP 5 Communication meets patient s needs & preferences PC EPs 1&2 / RC EP 30 (preferred language) AHC PCMH Update
13 Patient-Centeredness: Patient involvement in performance improvement LD EP 24 Patients have on-line access to their health information PC EP 4 Clinical record contains demographic info, family and work history, BP, and smoking status RC EP 28 Patient self-management goals PC EP 28 / RC EP 29 AHC PCMH Update
14 Comprehensive Care: PCMH must provide or facilitate patient access to: Acute care/chronic Care Oral/Optical/Eye health Behavioral health needs Rehabilitative services & equipment Urgent and emergent care Substance abuse treatment Age/gender-specific preventive care PC EP 1 AHC PCMH Update
15 Comprehensive Care: PCC may be an MD, DO, NP or PA HR EP 1 Patient is provided information on PCC s credentials & educational background RI EP 7 Roles/responsibilities of the primary care clinician & composition of patient s interdisciplinary team PC EPs 1,2,5,8,&12 /HR EP 3 Disease & chronic care mgmt PC EP 3 AHC PCMH Update
16 Coordinated Care: Provides population-based care PC EP 4 Tracking & follow-up on internal & external care recommendations/referrals PC EPs 6&7 Track patient s progress towards treatment goals PC EP 10 PCC & interdisciplinary team provide care for a panel of patients PC EP 4 AHC PCMH Update
17 Coordinated Care: Use a certified electronic health record to: Document and track care and create reports Appointment reminders Disease management, preventive care Support performance improvement Provide patient-specific education resources PC EP 5 AHC PCMH Update
18 Access to Care: Patients have 24 hours a day/7 days a week access to: Contact the PCMH to obtain a same day or next day appointment Request prescription renewal Obtain clinical advice for urgent health needs PC EP 1 Patients have on-line access to their health information, such as, diagnostic test results, labs, and med lists PC EP 4 AHC PCMH Update
19 Access to Care: Offers flexible scheduling to accommodate patient care needs, may be done via: - open scheduling - same day appointments - arrangements with other organizations PC EP 2 24/7 process for responding to patient s urgent care needs PC EP 3 AHC PCMH Update
20 System-Based Approach to Quality & Safety: Electronic prescribing process is used for 50% of allowable prescriptions MM EP 21 Computerized order entry system is used for at least 60% of medication orders MM EP 22 Computerized order entry system is used for at least 30% of lab orders PC EP 18 Computerized order entry system is used for at least 30% of radiology orders PC EP 19 Clinical decision support tools are used PC EP 45 AHC PCMH Update
21 System-Based Approach to Quality & Safety: Collection of data on: Disease management outcomes PI EP 40 Patient perceptions of access to care PI EP 41 Patient experience and satisfaction PI EP 42 Use of data to improve performance PI EP 11 AHC PCMH Update
22 Top 10 Most Challenging PCMH Standards AHC PCMH Update
23 Top 10 Most Challenging PCMH Standards: PC EP 44 - Self-management goals What s your process? How are they documented? PC EP 28 Pt education on SMGs What s your process? Where is this documented? RC EP 29 Pt s preferred language What s your process? How is this captured? Where is this documented? Is the process consistently implemented? PC EP 24 - Health literacy needs What s your process? How is this captured? Where is this documented? Is the process consistently implemented? AHC PCMH Update
24 Top 10 Most Challenging PCMH Standards (cont d): PC EP 6 Review & tracking referrals and tests ordered internal and external What s your process? How do you monitor for referral notes and test results? PI EP 42 - Data collected on access, communication, comprehensive care Are you capturing the patient s perception? PI EP 41 - Data collected on access Next avail appt? No show rates? Appt utilization? PC EP 4 - patient access to their health information within 4 business days May be achieved via PIN access, telephonic or website AHC PCMH Update
25 Top 10 Most Challenging PCMH Standards (cont d): RI EP 7 - information to patients on PCCs What is your process? Use of brochures or cards? posted on website, in the lobby or exam rooms? How are patients informed about PCCs credentials, educational background, special areas of interest, or languages spoken? RI EP 3 - information to patients about the mission, vision, and goals of the primary care medical home What is your process? Is this information shared consistently with patients? What s in your brochures? On your website? AHC PCMH Update
26 PCMH Resources: Check out the Joint Commission PCMH website PCMH overview Self-assessment Tool Question & Answer Guide Most Challenging Standards News, articles and links to other resources. List of PCMH-certified orgs AHC PCMH Update
27 AHC PCMH Update
28 AHC PCMH Update
29 The Joint Commission Disclaimer These slides are current as of 2/1/2018. The Joint Commission reserves the right to change the content of the information, as appropriate. These slides are only meant to be cue points, which were expounded upon verbally by the original presenter and are not meant to be comprehensive statements of standards interpretation or represent all the content of the presentation. Thus, care should be exercised in interpreting Joint Commission requirements based solely on the content of these slides. These slides are copyrighted and may not be further used, shared or distributed without permission of the original presenter or The Joint Commission. AHC PCMH Update
30 Questions? AHC PCMH Update
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