Our Journey to the Acclaim Award. David Gano, MSOD Regional Director Ambulatory Performance Improvement

Transcription

1 Our Journey to the Acclaim Award David Gano, MSOD Regional Director Ambulatory Performance Improvement

2

3 Mission Statement: To Extend the Healing Ministry of Jesus Christ. Vision Statement: CHRISTUS Trinity Mother Frances Health System, a Catholic health ministry, will be a leader, a partner, and an advocate in the creation of innovative health and wellness solutions that improve the lives of individuals and communities so that all may experience God s healing presence and love. Values: Dignity, Integrity, Excellence, Compassion, Stewardship Purpose Statement: Achieving national prominence in clinical medicine though excellence in quality and safety, research, education and innovation.

4 CHRISTUS Trinity Clinic June 2018 Employed Physicians 409 Employed APCs 283 Total Specialties 106 Ambulatory Clinics in Texas and Arkansas 1.3 Million Patient Visits in last 12 Months

5 Acclaim Workgroup 7 Primary Contributors -Executive Sponsor/SVP and Primary Care Institute Chair -Director of Population Health -Medical Director of Population Health -Director of Performance Improvement (Project Manager) -Director of Service Excellence and Patient Experience -Administrative Director -Medical Director of Quality

6 CHRISTUS Trinity Clinic Acclaim Award Timeline May 2018 Executive Sponsorship for Application Initiated and PM Assigned. Late May Acclaim Application Workgroup Formed and Meetings scheduled. June Initial Workgroup Meeting. Assignments of writing, due dates, and narratives determined. July First Rough Draft Completed Late July - Second Rough Draft Completed August Revision and One Voice editing Late August Review of Draft with Executive Leadership for Feedback September 3 rd Party Review of Application. Development of Appendices September 15 Final Review of Submission Document and Last Revisions September 20 Submission to AMGA w/ Confirmation Receipt December Notice of Recognition from AMGA Received.

7 Process 1. Identify those compelling items within your organization that meet the AMGA definition for attributes of a High Performing Healthcare System. 2. Identify the most impactful Narrative topics that your organization is doing to improve quality and the health of managed populations focusing on the IOM Triple Aim. 3. Show how technology and evidence based medicine is used to facilitate better patient care. 4. Give examples of how your organization has made significant strides to improve patient and physician engagement.

8 The Patient Centered Approach Cost Utilization Leadership Structure and Development Population Health Patient Centered Access Service

9

10 CHRISTUS Trinity Clinic Patient Experience Results (4/1/15) Percentile Rank: All Database / South / Texas Global DOMAIN Question n % All Sites N = All Facilities N = 831 AHA Region 7 N = 60 Access to Care % How often get urgent appt as needed % How often get appt soon as needed % How often get answer same day % Get answer as soon as needed % How often see provider within 15min % % of the Nation was achieving better results than we were!

11 Measurable Outcomes CGCAHPS Domain January 2015 Percentile Rank January 2018 Percentile Rank Overall Doctor Rating Access to Care / 3 Month Test Results / Care Coordination Physician Communication Quality Office Staff Quality Based on 3 Months Received Date, All Facilities, All Respondents

12 Single Department

13 Current Results Access Questions Top Box, 3 Month Ending September 2017 Right Away Appt As Soon as Needed Routine Appt As Soon as Needed Primary Care Surgical Cardiovascular Neuroscience Orthopedic System

14 Maintaining the Gain Create an access team whose responsibilities include oversight of access on a weekly basis Strong partnership with operational leadership teams Keep the project visible monthly reports to senior executives/ceo, middle managers and front line associates Celebrate successes

15 Manager s Council for Service Excellence Bridge to Senior Leadership Mentor new Managers Share Engagement Ideas Innovative Solutions

16 Close the Gap What you permit, you promote Close the Gap Weekly Improvements Let go of the door Walked to the patient Acknowledge & Introduce Offered Help Week 1-2 Week 3-4 Week 5-6 Week7-8 Week 9-10

17 Office Staff Quality 26 th percentile 90 th percentile Data Source: Press Ganey, CGCAHPS Visit Date

18 Population Health Risk Stratification Health Care Spend Percentage of Total Cost Know your population Understand risk of utilization Deploy resources appropriately to expected utilization High 1% 2-5% 29% 27% Care management-nurse Navs Intensive Medical Home Moderate or Rising 6-15% 16-30% 23% 13% Care Coordination Program Preventive Care Screenings Chronic Illness Maintenance Education & Outreach & In-reach Clinical Decision Support Low or Unknown % Membership Distribution Percentage of Total 7% Objectives Increase PCP visits Improve Quality Reduced Utilization Reduced Cost of Care

19 Localized Multidimensional Risk Models

20 Strategies (Cost Utilization) Tools (Population Health) Decrease hospitalizations Decreased unnecessary ER use Decrease readmissions Decrease unnecessary imaging Decrease home health spending Increase Advanced Care Planning Decrease skilled nursing spending Increase patient adherence to treatment Reduce high dollar medication use Risk stratification (Vitreos), Nurse Navigation Educate, Nurse Navigation, Access Project, Intensive Medical Home Project Transitions of Care, Nurse Navigation, Care Transitions Workgroup EMR integration, Provider education Home Health navigation project, preferred partners Provider education, Advanced Care Planning clinic Preferred partners Nurse Navigation, Social determinants, Diabetes Grant Program for Employees Pharmacist review, targeted outreach

21 Cost Analysis by Provider The next frontier

22 Provider Dashboard

23 Health Maintenance

24 Embedded SmartSets

25 Clinical Decision Support Tools

26 Risk of Admission or ED Visit

27 IP Readmission Risk Score

28 Outcomes: Diabetes Grant Program Program Restarted Program suspended

29 Outcomes: Intensive Medical Home Clinic

30 Key Points to Remember Answer the criteria exactly as prescribed. Specificity is critical. Read what you are going to submit. Look for flow and ease of understanding. Have someone else read your submission for one voice. Provide data to support your outcomes. Make sure your graphs and appendices are understandable to someone outside of your organization. Don t wait till the last minute. This is a time consuming process.

31 Open Forum