PCMH 2011 Standard 1: Elements D, E, F & G Slide 1
PCMH Learning Community Project Structure Assessment, Gap Analysis, Workplan Webinar Series Group Technical Assistance Learning Sessions (Face to Face) Slide 2
PCMH Learning Community Project Structure Learning Sessions Patient Centered High level view of patient centered concepts Some focus on NCQA definitions Brainstorming around transformation work Collaborative solution development Slide 3
PCMH Learning Community Project Structure Webinars Patient Centered Detailed review of patient centered concepts Heavy focus on NCQA definitions Recorded for review and reference Slide 4
PCMH Learning Community Project Structure Group Technical Assistance Patient Centered Detailed review of patient centered concepts at YOUR PRACTICE Specific advisement for transformation Clarification on webinars and learning sessions Slide 5
Patient Centered Medical Home 2011 Standards Slide 6
Selection Documentation Slide 7 Monitoring Patient Centered - Continuity Do our patient s select a provider of choice? Do we document this physician of choice? Do our patients see the same provider or care team?
PCMH 1D - Continuity Slide 8
PCMH 1D Continuity - Documentation Factor 1: Practice Policy for patient/family selection of a personal clinician Factor 2: Screen shot from its electronic system showing documentation of choice of clinician Factor 3: Report with at least one week of data showing total proportion of patient encounters that occurred with the selected personal clinician or team Slide 9
Slide 10 PCMH 1D Factor 1 Annotated policy highlights how the practice communicates to patients that they have the ability to choose and change PCP
Slide 11 PCMH 1D Factor 2 Screenshot that highlights how patient PCP is documented
Slide 12 PCMH 1D Factor 3 Screen shot shows the ability to track the amount of visits that do not occur with the provider of choice. Specific numbers are mentioned also
Slide 13 Patient Centered Medical Home Responsibilities We are responsible for coordinating care We are here for clinical advice Importance of past medical history and care obtained outside We offer evidencebased care and selfmanagement support
PCMH 1E Medical Home Responsibilities Slide 14
Slide 15 PCMH 1E Factor 1 Information shared with the patient clearly says that the practice is responsible for coordinating care
PCMH 1E Medical Home Responsibilities Slide 16
Slide 17 PCMH 1E Factor 2 Details around how to get in touch with the practice and the provider are also included in the document shared with patients.
Slide 18 PCMH 1E Factor 2 Details around how to get in touch with the practice and the provider are also included the document shared with patients.
PCMH 1E Medical Home Responsibilities Slide 19
Slide 20 PCMH 1E Factor 3 Enforces with the patient the importance of sharing medical history and any information from outside.
PCMH 1E Medical Home Responsibilities Slide 21
Slide 22 PCMH 1E Factor 4 Informs the patient how the practice addresses care and self-management support
PCMH 1E Medical Home Responsibilities Practice Policy outlining a process for giving patients information about the obligations of a medical home Examples of materials provided to patients (brochures, written statement, Web site, link to online video, etc.) Slide 23
Slide 24 Patient Centered Culturally & Linguistically Appropriate Race & Ethnicity Languages Percentages Materials
PCMH 1F Culturally and Linguistically Appropriate Services Slide 25
Slide 26 PCMH 1F Factor 1 Practice shows screenshot of how race and ethnicity are recorded in Patient Management System
Slide 27 PCMH 1F Factor 1 This report details out what percentage of the patient population identifies with various races and ethnicities
PCMH 1F Culturally and Linguistically Appropriate Services Slide 28
Slide 29 PCMH 1F Factor 2 This report details out what percentage of the patient population identifies with various races and ethnicities
PCMH 1F Culturally and Linguistically Appropriate Services Slide 30
PCMH 1F Factor 3 Slide 31 The policy explains how interpreter services are provided to the patient
PCMH 1F Factor 3 Slide 32 Information that is made available to staff on how to bring in interpreter services
PCMH 1F Culturally and Linguistically Appropriate Services Slide 33
PCMH 1F Factor 4 Slide 34 An example of a form that is available to patients in both languages
PCMH 1F Culturally and Linguistically Appropriate Services Factors 1 & 2: Report showing the practice s assessment of the racial, ethnic, and language composition of its patient population Factor 3: Documentation of the availability of interpretative services or a policy that it uses bilingual staff. Include practice policies and procedures for when a patient needs assistance in a language not spoken by staff. Factor 4: Provides or shows access to materials in languages other than English, a screen shot of a link to online materials or a Web site in multiple languages Slide 35
PCMH 1G The Practice Team Slide 36
Slide 37 PCMH 1G Factor 1 Job description clearly mentions collaboration with the entire care team
PCMH 1G Factor 2 Slide 38 Policy that clearly outlines how the Patient Care Team (PTC) communicates in DAILY huddles and other team meetings
PCMH 1G Factor 3 Slide 39 Precise policy that speaks to what standing orders for immunizations exists details around documentation of standing orders.
PCMH 1G The Practice Team Slide 40
PCMH 1G Factor 4-7 Slide 41 This course covered how to communicate with this patient population (1G.7) This course covered how to coordinate care with pediatric patients(1g.4) This course covered how we can encourage self-management of care for our OB/GYN patients(1g.5)
PCMH 1G Factor 4-7 Training checklist addresses how to do one of our population management activities (1G Factor 6) Training will also cover the Med Assistants role in coordinating care (1G Factor 4) Slide 42
PCMH 1G The Practice Team Slide 43
PCMH 1G Factor 8 Slide 44 Participation of the PCT in Quality Improvement initiatives is listed in a policy
Upcoming Dates Group Technical Assistance Every Monday, Wednesday, Friday 8:30 AM 9:30 AM 12:30 PM 1:30 PM 1-888-387-8686 conf ID 4383772 Screen Sharing (GoTo Meeting) - https://www1.gotomeeting.com/join/394185952 Slide 45