Injury+SEEK Learning Collaborative Call-in: 1-800-466-8543; code 342604
Action Period Call Agenda • Roll Call • Sustainability Discussion & Data Review – Dr. Samantha Anzeljc • Questions/Comments/Problems • Reminders
Conference Call Etiquette • Please MUTE your phone when you are not speaking – This will eliminate any background noise including incoming phone calls, conversations between team members, dogs barking, UPS Deliveries, etc. – Participants can mute/unmute their own lines by pressing 4*. • Please do not put your phone on HOLD – We appreciate your enthusiasm for your on-hold message, however, it is disruptive for the group to hear about your system ’ s care of bicycle injuries, when the mobile mammography unit will be in your area, etc.
Practice Roll Call - Polling Question – Do you plan to use the tools in practice after the Learning Collaborative in any form? Complete tools, partial, none, or unsure. – Olentangy Pediatrics – Medina Family Medicine – Pediatrics – Mercy Navarre Pediatrics/Residency Clinic – Mid-Ohio Pediatrics & Adolescents – Mounty Healthy Family Practice – Hillcrest Hospital – Forest Park Internal Medicine-Pediatrics
Quality Improvement, Sustainability, and Data
INTERVENTIONS Injury Prevention Plus SEEK • Form a 3-5 person interdisciplinary QI Team Key Driver Diagram § Empower team roles & responsibilities § Schedule and host monthly QI team mtgs. • Formally communicate project goal to practice and senior leadership Medical Directors: Sarah Denny, MD, FAAP and Michael Gittelman, MD, FAAP • Submit baseline and monthly data to inform Updated: June 7, 2017 improvement efforts • Utilize Quality Improvement methods § Outline Office Flow and IP+SEEK tool use SMART AIM § Conduct tests of change From January 2018 through • Educate primary care providers on proper anticipatory June 2018, each practice will KEY DRIVERS guidance around injury prevention and psychosocial work to incorporate the identification and topics Injury+SEEK age-appropriate § Participate in MOC 2 at Learning Session Engage Quality Improvement Team screening tools at well child • Incorporate Injury+SEEK tools in office flow and Supportive Office Environment visits for children birth to 4 § Configure roles in grading tools, counseling, referral process, and resource provision years of age to identify unsafe § Distribute at all well visits birth-4 years or risky behaviors. Assess Child’s Risk for Preventable Injuries Specific Aims: • Review parental responses to counsel, refer, or 1. For the submitted provide resources for incorrect answers § Share food access locations & benefits for food Injury+SEEK screening insecure families Provide Appropriate Injury tools, parents who provide § Offer resources or refer families for tobacco, drug inappropriate responses will Prevention and Psychosocial and/or alcohol use within the state or community receive counseling 90% of Counseling, Referrals and Resources § Complete PHQ9 for positive PHQ2 answers time. § Refer for positive PHQ9 & follow up 2.For the submitted § Give cabinet locks to families to secure unsafe items Establish Sustainable and Injury+SEEK screening § Give sleep sacks and use handout at Newborn & 2- Standardizable Practices for Injury tools, parents who provide month WCV Prevention and Psychosocial an inappropriate response § Gather information on car seat check sites anticipatory guidance § Provide educational materials to families will receive resources 75% of • Utilize provider reference materials on injury time. prevention and psychosocial topics to inform counseling with families GLOBAL AIM • Hold team meetings periodically to review Provide children with the improvement & maintenance efforts opportunity to grow up to • Secure resources for post-collaborative reach their fullest potential by • Integrate Injury+SEEK questions into history eliminating unintentional and collection process intentional injuries and • Embed Injury+SEEK in medical record psychosocial risks. • Update family resources on Injury+SEEK
Sustainability Sustainability Embed in everyday work Improvement Work Continuous tests of change
Collaborative Counseling and Resource Documentation 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% November December February March April May June N-1 Counseling 1-5 Yr Counseling Goal for Counseling N-1 Resources 1-5 Yr Resources Goal for Resources
Practice Roll Call - What can you trial to consistently counsel on inappropriately answered questions and/or provide resources? – Olentangy Pediatrics – Medina Family Medicine – Pediatrics – Mercy Navarre Pediatrics/Residency Clinic – Mid-Ohio Pediatrics & Adolescents – Mount Healthy Family Practice – Hillcrest Hospital – Forest Park Internal Medicine-Pediatrics
All improvement will require change, but not all change will result in improvement Purpose is to: § Learn Sustainability Factors § Characterize & define gaps for improvement Measurement § Participate in bidirectional feedback § Evaluate progress § Determine effect of improvement efforts Not just numbers but experiences Jeffcott, S. (2014, June). The Spread and Sustainability of Quality Improvement in Healthcare. Healthcare Improvement Scotland.
Key for Success – Use of real time data to drive improvement Connect improvement data collection strategies with existing strategies Sustainability Factors Use 7 steps to measure your improvements Measurement 1. Decide on your aim 2. Choose your measures 3. Confirm how to collect your data 4. Collect your baseline data 5. Analyze and present your data 6. Meet to decide what the data is telling you 7. Repeat steps 4-6, building upon your learning Jeffcott, S. (2014, June). The Spread and Sustainability of Quality Improvement in Healthcare. Healthcare Improvement Scotland.
% Tools with All Incorrect Responses Discussed 100% 80% 60% 40% 20% 0% February March April May June % Patients who were N-1 : All Wrong Discussed 1-5 : All Wrong Discussed Offered Resources 100% 80% 60% 40% 20% 0% February March April May June N-1: Tools with Wrong had Resources Offered 1-5: Tools with Wrong had Resources Offered
N-1 SEEK vs IP AG Discussion of Incorrect Responses 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% February (n=23) March (n=47) April (n=36) May (n=40) N-1: SEEK Incorrect Discussed N-1: SEEK Tools with Wrong Responses N-1: IP Incorrect Discussed N-1: IP Tools with Wrong Responses
1-5 SEEK vs IP AG Discussion of Incorrect Responses 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% February (n=39) March (n=56) April (n=51) May (n=46) 1-5: SEEK Incorrect Discussed 1-5: SEEK Tools with Wrong Responses 1-5: IP Incorrect Discussed 1-5: IP Tools with Wrong Responses
PDSA Cycles § Qualitatively / Quantitative Data Learning through Monthly Tool Entry Measurement § Degree/Effect of Improvement Efforts § Meeting Goals § Consistency
Doing something different rather than doing the same thing better Sustainability Key to Success – a clear benefit and Factors innovation in the improvement Innovation Diffusion of Innovation & Idea Quality § Clear advantage vs. current ways § Compatibility with current system and values § Simplicity of change & its implementation § Ease of testing before making a full commitment § Observability of change & its impact Jeffcott, S. (2014, June). The Spread and Sustainability of Quality Improvement in Healthcare. Healthcare Improvement Scotland.
Practice Roll Call 1. What questions did you previously have in your EMR? What will be added now that you’ve done this collaborative? 2. Describe how questions will be incorporated into your EMR (scan ST, dot/smart phrases, etc.). 3. How do you intend to use resources? – Olentangy Pediatrics – Medina Family Medicine – Pediatrics – Mercy Navarre Pediatrics/Residency Clinic – Mid-Ohio Pediatrics & Adolescents – Mount Healthy Family Practice – Hillcrest Hospital – Forest Park Internal Medicine-Pediatrics
Questions or Comments?
Part IV MOC Credit • The physician team leader within the practice will need to attest for each physician’s meaningful participation at project end • To receive credit, a team must: – Complete and submit 3 PDSA cycles – Attend Practice Coach and/or Action Period Calls – Submit data for 10 audits per month, per provider seeking credit
Part IV MOC Credit • If you are unsure of what materials you still need to submit, please contact Hayley to confirm and arrange for completion – We will work with you to ensure you can claim credit if possible – Make up calls and late data may be available • Link to claim MOC Part IV credit earned will be provided following completion of final survey and submission of all materials
Reminders • Please send at the earliest convenience: – Any remaining June Data/Tools • Please scan and send completed screening tools by email or fax • hsouthworth@ohioaap.org • 614-846-4025 • July Data – August 3 • PDSA Cycle Worksheets – July 31
Reminders • Final project evaluation survey will be sent by August 10 – Please complete by August 31 • Link to claim MOC Part IV credit earned will be provided following completion of final survey and submission of all materials
Questions or Comments?
Thank you!
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