2018 Population Health Focused Pilot QIA (PHFPQ) Quality Improvement Activity Brittney Jackson, LMSW, MBA Patient Services Director February 20, 2018
Agenda Topics • PHFPQ Background • Inclusion Criteria • Project Goals • Network and Facility Roles & Responsibilities • Project Timeline • Tools and Resources • Closing Comments p. 2
Learning Objectives • Learn about the history of ESRD Network Program and Network roles/responsibilities • Gain an understanding of the projects purpose, goals, interventions, and resources • Learn about the requirements and purpose of the Root Cause Analysis Questionnaire p. 3
Network Staff Patient Services Department Merari Rosario, MHA Brittney Jackson, LMSW, MBA Community Outreach Coordinator Patient Services Director 203-285-1223 203-285-1213 mrosario@nw1.esrd.net bjackson@nw1.esrd.net 1952 Whitney Avenue, 2 nd Floor, Hamden, CT 06517 Phone: (203) 387-9932 Fax: (203) 389-9902 p. 4
Island Peer Review Organization Background • Founded in 1984, IPRO, a national independent, not-for-profit organization, holds contracts with federal, state and local government agencies as well as private-sector clients nationwide. • Provides a full spectrum of healthcare assessment and improvement services that enhance healthcare quality to achieve better patient outcomes and foster more efficient use of resources. • Headquartered in Lake Success, NY and also has offices in Albany, NY, Hamden, CT, Camp Hill, PA, Morrisville, NC, Princeton, NJ, San Francisco, CA and now, Beachwood, Ohio. p. 5
ESRD Network Roles/Responsibilities • Improve quality of care for ESRD patients • Encourage patient engagement • Support ESRD data systems and data collection • Provide technical assistance to ESRD patients and providers • Evaluate and resolve patient grievances • Support emergency preparedness and disaster response p. 6
Population Health Focused Pilot QIA (PHFPQ) Vocational Rehabilitation Criteria • Select at least 10% of facilities in the Network service area (~20 facilities) Project Period • Baseline: October 2016 – June 2017 • Re-measurement: September 30, 2018 Requirements • Patient SME • NCC PHFPQ LAN participation p. 7
Population Health Focused Pilot QIA (PHFPQ) Vocational Rehabilitation Goals • Demonstrate at least a five (5) percentage point increase in referrals to the identified Employment Network (EN) and/or Vocational Rehabilitation (VR) agencies • Demonstrate at least a two (2) percentage point improvement in the number of patients receiving EN and/or VR services Data Source • CROWNWeb p. 8
Population Health Focused Pilot QIA (PHFPQ) Disparity Assessment Disparity defined by CMS in the 2018 Statement of Work as: • Differences in the delivery of health care, access to health care services and medical outcomes based on ethnicity, geography, gender and other factors. The Network will be reporting to CMS the identified disparities as part of this project with the goal of reducing identified disparities • Age ** • Ethnicity • Facility Location (Rural vs. Urban), • Gender • Race p. 9
Root Cause Analysis and Plan-Do-Study-Act Vocational Rehabilitation RCA • RCA utilized to identify the barriers to prevalent patients not being referred for VR/EN services PDSA • Utilize the PDSA cycle to test the processes initiated to overcome barriers p. 10
Root Cause Analysis and Plan-Do-Study-Act Barriers Facility Percentage Breakdown of Number One Barrier 1: Patient Not Barrier Interested • Patients do not want to return to work. 6.30% • Patients don’t want to lose their disability benefits. • Patient Not Interested Patients have other 31.30% Patients Feel Too Ill or Sick obstacles in their life such as Other limited time, family 62.50% obligation, and lack of transportation. • Patients feel that employers might think he/she is too sick to work. • Patients have multiple medical issues occurring. p. 11
Root Cause Analysis and Plan-Do-Study-Act Barriers Facility Percentage Breakdown of Number Two Barrier 2: Patient Feels Too Ill/Sick Barrier • Dialysis may replace kidney function, but not perfectly. • Patients feel too overwhelmed 20% with thought of working and dialysis. Patient Not Interested • Patient do not feel that they can Patient Treatment Schedule work in their previous or related Patient Feels Too Ill or Sick occupation (manufacturing, 20% 60% laborer, etc.) due to physical limitations and maintain their dialysis schedule and ancillary appointments. • Patients felt that other medical conditions contribute to not being able to work. • Deterioration of health status due to chronic illness. p. 12
Root Cause Analysis and Plan-Do-Study-Act Barriers Facility Percentage Breakdown of Number Three Barrier 3: Transportation Barrier • Patient does not have access to services to that will allow them to utilize 20% vocational rehabilitation services or work. 40% Patient Not Interested • Some patients do not Transportation own a car. Other • Patient has low income due to disability and limited work history. 40% • Systemic intersectional poverty. • Friends and Family are not a reliable source for transportation needs p. 13
Population Health Focused Pilot QIA (PHFPQ) Vocational Rehabilitation: Interventions Provider • Assessment of current referral process in the dialysis facility • Evaluate changes in life events that could change receptiveness to vocational rehabilitation Patient • Increase awareness of vocational rehab and change dialysis facility culture • Support patients with resources and goal setting tools Employment Network and Vocational Rehabilitation • Collaborate with vocational rehabilitation resources to advocate for the needs of ESRD patients p. 14
Population Health Focused Pilot QIA (PHFPQ) Interventions: Your Life. Take Charge! My Goal, My Roadmap, My Action Plan • Find your goal • Assess and plan • Take Action • Evaluate • Achieve and sustain p. 15
Population Health Focused Pilot QIA (PHFPQ) Interventions: Your Life. Take Charge! p. 16
Population Health Focused Pilot QIA (PHFPQ) Interventions: Your Life. Take Charge! p. 17
Population Health Focused Pilot QIA (PHFPQ) Interventions: Your Life. Take Charge! p. 18
Population Health Focused Pilot QIA (PHFPQ) Interventions: Your Life. Take Charge! p. 19
ESRD Statement of Work December 2017 - November 2018 Learning & Action Networks (LANs) • Patient Experience of Care • Healthcare Associated Infections (HAI) • Home Dialysis • Patient and Family Engagement (PFE) • Transplant • Population Health Focused Pilot QIA (PHFPQ) p. 20
CROWNWeb Definitions Vocational Rehabilitation Common Scenarios - Vocational Rehabilitation CROWNWeb Category Scenario: Referred to VR Social worker gave patient phone number for VR Referred to VR Patient is being recommended for VR, but has not agreed to participate Currently in VR Patient went to VR orientation and was assigned a counselor Currently in VR Patient filled out an application Declines VR Patient went to VR orientation and did not follow up after the orientation Declines VR Patient has indicated they do not want to participate in VR program Not Eligible for VR Patient has co-morbid conditions that prevent them from being able to work Not Eligible for VR Patient is undocumented and does not have a legal right to work in the US Completed VR Patient went through VR program and achieved their VR goals (got job, completed college, etc.) p. 21
CROWNWeb Reporting Vocational Rehabilitation p. 22
Patient Subject Matter Experts (PSMEs) How PMSEs Support QIAs • Involved in the development of QIA interventions and resources • Encouraged to participate in intervention implementation at the facility • PSMEs are asked to: – Consider becoming a Peer Mentor – Joining the Network Patient Advisory Committee – Share their ESRD journey story with others – Attend meetings led by the Network – Participate in national meetings and technical expert panels p. 23
eNewsletter • Provider audience • Sent monthly • Contact list from CROWNWeb • Project Updates – Intervention Material – Patient Resources – Data – Best Practices p. 24
Technical Assistance We’re Here to Help • The Network sponsors educational opportunities – Face-to-Face Meetings – Webinars – Conference Calls • The Network shares data – Comparative Network, state, and facility level – Incidence, prevalent, and demographic statistics – Annual Report p. 25
Questions? Comments? p. 26
ESRD Network of New England Website http://network1.esrd.ipro.org p. 27
For more information: Presentation Template Draft for Review Danielle Daley, MBA Jaya Bhargava, PhD, CPHQ Corporate Headquarters Executive Director Operations Director 1979 Marcus Avenue (203) 285-1212 (203) 285-1215 Lake Success, NY 11042-1002 ddaley@nw1.esrd.net jbhargava@nw1.esrd.net www.ipro.org Sarah Keehner, RN, BSN, CNN Brittney Jackson, LMSW, MBA Quality Improvement Director Patient Services Director (203) 285-1214 (203) 285-1213 April 6, 2017 skeehner@nw1.esrd.net bjackson@nw1.esrd.net p. 1
Recommend
More recommend
