Quality Improvement Committee(QIC Health & Wellness Health Care Review Monitoring Tool Data for Q1 April 2, 2019
Objectives • To understand how issues are categorized • To learn about the top focus areas for issue resolution • To discuss some ideas to address these top focus areas 2
Health & Wellness Health Care Review Tool • The first quarter is October 1, 2018 – December 31, 2018 • A minimum of 86% of an RN’s caseload is reviewed per year. • This averages to about 120 persons per nurse per year. For a total of 1080 persons per year. • DDS RNs provide technical assistance to the provider nurses and staff to help remediate issues. • The timely closure of issues is a goal for Health & Wellness. 3
Top 10 Areas Generating Issues Issue Number % of Total Missing Record/Data/Documents 71 5.2% Were the medical specialist’s recommendations addressed/implemented 70 5.1% within the time frame recommended? Does the immunization record show that the person has received all 64 4.7% recommended vaccinations? Were the PCP’s recommendations addressed/implemented within the 59 4.3% time frame recommended by the PCP? Has the HP been updated to reflect any changes within the timeframes 57 4.1% according to the Health and Wellness Standards? Health Passport (HP) and/or Health Care Management Plan (HCMP) 47 3.4% If recommended by the IDT and ordered by a physician at any point in the person’s plan year, was the there a current occupational therapy/Speech 45 3.3% Language/Physical Therapy assessment? Is there evidence that age and gender appropriate preventative health 40 2.9% care is provided in a consistent and current manner? Is the HCMP being updated according to the standards or as new changes in the person’s health care status occurs in accordance to the timeframes 37 2.7% identified in the Health & Wellness Standards? Is the Medication Administration Record (MAR) documented 36 2.6% appropriately? Total 526 38.3% 4
Age Distribution 35 32 30 # of People Receiving Services 25 26 26 24 22 20 20 20 19 15 16 10 11 8 5 6 4 1 1 0 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90 Age Represents the number of unique individuals reviewed (Unduplicated) 5
Issues by Facility Type 350 344 350 300 250 198 # of Issues 200 OCT NOV 150 113 DEC 100 45 45 44 39 34 19 50 11 4 0 Supported Living Intermediate Residential Host Home Care Facility Habilitation 6
H&W Timely Closure Rate Month Total # of Issues Closed On Time Closed Late On-Time % FY17 Target Oct 286 281 5 98% 86% Nov 451 402 49 89% 86% Dec 409 352 57 86% 86% FY19 Q1 Target met in Oct, Nov, and Dec Measure shows a decline in performance over the quarter 7
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