Thanks for joining our 2017 Grievance Quality Improvement Activity ACT 2 RESOLVE Intervention Kickoff We will begin the webinar momentarily.
Grievance Quality Improvement Activity 2017 Intervention Kickoff Webinar May 11, 2017
Welcome/ Opening Remarks Erin Baumann, Patient Services Director, NW2 Erin Baumann, Patient Services Director, NW2
Housekeeping Reminders • Be mindful of muting your phone when not speaking • Please don’t place the call on hold, instead disconnect your line and rejoin the call when able • We’ll also be monitoring our WebEx chat board throughout the webinar for questions or comments 4
Housekeeping Reminders • Be present and engaged in our topic presentations • Please be prepared for sharing and actively participating in the open discussion • Speak up on the line, send in questions/comments in the chat • Remain open- minded and respectful in hearing other’s opinions 5
Meeting Facilitators / Hosts Erin Baumann Patient Services Director ESRD Network of New York ebaumann@nw2.esrd.net 516-209-5348 Melissa Arrington Patient Services Director ESRD Network of the South Atlantic marrington@nw6.esrd.net 919-463-4515 6
Agenda • Overview of Grievance QIA Interventions • ACT2RESOLVE Intervention • ACT NOW Team Roles and Responsibilities • Overview of Educational Materials • Review of materials needed each month • Project Timeline • Open Forum Q&A • Closing Remarks/Next Steps 7
Learning Objectives • Discuss the ACT2RESOLVE Intervention • Understand new approaches and develop best practices • Understand Project Interventions and accompanying materials • Understand reporting requirements and deadline dates 8
2017 Grievance QIA & Interventions Overview Melissa Arrington, Patient Services Director NW6
What is a Grievance? A grievance is an escalated process that is necessary when a complaint is unresolved/unanswered to resolve and address the patient, acknowledge their experience and resolve any issues involved. Example: A patient complains that their dialysis chair is not ready upon their arrival and had to wait to start treatment each day and no one responds after a week. CMS defines a grievance as: • A written, verbal, or electronic request for assistance • Initiated by or on behalf of an ESRD patient(s) • ESRD issues including, but not limited to care, treatment, or providers 10
ESRD Network Authority and Role in Grievances • The authority establishing the scope of responsibility for the ESRD Networks is provided in Section 1881 of the Social Security Act and the Omnibus Budget Reconciliation Act of 1986. Section 1881(c)(2)(D) of the Social Security Act requires the Network to: – Implement “a procedure for evaluating and resolving patient grievances.” – Utilizing standards of care established by the Network to assure proper medical care.” – Responsible for identifying ESRD providers that are “not cooperating toward meeting Network goals and assisting [them] in developing appropriate plans for correction....” • Network Roles – Facilitator – Expert Investigator – Educator – Quality Improvement Specialist – Advocate – Referral Source 11 11
Analysis Outcome The following categories were identified as problem areas that affect the ability of facilities to handle grievances: – Patient-Provider Relationships – Communication – Operational Culture – Grievance Process 12
Grievance Project Outcome Objectives • Major Quality of Care (QoC) or Access to Care (e.g., major bleeds, wrong dialyzer, prescription changes w/o physician order, IVDs either at risk or actual) • Minor QoC issues (e.g., simple bleeding after dialysis, minor infection control issues) • Operational Issues (e.g., inadequate staffing, other issues related to the operation of the facility). • Interpersonal Issues (e.g., conflicts between patients, conflicts between staff and patients) • Environmental issues (e.g., facility too cold, basic maintenance issues such as chair, lobby) 13
Project Intervention Outcome Objectives • Improve communication process when addressing a patient concern or issue preventing escalation • Strengthening patient and provider relationships • Empowering patients to take a more active role in their care • Expanding the focus beyond the patient’s physical needs to a holistic patient centered approach • Assisting the facility in establishing and maintain an effective and efficient grievance process. 14
ACT NOW Project Intervention Melissa Arrington, Patient Services Director, NW6
ACT 2 RESOLVE NOW • Partnered Team Approach – Identification of 2 different staff disciplines as project leads (i.e. Nurse, Social Worker) – Identification of at least 2 Patient Advisory Committee (PAC) Representatives • Facility staff members and patient representatives will work together to promote: – Promote patient empowerment and patient involvement on health care team – Provide patient perspective and feedback on effectiveness of patient related initiates – Utilization and implementation of educational materials at facility • Role of the Network 16
ACT 2 RESOLVE TEAM Patient Toolkit 17
ACT 2 RESOLVE TEAM Objectives • Changing the thinking behind communication to improve upon interpersonal issues and encouraging proactive approaches instead of reactiveness • Establishing and understanding opportunities in partnership • Reframing current interactions between staff and patients • Creating avenues and procedures that address the real issues – Analyzing your grievances • Patient Perspective – Impact on effectiveness of initiatives – Policy implementation – Resolution of grievances and issues 18
ACT 2 RESOLVE TEAM Responsibilities Facility • Analyze reported Grievances (talk about types) • Promoting educational tools and resources with staff and patients • Implementing the “What Matters” concept • Analyzing all communications with patients • Acknowledging that goals and perspective gets lost in clinical care • Implementing shared decision making • Patient Participation – Activation – Perspective on initiatives, changes and resolution of issues – Opportunities for interested patients at the facility and/or with the Network 19
ACT 2 RESOLVE TEAM Responsibilities Patient • Grievance Resolution discussions • Promoting educational tools and resources with staff and patients • Advocate • Active Participation – Activation – Perspective on initiatives, changes and resolution of issues – Opportunities for interested patients at the facility and/or with the Network 20
ACT 2 RESOLVE TEAM Responsibilities Network • Facilitator • One on One Coaching • Support and Guidance • Advocate • Providing educational materials and resources 21
Let’s Practice Partnering ! Susan is a patient partner in her facility. She and other patients have been discussing their concerns about receiving no response from management regarding complaints about the dialysis chairs at the facility being old and broken. Susan is asked to chime in on the conversation and share on the subject. What happens next? 22
Communication Scenario Susan approaches Joanne, who is a nurse and apart of the ACT NOW team. Susan expresses the concerns that she and other patients have discussed. Joanne talks over Susan and then stops to answer her cellphone. She takes a call from her sister and they make plans to meet later. Joanne then begins to speak to Susan again. When Susan says that she and other patients feel frustrated with all of the issues gone unnoticed: – Joanne interrupts Susan before she finishes speaking then tells her she knows about the concerns, and begins to tell Susan about her own frustration about patients constantly complaining about everything. 23
What do you think about Joanne’s approach to Susan? What tips did Joanne follow or not follow? Did she use active listening techniques and promote a environment of trust? Remember, we must be mindful of ourselves and be respectful towards each other in order to focus on finding a resolution together. 24
Let’s Practice Some More! John is a patient and wanted to speak with Mike the Administrator at the facility about an issue he is having with other staff members. John is upset that staff members constantly have comments about his being late to treatment. John is a father and has to take his daughter to school everyday and that he has informed staff about his obligations. John tells Mike that he is doing the best he can to get to treatment on time, but finds it difficult. John suggests to Mike that he would like to be able to discuss other options to help his situation and how he and other patients can be educated on them. John approaches Mike, and asks if it is a good time for them to talk. John tells Mike he would like to talk about his issue and how resolving it can possibly help other patients. Mike invites John to sit down with John and listens to his concerns without interrupting. Mike asks John questions about his schedule and the responsibilities he has outside of treatment. Mike suggests that they create goals together and continue to assess them 25 going forward.
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