The New Agenda: Patient Centered Strategies for the Exam Room Kickoff Webinar March 28, 2016 Special thanks to our funders:
New Agenda Team Jennifer Wright Tammy Fisher CCI, Improvement CCI, Senior Director Advisor - Program Coach Meaghan Mallari Hunter Gatewood CCI, Program Coordinator Signal Key, Consultant - Program Coach Rich Frankel University of Indiana, Professor of Medicine, Research Scientist - Co-developed Four Habits Model. Content expert for program & trainer
Agenda • Introductions • Why focus on communication? • Skills & strategies – what you will learn • Who will get trained – selecting pilot clinicians • Learning opportunities – how you will learn • Collecting data to learn what works • Key program dates • Wrap up – action items
New Agenda Grantees LifeLong Medical Care Sacramento Tiburcio Vasquez Health Center Native American Health Center Community Medical Centers, Inc. Chinese Community Health Services Universal Community Health Center MayView Community Health Center Watts Healthcare Corporation Kokua Kalihi Valley Comprehensive Family Services
Grantee Introductions • Tell us something that is unique or special about your organization.
Why are we focusing on communication? • Communication with clinician is the strongest predictor of patients’ ratings of their overall experience with care • Most patients seeking care are “healthy” - biopsychosocial approach is ideal as framework for care • A lot of time interacting with the EHR in the exam room leads to lower patient experience scores and patient outcomes of care • Research demonstrates effective, patient centered communication care results in positive functional and biomedical outcomes • The time cost to be patient or relationship centered is no more than one additional minute • Clinicians who are perceived to be brusque and hurried are at greater risk for malpractice in the event of an adverse outcome • Effective communication skills , including empathy, can be learned and put into practice with little time cost
Model for Change: Four Habits 1 SHARED 2 4 PRESENCE 3
Questions?
Start with the ready and willing: Selecting Clinicians • POLL: Who has already selected their participating clinicians? • How did you determine which clinicians should participate in this program?
Start with the ready and willing: Selecting Clinicians • Going from good to great communicators • Well-respected by colleagues and liked by patients • Excited about this program, ready to experiment and learn • Early adopter, early majority, socially connected • Champion, willing to help spread skills to others later
Learning Opportunities Resource Trainings Coaching Webinars Website
Trainings May 5 th : Berkeley City Club, Berkeley, CA • Learn the Four Habits • Understand aim statements and measurement for learning June 15 th : Sacramento, CA (venue TBD) • Share experiences testing skills • Share data collected • Leverage the care team to optimize skills use Who should attend the trainings? • Pilot Clinicians • Project team lead for this grant • Senior clinical leader or other senior leader/operations staff on this grant
Coaching Coaching Calls (1-1 w/ each grantee): at least once per month with Jennifer or Hunter • Support the project team and clinicians in testing the Four Habits and learning about their effects Who attends: all members of project team, including at least one pilot clinician Case Conference Calls (all clinicians): occurs twice, following each training with Rich • Support clinicians in using the Four Habits skills; identify and problem solve together on challenges Who attends: all clinicians participating in the New Agenda program; other members of the project team are welcome as observers
Webinars Share & Learn Webinars • 3 webinars during program • Hear from each other about best practices and challenges • Who attends: all project teams, clinicians optional Sustainability & Spread Webinar • 1-2 webinars • Review principles of sustainability/spread/scale; share data; share learnings • Who attends: everyone Outcomes Celebration Webinar • 1 webinar • End of program celebration; teams share their journeys through storyboards • Who attends: everyone
Resource Website www.new-agenda.com
What is working? 1. Collecting data for learning 2. Collecting data for spread and scale
Data for Learning Rapid experimentation • Patient voice : Comment cards, exit interviews, patient observation, other ideas? • Clinician voice : regular check-ins, monthly reports Report results from rapid experiments in coaching calls. Monthly narratives: Due the last day of each month, reporting on that month’s progress • 4-questions – what are you testing and how is it going? • Data informs coaching and case conference calls • Completed by each clinician
Data for Learning How to run a rapid experiment in 6 steps 1 Write out your idea / solution. Tip: Select only one idea or element of a solution and keep it simple! 2 Write out your key assumptions about the idea. Tip: Keep the assumption small and ‘right scoped’! 3 Brainstorm how you will test your assumptions. Tip: Do this with others-it is not a solo mission! 4 Select one experiment that you can test fast. Tip : Vote and Prototype as a team-2 people count as a team! 5 Put your experiment to the test in the real world. Tip : It should take minutes, hours, days- not weeks or months! Reflect on what you learn and ‘build or kill’. 6 Tip: Modify your next experiment based on what you heard + observed!
Data for Spread and Scale • Patient Experience Data Pre- and Post-program: – Conducted in April and December – IVR or other clinic-selected method • Skills Assessment: – pre (April 15) and post (Dec 31) assessments – Evaluate the capability and use of the Four Habits’ 23 skills – Completed by each clinician participating • Clinician Experience Report: – Due end of June, August, October, November – 3-question narrative report about clinician experience during this program – Completed by each clinician Report in final narrative – January 31, 2017 And, please submit your financial report too!
Reporting deadlines • Baseline patient experience data collected by April 29 th • Clinician skills assessments – April 15 th , Dec 31 st • Monthly clinician narratives - due the last day of each month • End of program patient experience data collected by Dec 31 st • Final narrative report – Jan 31, 2017 • Final financial report – Jan 31, 2017
Program Timeline Month Learning Opportunities Reporting • • March First Coaching Call Submit IVR data if possible • Kickoff Webinar – March 28 • • April Coaching Calls April 8 (latest date): submit IVR data • April 15: skills assessment due (pre-assessment) • By April 29: baseline data on patient experience has been collected • • May Skills Training: May 5 (Berkeley, CA) May 31: monthly report due • Case Conference Call • Coaching Calls • • June Skills training: June 15 (Sacramento, CA) June 30: monthly report, including clinician experience • Share & Learn Webinar reported questions due • Coaching Calls • • July Case Conference Call July 31: monthly report due • Coaching Calls • • August Coaching Calls August 31: monthly report, including clinician experience reported questions due • • September Share & Learn Webinar Sept. 30: monthly report due • Sustainability & Spread Webinar • Coaching Calls • • October Share & Learn Webinar Oct. 31: monthly report and clinician experience report due • Coaching Calls • • November Coaching Calls Nov 30: monthly report due and clinician experience report due • • December Outcomes Celebration Webinar Dec 31: post-program skills assessment due • Dec 31: final collection of patient experience data • January Jan 31, 2017: Final narrative and financial grant reports due
Next Steps • Select participating clinicians ASAP. Meaghan will reach out to confirm each team’s selected clinicians and their contact information. • Set up April coaching calls with coach. • By April 8 th : If participating in IVR, submit data directly to vendor (look for more emails with more info from Meaghan and your coach). • If not using IVR, work with coach to determine method for collecting baseline and post patient experience clinician level data. • April 15 th : Clinicians submit skills assessment (pre-assessment). Meaghan will email instructions and assessment today or tomorrow. • April 29 th : complete collection of baseline patient experience data (for those participating in IVR, this will be completed by the vendor).
Questions? Tammy Fisher: tammy@careinnovations.org, 415-426-4887 Meaghan Mallari: meaghan@careinnovations.org, 415-561-6393
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