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Performance Driven Bar graph Academy SESSION 4: EFFECTIVE MEASUREMENT PRACTICES
Brought to you by the Managed Care Technical Assistance Center Speaking: Briannon O’Connor Associate Director CCSI’s Center for Collaboration in Community Health
Reminders ‣ Please make sure everyone in your work group registers for one JUNE in-person session ‣ If you’re joining us for the first time, complete the baseline survey and review Webinars 1-3 ‣ Webinars are recorded and you should have received materials ahead of this webinar ‣ Use pda@ccsi.org email for any questions, comments, etc. ‣ Chat in questions/comments to all panelists at any time
What is the PDA?
Goal of the PDA Elements of a Performance Driven Organization Developed by CCSI’s Center for Collaboration in Community Health
Actively participating in the PDA will… ‣ Position you to know your cost, know your quality, and know your impact within the broader system of care ‣ Generate a workplan for integrating knowledge gained and transfer knowledge within you organization ‣ Provide tools and resources to support effective collaboration, measurement, financial analytics, and leadership values to support continuous growth and improved efficiencies ‣ Document your agency’s growth and improvement through the evaluation ‣ Demonstrate your agency’s commitment to performance driven principles through a certificate of completion
Where we’ve been ‣ Developing a culture that supports performance driven principles and prioritizes data-driven decision making ‣ Effective collaboration as a key to success and optimizing impact ‣ Best practices to support your human resources and heighten accountability for performance
6. Practice Development 4. Effective Measurement Semester 2: Finance and Leadership 5. Continuous Quality Improvement 7. In-person sessions
Effective Measurement Practices The Performance Driven Academy BRIANNON O’CONNOR, PHD ASSOCIATE DIRECTOR, CENTER FOR COLLABORATION IN COMMUNITY HEALTH COORDINATED CARE SERVICES, INC.
Background of Today’s Speaker ‣ Doctorate in Clinical Psychology • Expertise in children’s mental health, research methodology, statistical analysis, evaluation in real-world behavioral health settings, performance measurement ‣ CCSI • Associate Director, Center for Collaboration in Community Health • Supporting behavioral health providers and networks in meaningful data analytics and cross-system collaboration for improved outcomes
Today’s Learning Objectives ‣ Provide far too much information for a brief webinar ‣ Define measurement and its value ‣ Review tips for measurement best practices ‣ Provide examples for productive information gathered from readily available data ‣ Discuss examples for moving beyond the basics ‣ Introduce tools to support measurement planning ‣ Hear a provider describe their approach to measurement
What’s in a name?
What’s in a name?
What’s in a name? ‣ Measure: Using data to understand a process, comparison, outcome ‣ Data: Discrete (numbers) information collected systematically; ideally stored electronically ‣ Too simple?
Where can measurement bring value to your organization? Outcomes / Staff Financial Process clinical variables measures progress ‣ Streamline processes, become more efficient ‣ Enhance staff buy-in ‣ Improve quality of care ‣ Improve bottom line ‣ Marketing, position for successful VBP arrangements and network collaborations
Just get started….thoughtfully
Measurement as a new skill ‣ Perfect is the enemy of good ‣ Understand data limitations, but don’t get hung up on them ‣ Make it part of the routine ‣ Practice, practice, practice ‣ Start easy; early success leads to continued efforts
Where to start or re-energize efforts ‣ Start with what you’re good at • What is the impact of your service? What do you do well? • Why do individuals/families/youth seek out this service? • What outcomes are you and your staff most proud of? • What have other service providers told you about what you do well? Why do other providers refer to you? What are you known for? • What do you consumers say about what you do well? • What would the alternatives be if this service didn't exist? • See Brainstorming Impact Tool
Where to start or re-energize efforts ‣ Focus on immediately actionable information that is meaningful and likely to show change soon • Reducing ED visits vs. Mental Health Engagement in Care 30–Days (VBP Quality Measure) 100 100 90 90 80 80 70 70 60 60 50 50 40 40 30 30 20 20 10 10 0 0 2015 2016 2017 2018 January: % new February: % new March: % new clients Rate of Potentially Preventable ED visits-Agency clients engaged in clients engaged in engaged in care-30 care-30 days care-30 days days Clinical Team A Clinical Team B Clinical Team C
Where to start or re-energize efforts ‣ Focus on immediately actionable information that is meaningful • Reducing ED visits vs. Mental Health Engagement in Care 30–Days (VBP Quality Measure) Staff Performance Appraisal Rating Celebrate Scale 1) Rarely meets objective 2) Occasionally meets objective 3) Meet objective half of the time 4) Usually meets objective 5) Always meets objective successes! Score 1- Area of Responsibility Notes/Additional Detail 5 100 Client Engagement and Attendance: 1= <64% Show Rate Based on show rate data as 2= 65-69% Show Rate 80 compared to target. Steps to 3= 70-74% Show Rate 60 improve: Uses engagement data to 4= 75-79% Show Rate 40 measure joining, tracks show rate 5= >80% Show Rate for caseload, uses client attendance 20 *Calculated monthly and year to date agreements, sends letters, 0 documents follow-up, etc. January: % new February: % March: % new clients engaged new clients clients engaged in care-30 days engaged in in care-30 days care-30 days Clinical Team A Clinical Team B
What question are you trying to answer AKA Why I cringe at the question “What does the data show?”
Parallel Process: Measures should be SMART • Specific • The who, what, when, where, why without jargon or ambiguous language S • Measurable • How will you know you’ve met the goal? What data will be used? M • Achievable • Within reach A • Relevant • Meaningful to the organization, staff, bigger picture R • Time limited • When will we review? When do we expect change? T
Good idea Better measures Improve access to services Families who initiate contact will be given an appointment within 2 weeks At least 75% of referrals will be proactively contacted within 48 hours ER visits for behavioral health Crisis services will be available within 30 minutes of all zip crises will be reduced codes in the county At least 90% of individuals at risk on Questionnaire at Intake will be provided with targeted crisis management plans and peer support contact information Services provided will reflect Treatment educational materials will be translated into cultural/social identity Spanish and Chinese awareness Providers will document engaging in shared decision making with families and important others for at least 80% of new clients in Q3 2018
Focus and prioritize
Consider… ‣ How does your impact and question you have for your data fit within the big picture of state goals, VBP metrics, MCO priorities, etc.?
Fitting into the Big Picture ? What we do ? well State Goals ? ? Our Impact VBP What services Quality are provided Measures Start on the right Ask the question how . How would this occur? How would you know? End on the left What do we do that contributes to this?
Access Mobile Example Crisis plan in Crisis place Services Crises Family self- management wellness tools Support use of de- State Goals Education escalation about relapse strategies Reduce prevention, State avoidable Outcomes identifying ER/ triggers Reduce inpatient avoidable use ER/ inpatient Foster Attend family use Improve supportive group sessions Connections Outcomes Improve relationships with social Outcomes supports Skill building Supports (natural/ community) Awareness of Access Identify available Benefits barriers community -Social resources services Advocacy -Healthcare -Stable housing
Prioritize measurement efforts ‣ Focus on a few measures only ‣ Enhance buy-in • Staff input on where to start • Consumer feedback
Master the basics
Make the most of readily available data ‣ Who is served? • Understanding the basic characteristics of your consumer population ‣ How are they served? • Utilization data, quantifying the services you provide ‣ How well are they served? • Clinical progress, outcomes, defining the impact of your service ‣ What is the cost of serving them? • How effectively are you using your resources in support of your mission • Stay tuned for Semester 2 See also Dashboard Tool Version 1
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