Building a Quality Report Card - Louisiana Department of...
Transcript of Building a Quality Report Card - Louisiana Department of...
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Objectives
• Learn to define what a measurable quality metric entails
• Discover how to create meaningful dashboards that drives change
• Learn how to use Excel as your data collection friend
• How to do an internal review of current measures and opportunities to improve
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Tools Provided
• These slides in pdf
• Blank Quality Playbook
• RHC Performance Improvement Template
• CCM Completion Chart
• Eight Forms of Waste
• Guide to Quality…..Shhhhhh
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Why Are We Talking About Report Cards?
• National Standards
• Benchmarking
• MIPS/MACRA
• Most of all….Consumers are Watching!
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Quick Review
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Driving Quality Metrics that Produce Results
• Think STEEEP
• IOM Six Domains of Health Care Quality
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Safe
• Avoiding harm to patients from the care that is intended to help them
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Timely
• Reducing waits and sometimes harmful delays for both those who receive and those who give care
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Effective
• Providing services based on scientific knowledge to all who could benefit and refraining from providing services to those not likely to benefit (avoiding underuse and misuse)
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Efficient
• Avoiding waste, including waste of equipment, supplies, ideas, and energy
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Equitable
• Providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status
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Patient-centered
• Providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuing that patient values guide all clinical decisions.
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Three Types of Measures
• Structure
• Process
• Outcome
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Structure Measure
• Evaluate the infrastructure of health care setting and ability to deliver care (clinics, organization and resources)
• Staffing
• Staff skill and capabilities
• Policy & Procedures
• Availability of resources
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Process Measure
• Used to determine the extent to which providers consistently give patients specific services that are evidence-based
• Think: did the patient receive the recommended care or not?
• Focused on areas of prevention and chronic disease management
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Outcome Measures
• Evaluate patients’ health as a result of the care they have received.
• Looks at effects the care has had on their health, health status, and function.
• Can be more challenging to gather the data and hard to hold patients accountable to the recommended treatment
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Ongoing Climb:
Always be asking, “ How can
we do things better?”
Safe
Timely
Effective
Efficient
Equitable
Patient-Centered
Included a review for:
Structure
Process
Outcome
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Very Brief Intro to Lean
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Single-Piece
Flow
Lean Toolbox
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The Three Principles of Lean
1. Engage the people who work in the process to improve the process
2. Focus on creating value from the customer’s perspective
3. Bring measurable and sustained improvement
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Lean Principle #1: Process
“A bad process
will beat
a good person
every time”
- W. Edwards Deming
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Lean Principle #2: Customer
Customers judge value on:
• Speed – How quickly do I receive it once I request it
• Accuracy – The information is correct and responded to my request
• Understandable – The information is easy to read and understand
• Convenience – It is convenient for me to get it, I can get it when I want it (and not when you are willing to give it to me)
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Lean Principle #3: Sustainment
“If you don't know where you are going, you will
wind up somewhere else.”
- Yogi Berra
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Eight Areas of Waste in Healthcare
As you learn to “see” your
processes in new ways, you
develop what are called “eyes for
waste” so you can identify the
waste and then eliminate them in
a systematic method.
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8 Types of Wastes -- DOWNTIME
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How Does Waste Affect Me?
Causes physical fatigue
Causes emotional fatigue
Increases frustrations
Increases stress
Causes you to blame others
Steals your time
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Enough About Definitions
What makes a good quality metric
A good measure drives change
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Making a Measure Work for You
• Is it meaningful?
• Does it make sense?
• Is it measurable?
• Do you have staff buy-in?
• What is the area of impact? Process? Outcome?
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Where to Start?
• Problematic Area(s)• Community needs
• Primary population
• Primary disease(s)
• Staff engagement
• Meaningful
• Baseline data
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From Managers/Staff
• No time
• Not meaningful
• Cannot fix it
• Staff won’t collect
• Late data
• No analysis
• No plan of action
• Staff cannot speak to the improvement
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If someone came in and asked you what you do or have done
for quality improvement
………….could you answer them?”
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First Impressions
• Ease of appointment scheduling?
• Same day appointments
• Same day nurse phone calls
• Wait times in waiting rooms/exam rooms
• First time patient experience
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Rooming
• Complete questions • Fall screening?
• Depression screening?
• Prevention screenings?
• Chart inclusive and ready for provider?
• Full medication reconciliation review?
• Any labs that should be on the chart?
• Referral/consult reports?
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Physician Support
• Involve providers in the process of defining and selecting quality metrics
• Selecting metrics on the basis of medical evidence that proves a positive correlation with quality outcomes
• Holding providers accountable for quality measures that are reasonably within their control
• Streamlining the collection of data so as not to detract from the quality of the patient experience
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Data Collection Tool
Making Excel a Friend
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Graph Selection
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Types of Graphs
• Area
• Column
• Bar
• Line
• Pie
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Common Elements of Graphs
• Colors
• Depth
• Axes
• Labels
• Title
• Legend
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Benefits and Pitfalls
• Benefits• Visually communicate results
• Analyze information from multiple periods, entities, sequences, etc.
• Patterns
• Pitfalls• Data overload
• No conclusion
• Spreadsheets
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Deceptive Graphs
• Emphasize or de-emphasize changes by affecting the axis
• Use different scales or starting points
• Use percentages to show growth
• Avoid trend lines
• Avoid displaying actual values
• Delivery
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Deceptive view
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IDEA – PDCA Tool
IDEA
• Improvement Opportunity
• Data Collection Methodology
• Explain Findings
• Action Steps
PDCA/PDSA
• Plan
• Do
• Check/Sustain
• Act
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Presenting the Data: In Dept.
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Second half
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Let’s Break it Down
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Where does the data go?
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Data Points…
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The Reporting
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Summary
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PERFORMANCE IMPROVEMENT
Dashboard Reporting
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Simple
Visual
Relevant
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Benefits of Dashboards
• Organize
• Summarize
• Focus
• Present
• Quick
• Easy to understand
• Interactive
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Keep it Simple
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Reporting to Board/Committees: The Dashboard
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Metrics and Data Build Your Dashboard
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Board Report Example
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Our Data Collection Tool Summary Dashboard
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Another Tool For You
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Employee Engagement
• Don’t forget to share your data!
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Questions