Practice Facilitation: Transforming Healthcare Today - Health Care Home Learning Days - National Council
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
Practice Facilitation:
Transforming Healthcare Today
Jeyn Monkman, Institute for Clinical Systems Improvement
Pam Pietruszewski, National Council for Behavioral Health
Candy Hanson, Stratis Health
Health Care Home Learning Days
April 26, 2016
Objectives 1. Learn what practice facilitation is and how it is being used as an evidence based strategy to improve health care practice and quality. 2. Consider transformation strategies based on examples from participating organizations. 3. Increase knowledge of the Minnesota Accountable Health Model and the impact on your organization for facilitating practice change.
Did you know?
2016
2017 2019
Meaningful Use and
VBM begins for all Merit-Based
Physician Quality 2018
solo and group Incentive Program
reporting System
practices MU and PQRS (MIPS)
(PQRS) underway
MU, PQRS and VMB end & Alternative
Value Based Modifier 12/31
continue Payment Model
(VMB) begins with
Program begins
practices with 10-99
EPs
What is Practice Facilitation?
Practice facilitation is a supportive service provided to a
health care practice. Its aim is to help the practice reach
specific improvement goals while building the internal
capacity of a practice to engage in improvement activities
over time.
- Source: Agency for Healthcare
Research & Quality (AHRQ)
Adaptive Reserve:
A practice’s ability to make and sustain change
What it takes:
• Shared vision
• Shift in the ways people think about and understand their roles
• Adopting different mental models of the work
“Transformation occurs not at a steady & predictable pace,
but in fits & starts.”
Nutting et al. Annals of Fam. Med. 2010
Who is here?
WIIFM
ICSI Program Participants
Residential based
care and primary
Specialty Care Comprehensive care as well as
Integrated Health
Primary Care Clinic: Social Services care coordination
Care
Clinic Non-profit
Pediatrics Organizations for seniors and
Organization
people with
disabilities
Transformation of Health Care: What are we doing to get there? Technical Assistance: Practice Facilitation Coaching and Education
What Does the Road Look Like?
Altru Health System-Roseau & Warroad Clinics: Minnesota Community Measure
(MNCM) Vascular Care Measure & Annual visit with Primary Care Provider
Appleton Area Health Services: Closing the follow up and preventative care loop
Bluestone Physician Services: Reducing Emergency Department visits for health
plans with which they have risk contracts
Catholic Charities of Minnesota: Developing a formalized medical respite program
in which there are entrance and completion points
East Lake Clinic Hennepin County Medical Center : Asthma Action Plan (AAP) and
Asthma Control Test (ACT) Completion RatesHow Technology Supports Your Success
Google Docs: An online word processor that lets
you create and format text documents and collaborate
with other people in real time.
SmartSheet: is a software as a service (Saas)
application for collaboration and work management
that is developed and marketed by Smartsheet.com,
Inc. It is used to assign tasks, track project progress,
manage calendars, share documents and manage
other work. It has a spreadsheet-like user interface
EXCEL: An electronic spreadsheet is a computer
software program that is used for storing, organizing and
manipulating data.Team Roles/Composition
Physician Champion
Nurse Manager and/or Leader
Ancillary Staff (Lab, Front Desk, etc.)National Council
Program Participants
13
Community 13 Practice Transformation Grantees
Mental 12 in BHH Learning Community
Health
Centers 4 Certified HCH’s
4 in SIM Learning Collaborative
4 E-Health grantees
4 in Accountable Comm. for Health
3 in Integrated Health Partnerships
3 Federally
1 Emerging Professionals grantee
Qualified
Health 50% from outstate/rural
CentersTransformation of Health Care
What are we doing to get there?
Accountable Accountable
Care Pre- Care Post-
Assessment Assessment
Transformation
Planning Site Visits
Education & Community
Coaching Partnerships
AssessmentWhat are your Core Messages? • Not intuitive and takes longer than expected • All change agents must repeat a simple & clear message explaining the change. • Co-create with stakeholders “Recognizing our clients are at heightened risk for multiple chronic health conditions, we are intentionally taking a whole health approach to care.” “We partner with our consumers to provide respectful integrated person centered care and promote wellness.”
What is your Goal Statement? We will have an integrative client registry, accessible to all staff, that is capable of tracking performance indicators resulting in quality care. We will have expanded use of non-MD innovative provider types such as Community Health Workers and Certified Peer Specialists. We will have 60% of clients diagnosed with Major Depression showing a 30% reduction in PHQ-9 scores within 6 months of initiating treatment. We will have a process for exchanging client data between behavioral health and primary care clinics.
Primary Measure of Success Demonstrated advancement on the MN Accountable Health Model: Continuum of Accountability Matrix
Aggregate results of Practice Facilitation Program
Minnesota Accountable Health Model:
Continuum of Accountability Assessment Tool
ICSI Partners: Red NC Partners: Green A B C D
Model Spread and Multi-Payer Participation XX
Payment Transformation X X
Delivery, Community Integration, Partnership X X
Infrastructure to Support Shared Accountability X X
Health Information Technology Capabilities X X
Health Information Exchange Capabilities XX
X X
Data Analytics CapabilitiesTransformation
Payment Transformation National Council: • 82% of all organizations are Pre-level or Level A. • Examples of participation alternatives to FFS arrangements: HCH or other care coordination fees, QI/incentive payments ICSI: • 90% of or teams are level B or lower.
Delivery and Community Integration and Partnership • Need increased internal & external care coordination and teaming • Need to develop QI processes to review integration practices
Health Information Technology
Capabilities
• EHR Implementation has been high priority and
represents most progress
• EHRs are in place but not yet used for all of the
functions capable of performing
• Clinical and analytic use represent opportunity for
accelerated change (level B for many for behavioral
health and level D for ICSI)Health Information Exchange
Capabilities
• The second most Level D rankings after HIT -- although
over half of the organizations are Pre-Level or early Level A
• Challenges with:
- Exchanging patient information with other providers
- Electronically prescribing controlled substancesHow are you Tracking Progress?
Level
Domain A B C D
C. Delivery and Community
Integration and Partnership
G. Data Analytics Capabilities
Goal #1: ____________________________________________________
Date SMART Progress Factors Action Champion Completion
Objectives this period affecting steps Date
successTrend Charts
Lessons Learned
Time for Questions
Contact Information Jeyn Monkman Phone: 952-883-7980 Email: jmonkman@icsi.org Website: www.icsi.org Pam Pietruszewski Phone: 202-684-7466 Email: pamp@thenationalcouncil.org Website: www.thenationalcouncil.org Candy Hanson Phone: 952-853-8524 Email: chanson@stratishealth.org Website: www.stratishealth.org
You can also read
