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Practice Improvement Network Working together to perfect your medical home

PIN. Practice Improvement Network Working together to perfect your medical home . Practice Improvement Network’s Quality Improvement in Small Practices Presented by Donald Lurye , MD, Chief Executive Officer Elmhurst Clinic, LLC and IAFP Practice Transformation Committee Chair. PIN.

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Practice Improvement Network Working together to perfect your medical home

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  1. PIN Practice Improvement Network Working together to perfect yourmedical home Practice Improvement Network’s Quality Improvement in Small PracticesPresented byDonald Lurye, MD, Chief Executive Officer Elmhurst Clinic, LLC and IAFP Practice Transformation Committee Chair

  2. PIN Practice Improvement Network Working together to perfect your medical home • Agenda • The Practice Improvement Network (“PIN”) • Status of the PIN Small Practice Pilot Program • Resources and References, Q&A

  3. PIN Practice Improvement Network Working together to perfect your medical home • Agenda • The Practice Improvement Network (“PIN”) • Status of the PIN Small Practice Pilot Program • Resources and References, Q&A

  4. PIN Practice Improvement Network Working together to perfect your medical home • The Practice Improvement Network • At the end of 2010, the PCMH Committee of the IAFP recommended the • creation of the Practice Improvement Network (PIN) initiative. • The IAFP recognizes that one PCMH model does not fit all practices. Each • practice should be empowered to define how it will transform in the coming • years. • IAFP member stewardship in the Illinois Medicaid program’s primary care case • management & chronic disease management programs, Illinois Health Connect • and YourHealthcarePlus demonstrate IAFP’s commitment to support practice • transformation.

  5. PIN Practice Improvement Network Working together to perfect your medical home Elements of the Practice Improvement Network IAFP has invested considerable resources in staff, educational materials, and technology in support of this project and the duration of Phase I is estimated at 24 months. Communicate the messages of PCMH as a facet of which is essential to health reform transformation. Relevant live and web-based CME programs, networking opportunities. A demonstration project focusing on small practices, with a maximum of eight physicians, within the state of Illinois. IAFP-produced communications and social media platforms that support the PIN initiative.

  6. PIN Practice Improvement Network Working together to perfect your medical home • Agenda • The Practice Improvement Network (“PIN”) • Status of the PIN Small Practice Pilot Program • Resources and References, Q&A

  7. PIN Practice Improvement Network Working together to perfect your medical home Elements of the Practice Improvement Network Small Practice Project • Coaching and Mentoring: • Orientation Program • Dedicated, IAFP-Selected Coaches & Self-Study Options • Ambassadors • Education: • Continuing Medical Education • Assessments & Evaluations • Rapid Cycle Plan-Do-Study-Act Projects • Communication: • Peer Collaboration Portal: Delta-Exchange • Newsletters and Program References Material

  8. PIN Practice Improvement Network Working together to perfect your medical home • Status of the Small Practice Pilot • Between June and August, small practices who indicated interest in participating in the program were interviewed • The practices were asked a series of questions including their goals and concerns related to the PIN pilot. • After reviewing the PIN pilot curriculum and program requirements, some practices decided against participating either indefinitely or at this time. • Approximately of a pool of 30+ practices, 12 practice remain viable candidates for the existing pilot program.

  9. PIN Practice Improvement Network Working together to perfect your medical home • Feedback from Small Practice Pilot Practices • Small practice goals: • Maximize reimbursement opportunities • Better utilization of Nurse Practitioners and Staff • Improve patient satisfaction • Complete Plan-Do-Study-Act projects related to: • Group visits • Open Access Scheduling • Staff Development • E-Prescribing

  10. PIN Practice Improvement Network Working together to perfect your medical home • Feedback from Small Practice Pilot Practices • Perceived barriers to participating in the pilot program: • Cost: the $2,500 fee is prohibitive for some practices • Time: the physicians, not the practice managers are hesitant to move forward due to CME requirements and attendance requirements at the annual meeting. • Competing interests: some practices are already pursuing NCQA recognition • CONCLUSION: Tailor the existing program to meet • the needs of small and solo practices.

  11. PIN Practice Improvement Network Working together to perfect your medical home • The Small Practice Pilot Program: • Back to the Drawing Board • How can we best support the 12 practices that have opted to participate in the program? • More, intensive coaching during start-up phase • More focus on tangible, immediate needs • Improvements and enhancements: • Help practices improve coding, reporting and financial review methods to become more financially sustainable. • Provide practices with support towards meeting Meaningful Use criteria. • Continue to build the Practice Improvement Network through live, onsite CME presentations, opening Delta-Exchange access to the entire IAFP membership and other activities to be announced in 2012.

  12. PIN Practice Improvement Network Working together to perfect your medical home • Plan-Do-Study-Act (PDSA) & CME Overview • for the Small Practice Pilot Project • Practices are required to complete PDSAs on four topics during the course of the PIN pilot: Childhood Asthma, Diabetes, Depression and Heart Failure. • Practices are required to participate in monthly CME webinars, which are available to all IAFP members. • Practices are required to participate in PIN webinars the last Wednesday of every other month. These are Q&A sessions, led by the PIN project manager, coaches or ambassadors, will serve as a forum to facilitate peer-to-peer exchange or special topics.

  13. PIN Practice Improvement Network Working together to perfect your medical home • Plan-Do-Study-Act for Quality Improvement • Overview • The Small Practice Pilot Plan-Do-Study-Act project requirement includes: • Selecting a topic • Reviewing any IAFP-approved Continuing Medical Education modules • Completing the IAFP Quality Improvement Worksheet related to the topic • Sharing the results of your Plan-Do-Study-Act project with your coach, the IAFP project manager and possibly other small practice pilot practices • Smoking Cessation will be the first Plan-Do-Study-Act project topic • The Smoking Cessation Plan-Do-Study-Act project should take approximately 2-3 weeks to complete and all practices will be required to complete this project at the same time. • After completing the Smoking Cessation Plan-Do-Study-Act project, practices will also be required to complete Plan-Do-Study-Act projects on Childhood Asthma, Diabetes, Depression and Heart Failure during the course of the PIN at a time as determined by the practice.

  14. PIN Practice Improvement Network Working together to perfect your medical home Program Overview and Goals Plan-Do-Study-Act Projects Step 1: Plan Step 2: Do Step 3: Study Step 4: Act Source: Institute for Healthcare Improvement , www.ihi.org

  15. Diabetes: Planned visits for blood sugar management. PIN Practice Improvement Network Working together to perfect your medical home Program Overview and Goals Plan-Do-Study-Act Projects Tips for Successful Linked Tests of Change • Plan multiple cycles for a test of a change. • Think a couple of cycles ahead. • Scale down the size of the test (the number of patients or location). • Test with volunteers. • Do not try to get consensus, "buy-in," etc. • Be innovative to make the test feasible. • Collect useful data during each test. • Test over a wide range of conditions. • Try a test quickly; ask, "What change can we • test by next Tuesday?“ • Don’t forget: your coach is here to help you! Source: Institute for Healthcare Improvement , www.ihi.org

  16. PIN Practice Improvement Network Working together to perfect your medical home • Agenda • The Practice Improvement Network (“PIN”) • Status of the PIN Small Practice Pilot Program • Resources and References, Q&A

  17. PIN Practice Improvement Network Working together to perfect your medical home The Patient Centered Medical Home IAFP PIN Resources and References • Institute of Medicine’s Six Elements of Quality: • http://www.iom.edu/ • Patient-Centered Primary Care Collaborative – Compilation of PCMH pilot and demonstration Projects: http://www.pcpcc.net/ • Physician Quality Report System – Satisfactorily Reporting 2011 Measures Claims and Registry https://www.cms.gov/PQRS/downloads/w2011PQRSSatisfRprtngPQRSMsresClmsRgstryTS061711f.pdf • Guidelines for Patient-Centered Medical Home (PCMH) Recognition and Accreditation Program http://www.acponline.org/running_practice/pcmh/understanding/guidelines_pcmh.pdf • AAFP Family Physician Mini MBA Resource Guide http://www.aafp.org/online/etc/medialib/aafp_org/documents/prac_mgt/specialtopics/minimbaresourceguide.Par.0001.File.tmp/FPMiniMBAGuide.pdf • Conferences, White Papers, Articles will be posted to the Coach Dropbox, Facebook Page and referenced and in the Weekly e-News. • http://www.iafp.com

  18. PIN Practice Improvement Network Working together to perfect your medical home The Patient Centered Medical Home IAFP PIN Resources and References Institute of Medicine’s Six Elements of Quality Patient safety. Are the risks of injury minimal for patients in the health system? Effectiveness. Is the care provided scientifically sound and neither underused nor overused? Patient centeredness. Is patient care being provided in a way that is respectful and responsive to a patient's preferences, needs, and values? Are patient values guiding clinical decisions? Timeliness. Are delays and waiting times minimized? Efficiency. Is waste of equipment, supplies, ideas, and energy minimized? Equity. Is care consistent across gender, ethnic, geographic, and socioeconomic lines? Source: Institute of Medicine 2001.

  19. Diabetes: Planned visits for blood sugar management. PIN Practice Improvement Network Working together to perfect your medical home Closing Remarks The findings presented today demonstrate that the PIN Small Practice Pilot has served as a Plan-Do-Study-Act project for the IAFP. Source: Institute for Healthcare Improvement , www.ihi.org

  20. PIN Practice Improvement Network Working together to perfect your medical home For More Information on the Practice Improvement Network: Visit www.iafp.com or Email the PIN Project Manager, Helen Kate Liebelt at hkliebelt@iafp.com or call 224-688-0430.

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