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Improving Asthma Care

Improving Asthma Care . Holger Link, M.D. Carrie Phillipi, M.D., Ph.D. Art Jaffe, M.D. Outline. Why You do Care Building teams and partnerships to improve patient outcomes The Doernbecher Experience. Why You Do Care. 75,000. Jonathan David Henry.

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Improving Asthma Care

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  1. Improving Asthma Care Holger Link, M.D. Carrie Phillipi, M.D., Ph.D. Art Jaffe, M.D.

  2. Outline • Why You do Care • Building teams and partnerships to improve patient outcomes • The Doernbecher Experience

  3. Why You Do Care

  4. 75,000

  5. JonathanDavidHenry

  6. How can we partner with our patients and others to achieve better outcomes?

  7. Act Plan Study Do What are we trying to accomplish? How will we know that a change is an improvement? What change can we make that will result in improvement? Asthma Education Packets Asthma Nurse Educators Discharge Education Checklist

  8. What is Chapter Quality Improvement? The involvement of AAP chapters in state and/or local activities aimed at improving the quality of care for children. These activities involve measurement and the collection of data over time to assess changes in practice performance.

  9. Key Players • American Academy of Pediatrics • - Project Lead • Cincinnati Children’s Hospital Medical Center • - QI expertise and coaching • 4 Chapters • - Alabama • - Maine • - Oregon • - Ohio • 49 practices • 282 Clinicians

  10. The Oregon Chapter Team • Sandra Miller • Theresa Rice • Holger Link & Carrie Phillipi • Arthur Jaffe (OPS)

  11. The Oregon Practices Peace Health Medical Group Riverbend Peace Health Medical Group Barger Peace Health Medical Group South Peace Health Medical Group Downtown Hillsboro Pediatrics Southern Oregon Pediatrics Oregon Medical Group Garden Way Childhood Health Associates of Salem Legacy Emanual Childrens Clinic Doernbecher Pediatrics Doernbecher Pediatrics Westside

  12. CQN Asthma Pilot Project MAINE OREGON OHIO ALABAMA 12 Practices 11 Practices 13 Practices 13 Practices 49 Practices 282 Clinicians

  13. Improvement Methods

  14. How are we doing at the National Level?Practice System Changes Registry Implementation Status

  15. How are we doing at the National Level?Practice System Changes Options for Practices without a Registry

  16. Commitment to Quality as a result of CQN Participation No Change in my commitment to QI work, 9% More committed to QI work, 91%

  17. Chapter Team Perspective: Value of Program Components

  18. Improvement Work Continuous tests of change Sustainability Imbed in everyday work Our First 6 months Improvement Work Scale Up & Spread Taking local improvement And actively disseminating it across a chapter and/or practice

  19. Our DCH Experience Art Jaffe Julie Johnson Lisa Johnson Everyone on the Gen Peds Clinic Team

  20. GOALS • Describe structure and process • Discuss our local focus • Show baseline data • Choosing PDSA’s and tracking results • Successes and challenges • The future: sustainability and generalizability

  21. Base-line: % Well-controlled (visits vs patients?)

  22. Base-line: % Well-controlled (visits vs patients?) OOPS! No data reported back from AAP!!

  23. % Well-controlled Through July, 2010 DCH General Pediatrics Clinic Oregon

  24. Base-line: % Optimal Care DCH General Pediatrics Clinic Oregon

  25. Drilling Down On Optimal Care Validated Instrument Step-wise Approach to Care

  26. Drilling Down On Optimal Care Flu shot given or recommended Use of Asthma Action Plan

  27. Targets of Opportunity • Validated Instrument - ACT and TRACK forms • Asthma Action Plan - PDSA iterations of plans - EPIC issues - The saga continues

  28. Optimal Care: Good News in June!!! DCH General Pediatrics Clinic Oregon

  29. And then there was July DCH General Pediatrics Clinic Oregon

  30. The Future • Sustainability - What happens when the project ends? • Generalizability - Asthma management throughout Oregon - Chronic care management in DCH • Registry - Management of populations, not patients - Clinical care vs. research data base - Options for all of us

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