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All Hands

All Hands. June 13, 2013. Agenda. Recruitment update ( Malinda Williams) Employee of the Month ( Malinda Williams ) State of the Division (Mike Pignone) CRC Project update (Shana Ratner) Epic (Tom Miller) The Interns are coming (Tom Miller )

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All Hands

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  1. All Hands June 13, 2013

  2. Agenda • Recruitment update(Malinda Williams) • Employee of the Month (Malinda Williams) • State of the Division(Mike Pignone) • CRC Project update (Shana Ratner) • Epic (Tom Miller) • The Interns are coming(Tom Miller) • Wellness at Work (Diane Dolan-Soto)

  3. Employees Welcome to New Employees Best Wishes Marilyn Bender is retiring • Melissa Heyward, LPN • Janet Horvath, LPN • Tracey Matthews, Administrative Associate

  4. Enhanced Care Transitions Incoming Outgoing Pharmacy Resident Justinne Guyton, PharmD Leaving June 28 St. Louis College of Pharmacy Care Assistants Carol Bledsoe Last Day June 7 Heading to ECU SOM Natalie Phillips Last Day July 3 Poorva Apte Last Day July 14 Heading to ECU SOM Nutritionist Kerry Phillips, RD, LDN Last Day July 31 Heading to UNC Gillings School of Global Public Health • Pharmacy Resident • Jennifer Simon, PharmD, Beginning August 1 • Care Assistants • Sharon Eshet, Pain/Depression Programs • Aly Worf, Diabetes/Hospital Readmissions

  5. Recruitment update • Clinic Manager ~ Final round of interviews • LPN ~ Interviewing • Admin Associate ~ Interviewing • Dietician ~ Interviewing • Care Assistant ~ Posted

  6. Promotions & Recognition • Tim Ives - voted best preceptor with patients for the year by our UNC-based PY4 pharmacy students • Dan Jonas - promoted to Associate Professor • Michael Pignone – Appointed Director, UNC Health Care Quality Institute - Appointed Associate Chair Quality Improvement, DOM • Darren DeWalt- Appointed Associate Director for Ambulatory Quality, UNC Healthcare Quality Institute; - Appointed Section Chief for Research for Gen Med Division. • Carol Golin –Tenured • More listed in Dr. Pignone’s presentation

  7. Employee of the Month Malinda Williams

  8. March Employee of the Month • Eva Wamagata • Exemplary employee, devoted to strong patient care. Great beside manner. • Always professional, patient-centered, and thorough. • Keeps clinic-flow moving. • Always a pleasure to work with. Would nominate her every time if I could!

  9. April Employee of the Month • Naomi Sheppard • Comes to work with a smile on her face every day! • Always willing to lend an extra hand. • Seeks out solutions and uses her creativity to make things work. • Excellent job with triage and provides a great handoff to providers.

  10. May Employee of the Month • Robb Hartman • Not only kind to patients; but to co-workers as well. • Addresses most patients by name, even those who are fairly new. He really takes time to know them. • Makes side 1 a really fun place to work with his wonderful sense of humor. • He is really Awesome!!!!

  11. Work is now the resting place for Dr. Ratner

  12. Alex Erickson’s new world!

  13. Division Highlights Michael Pignone

  14. Outline • Educational highlights • Research highlights • QI highlights • Transitions and outlook for the coming year

  15. Educational accomplishments • Paul Chelminski- awarded first Saunders Award and elected to Council- American Association of Program Directors • Marco Aleman – Chairman, Hispanic Health Task Force • Christopher Klipstein– Best 3rd Year Clerkship Award • Cristin Colford – Academy of Educators Innovations in Teaching Award and APDIM Award for Excellence for Programmatic Innovation –” Residents as Teachers” • Sam Cykert– again earned the honor of selection as a member of the Academy of Educators for excellence in teaching. • Amy Shaheen –again earned the honor of selection as a member of the Academy of Educators for excellence in teaching. • Shana Ratner – elected to Academy of Educators • Amy Weil – founds and directs UNC chapter of Gold Humanism Honor Society and founds Pass the Torch Program to promote faculty development in humanism

  16. QI highlights • Hospital Follow up program • 65% reduction in 30-day readmissions • National SGIM Plenary presentation + posters at Society of Hospital Medicine and IHI • 1st prize at UNC Quality Fair • Model for spread to all UNC outpatient practices • Meaningful Use- all providers certified! • Successful renewal of NCQA Level 3 PCMH !

  17. QI – other areas • Tobacco Cessation • Immunizations • Depression • Chronic pain • Alcohol Misuse • COPD • CRC screening

  18. QI highlights- clinic processes • Created patient label stickers  improved staff satisfaction + clinic flow • Responded to resident satisfaction survey • Hired social worker (Robin), lengthened appointment times for residents  improved resident satisfaction scores

  19. Research highlights • Reuland: New grant to develop and test a Spanish colon cancer screening decision aid • Jonas: Several new EPC grants • Recruited StacieDusetzina and Arlene Chung • Cindy Feltner joined the Division and EPC • Dozens of research articles published in peer reviewed journals

  20. Transitions • Carmen Lewis Come to OCB Conference Room to say Goodbye June 21, 12:00-1:30 • Christine Jones • DeboOdulana • Marina Arvanitis

  21. Outlook for 2013-14 • Lots of change! • EPIC • Residency decompression • New provider – Liz Greig • More quality improvement work • Building patient satisfaction

  22. CRC Project update Shana Ratner

  23. Lean 6 Sigma Green Belt Project • Project Team: Brooke McGuirt, Dr. Ratner, Summer Hogan, Shaun McDonald, Kim Young-Wright, Jonathan Thornhill, Dr. Miller, Dr. Reuland • Overall screening rate (age 50-74): 64.5% • Root causes: • Variable documentation in HCM • Access in GI Procedures • Abandoned referrals from GI Procedures/notification/re-referral • Visit based approach misses certain populations (younger) • Comorbidity

  24. Addressing Root Causes • HCM: Please document in HCM. Verbal from patient. Records if polyp • Access in GI Procedures: Hillsborough branch opening next month. • Feedback loop w/GI: we are working to establish this. • Visit based approach: piloting population based approach on 50 year olds • Comorbidity: excluding those with Charlson Comorbidity score of 4 or greater from letters

  25. Happy 50th Birthday Letter • Piloting 2 letters to patients at age 50 • Come in for “Welcome to 50” physical, address HCM • Letter with choice—stool cards enclosed and instructions about self referral to GI

  26. Epic Tom Miller

  27. The Big Picture • “Improve care • across the entire • health care system….” • Establish one system wide method to guide the patient visit.

  28. UNC Health Care’s Epic@UNC System 1 Patient ID Problem List Med List Patient Bill Chatham Hospital UNC FP UNC PN Home Health UNC Hospitals Rex LLC Etc. Rex Hospital

  29. Who Else Uses Epic?

  30. Comprehensive Scope of Epic Products CPOE / Order Mgmt. Physician & Nursing Documentation Patient Portal Scheduling, Registration, Patient Accounting Medication Administration / Pharmacy Home Health ED Ambulatory PeriOp / Anesthesia Other Departmental Clinical Applications* • Clinicals (acute care and ambulatory) • Patient Access • Patient Accounting

  31. Implementation Process

  32. Implementation process

  33. Nurse

  34. Provider

  35. Next Steps • Build – summer and fall • Set up disease based templates and macros to promote rapid documentation • Dictation will be an option • Train – Jan. 2014 • Minimum of 15 hours for doctors • Personalization labs • Nurses and other staff – 10 hours • Preparation • 24 inch monitors • New printers • ? Room Rearrangement • Go Live – April 4, 2014

  36. Go Live • April 4, 1014 • Reduce Templates by 50% for 4 weeks • Reduce by 25% for another 4 weeks • Avoid follow up appointments in April 2014

  37. The Interns Are Coming

  38. Wellness at work Mind Body Skills for the Internal Medicine Clinic UNC Internal Medicine Counseling Program Diane Dolan-Soto, LCSW 2013

  39. MBS Widely Used Mind Body Skills are offered to staff and patients in many hospitals, clinics and universities across the country. • 38% of Americans used CAM* in 2007 (increase from 2002) • MBS taught at IMC are among top 10 CAM practices • 12.7% practiced deep-breathing exercises • 9.4% practiced meditation • 1 in 30 using MB therapies , referred by a medical provider *Complimentary Alternative Medicines -2007 National Institute of Health survey

  40. Mind Body Skills • Are based on a wide range of cultural philosophies and practices. • Come learn from a skilled and certified practitioner about MBS offered to patients • Enjoy the benefits for yourself Mind Body Skills reduce stress, enhance performance, energy level and aid creative problem solving

  41. Benefits vs Risk Use of MBSs is best done in conjunction with treatment by PCP • Benefits • No serious adverse effects reported • Aids relaxation of mind and body • May reduce dependence on medications or affect systems requiring lower doses • Skills can be practiced independently • MBS are fun as well as effective • Risk • If used in place of appropriate medical care, may delay diagnosis or use of other well-established treatments Yoga Dogs by Dan Boris

  42. Interested in MBS? • Attend the Biology of Stress Workshop* • Open to anyone who works at IMC • *Prerequisite for MBSG • Sign up for MBSG • 6 group commitment • Some MBS that will be offered: • Breath work • Autogenics (self-hypnosis) and biofeedback • Meditation • Guided imagery • Movement www.reddit.com

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