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OPPE / FPPE Uniform Process

OPPE / FPPE Uniform Process. Larry Thacker, CPMSM Business Systems Analyst. Statistics about Novant Health. Current State of Novant Health. Presence in NC, VA and GA 13 Facilities 3 joint venture Ambulatory Surgery Centers 2 Ambulatory Surgery Centers

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OPPE / FPPE Uniform Process

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  1. OPPE / FPPE Uniform Process Larry Thacker, CPMSM Business Systems Analyst

  2. Statistics about Novant Health

  3. Current State of Novant Health • Presence in NC, VA and GA • 13 Facilities • 3 joint venture Ambulatory Surgery Centers • 2 Ambulatory Surgery Centers • Joint venture acute care facility with UVA • 4,600 +/- Credentialed providers • 4,100 +/- in OPPE / FPPE Process • 300 + Physician Practices • 6 Medical Staff Offices • 1 Central Verification Office OPPE / FPPE Process

  4. Early Beginnings Applies to both OPPE and FPPE

  5. In the Beginning • Early Decisions • Went to visit The Joint Commission at their headquarters • Clearly from the early stage TJC wanted to provide freedom • Left decisions to the facilities and the organized medical staff • A subcommittee was established • VPMA, Chief of Staff, Dept Chairs, MSO, CVO, Legal, Clinical Improvement and Regulatory • Basic indicators and thresholds were established • OPPE Data Range – 6 months • FPPE Data Range – 2, quarterly reports • Process was watched over the first 12 months OPPE / FPPE Process

  6. Challenges and Progress • Identifying the data sources and reporting mechanisms • How to store and track the data in a useful uniform format • Excel was where we looked first • Developed a spreadsheet with 100+ workbooks • First we saw a dramatic improvement in the number of medical record delinquent days dropped over 13,000 + days • Educating the providers and staff • Employee resources • How to handle the providers with issues OPPE / FPPE Process

  7. Challenges and Progress • Thresholds were to liberally applied • Red on the forms made the provider see RED • Providers didn’t like being AVERAGE • Solution was 50 shades of OPPE / FPPE • Data periods Changed • Reporting time frame changed • Discovered very early our data ranges needed to be extended • Moved to 8 month OPPE reporting periods • Moved to 2, four month reporting period for FPPE • Reduced the number of Nursing / Clinical Staff Feedbacks OPPE / FPPE Process

  8. Challenges and Progress • Identified quickly Excel wasn’t the solution • Statistical reporting was very difficult due to the provider being in OPPE and FPPE (stored in different spreadsheets) • Reappointment timeline • Push – Pull relationship • Dimension Data • EMR did not resolve • Delinquency days • Timeliness of signing records • EMR did resolve : • STD (Sign, Date and Time) itemsEcho– OPPE Module • Echo – OPPE Module • since 2010 have processed over 27,000 OPPE/FPPE reports OPPE / FPPE Process

  9. Data Applies to both OPPE and FPPE

  10. Novant Health: Enter Presentation Title in Footer Menu

  11. Data Sources – “Fingers in all things data” • Sample Size • Sample Size project • H&P, Unsigned Consents, STD, TO/VO • Monthly reports by facility • Peer Review • Peer Review Policy • Activity Data • Imports ran by the BSA’s for Dimensions (HL7) • Others have to enter manually • Nursing / Clinical Staff Feedbacks • Collected in OPPE once every 24 months • Collected during the 2nd period of FPPE unless improvement needed has been identified • HIM • Medical record delinquencies • Suspensions EPIC / Dimension • Data will still occur for the data indicators Always looking for other data sources Always looking to improve the process through automation OPPE / FPPE Process

  12. OPPE Basics

  13. OPPE • Who is in OPPE • A Practitioner • Who holds at least one or more clinical privileges • On staff longer than 8 months • Not currently in a FPPE • Reports are generated for each Medical Staff Office • Based 5 Primary Specialty cycles OPPE / FPPE Process

  14. OPPE / FPPE Process

  15. FPPE Basics

  16. FPPE Basics • Who is in FPPE • Any practitioner that would meet any one of the following requirements: • New Practitioner with one or more clinical privileges • Existing practitioner who has requested an additional privilege • Improvement needed threshold(s) met during OPPE process • Referral from Credentials Committee, Med Exec or BOT • Reports are generated based the month placed into FPPE • FPPE reporting is performed on 2, four month cycles • 8 months is a complete FPPE process unless one additional 4 month period is necessary to sync with the OPPE cycle • Possibility of an adjustment cycle to synchronize with the OPPE cycle • Could be placed into an extended FPPE if improvement has not been demonstrated or addition of privilege • Extended FPPE cycle can not go beyond 24 months OPPE / FPPE Process

  17. OPPE / FPPE Process

  18. See Larry and Robin Run!!! OPPE / FPPE Process

  19. Echo OPPE Module Applies to both OPPE and FPPE

  20. Wish Came True • THE OPPE Module OPPE / FPPE Process

  21. Data Storage • Parts of ECHO involved • Checklists • OPPE / FPPE cycle checklist – MSO (Who, What and When) • Tracks OPPE or FPPE with a Reporting Mechanism Checklist • When placed into OPPE or FPPE • What OPPE cycle the practitioner is in • When the Nursing / Clinical Staff Feedback is due • Who is the Primary Reviewer (Dept Chair or Section Chief) • Who is the Chief of Staff or Credentials Chair • When the last data audit was performed on the individual provider • Nursing / Clinical Staff Feedback moving to an automated Survey Module • Peer Review • Medical Record Status (delinquencies and suspensions) • QA Review (all other provider indicators) • Population (activity and procedural data) OPPE / FPPE Process

  22. We, as a team have processed over 27,000OPPE and FPPE since January 2010! OPPE / FPPE Process

  23. Forms and Committee Reports Applies to both OPPE and FPPE

  24. OPPE / FPPE Process

  25. OPPE / FPPE Process

  26. OPPE / FPPE Process

  27. OPPE / FPPE Process

  28. What the Future Holds

  29. Future Goals Automation • Nursing / Clinical Staff Feedbacks • SURVEY MODULE • Providers able to log in and view OPPE / FPPE forms • Provider Navigator • Online Chair Review Provider Assessment Portal • Peer Review Portal • HL7 Module live population data • Online Application • Additional Indicators • Changes to the process • Updated FPPE policy 2015 • Notification of any new data source • Uniform Additional Privilege Checklist • Customized privilege line • Uniform By-Laws • Uniform staff status OPPE / FPPE Process

  30. Questions

  31. OPPE / FPPE Process

  32. Larry Thacker, CPMSM lrthacker@novanthealth.org OPPE / FPPE Process

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