1 / 16

Quality Improvement Series Session 7- System Redesign Windy Stevenson lammersw@ohsu.edu

Quality Improvement Series Session 7- System Redesign Windy Stevenson lammersw@ohsu.edu Cindy Ferrell. Today’s Agenda. Recap . Problem: The DCH ambulatory clinic problem lists are incomplete and inaccurate. Patients with BMI>85%ile do not have obesity listed on their problem lists.

tivona
Download Presentation

Quality Improvement Series Session 7- System Redesign Windy Stevenson lammersw@ohsu.edu

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Quality Improvement Series Session 7- System Redesign Windy Stevenson lammersw@ohsu.edu Cindy Ferrell

  2. Today’s Agenda

  3. Recap • Problem: The DCH ambulatory clinic problem lists are incomplete and inaccurate. • Patients with BMI>85%ile do not have obesity listed on their problem lists. • Drivers: • Improve patient care- facilitate decision support • Improve provider efficiency (reduce chart review) • Lessons Learned: • We have to narrow our scope • Just saying we fix the system is woefully inadequate • Everything is more complex than we expect • Random audits of an ill defined product are not helpful • We are still limited by our access to data

  4. Let’s say your dog keeps running into the street Changing behavior This works when there is no natural consequence (fence) This works in a system with immediate feedback (treats or shock collar)

  5. Two Real-life examples

  6. Two Real-life examples

  7. The Science of Reliability

  8. How do we get from CHAOS to Level 1? • Work harder next time • Feedback on compliance • Increase awareness and vigilance • Also known as work harder

  9. How do we get from Level 1 to Level 2? • Real time identification of failures • “forced function” check lists • Redundancy • Make the right thing the easy thing • Provide decision aids

  10. So, what’s our first AIM? Specific we are intentional and focused Measurable we can prove we’ve had an impact Actionable there are no known insurmountable barriers Realistic it’s within our scope Timely we’ll do it within a time frame

  11. Our First AIM: ____ % of patients of ____ age seen by _______ in the ________ clinic(s) with a BMI > ____ %ile will have _______ listed on their problem list by ______ (date)

  12. Let’s envision our ideal state • Process Mapping

  13. How do we get there?

  14. Obesity and Meaningful Use- more opportunity The percentage of patients 2‐17 years of age who had an outpatient visit with a PCP and who had evidence of BMI percentile documentation, counseling for nutrition and counseling for physical activity during the measurement year.

  15. Take Home Points (review) Real (sustainable) change comes from changing systems, not changing within systems Be specific about what you want to accomplish, and why; be intentional Focus on patients Start before you think you are ready; don’t get paralyzed

More Related