a multi-pronged approach to improve provider...
TRANSCRIPT
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A Multi-Pronged Approach to Improve Provider SatisfactionSession 149, March 7, 2018 1 - 2 p.m.
Thomas Selva, MD, CMIO, MU Health Care
Bryan Bliven, CIO, MU Health Care
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• Thomas Selva, MD
• Bryan Bliven
Has no real or apparent conflicts of interest to report.
Conflict of Interest
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Learning Objectives• Identify key components in a multi-pronged approach to positively
impact provider satisfaction
• Demonstrate the importance of provider EMR surveys
• Recognize the value of physician-funded positions on a EMR council
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Basic Principles
Basic principles: no matter what,
no matter when, no matter
who…any CMIO / CIO has a
chance to sweep any user off their
feet. They just need the right
broom.
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EMR Survey Results• Questions are grouped into five categories to facilitate analysis and
to track response trends
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2.5
3
3.5
4
4.5
2012 2013 2014 2015 2016 2017
Targeted Impact
Ease of Access
Efficiency
Communication
Patient Safety
Research and Process Improvement
2017 Average Score
% Change from 2016
Ease of Access 4.11 10.5%
Patient Safety 3.45 -2.3%
Communication 2.96 -6.6%
Efficiency 3.07 0.0%
Research & Process Imp. 2.22 -5.1%
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Shared GovernanceCEO/President of Cerner
Tiger Institute Board of Governors5MU/5Cerner
University System President
Tiger Institute Prioritization and Steering Committe (TIPS)
Operations Project Management
Value Creation OfficePopulation Health Workgroup
Docu
menta
tion
Pro
vid
er
Experience
Patient
Engagem
ent
Devic
e O
Vers
ight
Clin
ic I
nfo
rmatics
Multi-D
Info
rmatics
Ord
ers
Managem
ent
Ente
rprise
Media
TIPS Sub-Committee
Pharm
acy
Advis
ory
Clin
ical D
eci
sion
Support
/ E
BM
Registry Management
Value Based Performance / Ops
Data Governance
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Measure/Measure/Measure• DART Team Engagement Results
0:02:53
0:10:05
0:17:17
0:24:29
0:31:41
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
90.0%
Au
g-1
5
Se
p-1
5
Oc
t-1
5
No
v-1
5
Dec
-15
Jan
-16
Fe
b-1
6
Ma
r-16
Ap
r-16
Ma
y-1
6
Ju
n-1
6
Ju
l-1
6
Au
g-1
6
Se
p-1
6
Oc
t-1
6
No
v-1
6
Dec
-16
Jan
-17
Fe
b-1
7
Ma
r-17
Ap
r-17
Ma
y-1
7
Ju
n-1
7
Ju
l-1
7
Dyn Doc Time Compared to Power Note Time
% DynamicDocumentation
DynDoc TimePer Note
PowerNoteTime Per Note
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Measure/Measure/Measure• DART Team Engagement Results
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
90.0%
0:00:00
0:28:48
0:57:36
1:26:24
1:55:12
2:24:00
2:52:48
3:21:36
3:50:24
4:19:12
4:48:00
Dyn Doc Impact to Outside Hours Documentation
% DynamicDocumentation
DocumentationTime OutsideHours
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Plan/Do
• Case Study:
– PILDP Project – reduce readmissions
• Cone it down: Start with small test of change on quantifiable population
• CHF – leading cause of readmissions
– Problem is not identifying patients with CHF when admitted for other issues
– Build algorithm to look at previous admissions, problem list, subset of labs and medications.
– Fire alert on admission that patient may have CHF
– Add CHF to problem list
» Sets off process / orders to assure daily weights, discharge education
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Plan/Do• Case Study:
– PILDP Project: Who is My Doctor…Right Now?
• Solve the problem of who is the resident caring for the patient ”at this moment”.
• Large source of frustration for nursing, consulting, and ancillary services.
• Engage “big-small” test of change on Medicine Service using Cerner I-PASS Handoff tool.
• Challenge: It works! Now spread it to the entire organization.
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Educate• DART Team / EMR Training Team Engagement
– Meeting with departments during faculty meetings or residency staff meetings.
– Participation in ”EMR Happy Hour” sessions
– Cover “hot tips” or topics of interest to help assure staff are using the best workflows to achieve optimum efficiency with the EMR and associated tools.
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Communicate
• Regular “flash” updates from CMIO via e-mail to all staff
– Distribution list grows each month as staff get interested
• End of the month CMIO Digest of all updates sent during the previous month
– One more “bite at the apple”
• All CMIO updates stored on CMIO blog site for easy retrieval
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EMR Survey Results• Overall satisfaction is evaluated with the question “I am overall
satisfied with the EMR”
– Prior to 2014, overall satisfaction was calculated as an average of all year-over-year comparable questions
3.03
3.15
3.25 3.27
3.30
3.2
2.93
2.98
3.25
3.16
2.9
3
3.1
3.2
3.3
2012 2013 2014 2015 2016 2017
Consistent Improvement
Average Score Overall Satisfaction
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Questions?
• Thomas Selva, MD
www.linkedin.com/in/
thomas-selva-49207351/
• Please complete the online session evaluation
• Bryan Bliven
• @bbliven24
• www.linkedin.com/in/bryanbliven/