bright futures webinar - amazon web...
TRANSCRIPT
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Bright Futures WebinarSharing Learnings from Our Pilots
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Provide an overview of the learnings from our Bright Futures Pilot countiesShare tools and resources for local implementationReview next steps for other agencies beginning implementation
Objectives
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Buncombe
Anson
Ashe
Beaufort
Bertie
Bladen
Brunswick
Burke
Caldwell
Carteret
Caswell
CatawbaChatham
CherokeeClay
Columbus
Dare
Davie
Duplin
ForsythFranklin
Gaston
Gates
Graham
Greene
Guilford
Halifax
Harnett
Hertford
Hoke
Hyde
Iredell
Jackson
Johnston
Jones
Lee
Lenoir
McDowell
Macon
MadisonMartin
Moore
Nash
NewHanover
Northampton
Onslow
Orange
Pamlico
Pender
Person
Pitt
Polk
Randolph
Robeson
Rockingham
Rowan
Rutherford
SampsonScotland
Stanly
StokesSurry
Swain
Transylvania
Tyrrell
Union
Wake
Warren
Washington
Watauga
Wayne
Wilkes
Wilson
Yadkin
Yancey
Chowan
Pasquotank
Perquimans
CamdenCurrituck
MontgomeryHenderson
GranvilleVance
Durham
Mecklenburg
LincolnCabarrus
RichmondCumberland
Alexander
Craven
Haywood
Alleghany
Mitchell Avery
Cleveland
Alamance
DavidsonEdgecombe
Greene
2
1
3 5
6
4
BertieDavie
1 Linda Harrison
2 Malyn Pratt
3 Melody McCune
4 Jean Vukoson
5 Lynette Robinson
6 Stephanie Fisher
Bright Futures Pilots
See Pilots Contact List for localagency contacts.
EHR Counties
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Multidisciplinary team approach
How did we approach change?
Wilson Implementation Team
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Pilots used the Value Stream Map & lean thinking to understand their “current state”in workflow processes
Identify waits and duplication (wastes)Clarify what happens at each stepHighlight PDSA ideas
How did we approach change?
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Wilkes County: pink stickies = wait or waste
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Wilkes PDSA Ideas
RN required tasks vs. CHA tasks
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Wilkes County PDSA Ideas
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Rockingham vsm
HHenderson Current State
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Henderson Future State
PDSA ideas
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Rockingham VSM from Regional Meeting
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Rockingham Team VSM
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Wilson Current State VSM
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Wilson Futures State VSM
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PDSA Wilkes
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PDSA Rockingham
Percentages? TPR?
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PDSA ALL:Where do we update
Changes in FH or PH?
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A QI approach makes a big difference!“Doing the same thing as you have always done it will produce the same results.”“Trials helped engage staff in the process and
remove assumptions and “that won’t work attitudes.”
“The process forced us to think differently regarding staff roles.”
“Sharing data regarding improvements will support ongoing changes.”
What have we learned?
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Nothing is perfect. Bright Futures meets a broad set of criteria but PDSAs revealed need for tweaking.There is no one right way to do this!
Who does what will vary agency to agency based on staffingSteps will vary: lab prior to provider or after providerTechnical support vs. hardcopy decision tools varies
What have we learned?
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CHA Completes
Wilkes County
MD or NP Completes
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Support RN completes
ERN or NP completes
Wilson County
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What changes were made that resulted in improvements?
Reduced Lead TimeReduced waits between stepsEliminated bottlenecksRemoved stepsEliminate duplication in process & documentation
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What changes were made that resulted in improvements?
Reduced Lead TimeEngage clients in providing information/completing forms where possibleUse interpreter to assist with history and pre-visit assessments (instead of RN & interpreter)
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What changes were made that resulted in improvements?
Move to documentation by exceptionERNs become comfortable with less documentation: Training requirements vs.. practiceBF forms provide flexibility to support UAP completion
Yes No Don’t know or Unsure
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CHA or Interpretercan assist with Y/N/Unsure
Or c
heck
box
es
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ERN Practice
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No need to SOAP each issue if it can be documented in this space
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Targeted Guidance
Use Health Literacy strategies
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What changes were made that resulted in improvements?
Policies & Procedures to support documentation of only positive findings or risk will be requiredDevelopment of EHR screens are moving to similar formats
History: Yes No Unanswered Physical: Not checked Not done
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What changes were made that resulted in improvements?
Optimize staff to highest level of performance for education & licensure
Training & competency testing for UAPRN assessment, education, & program & population managementERNs as “providers”
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What changes were made that resulted in improvements?
Developed technical supportsElectronic files for age specific forms including developmental forms
Henderson County translated the Initial History to Spanish/English
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What changes were made that resulted in improvements?
Teach & empower staff Provide continuous feedback & ideas for improvement huddlesCreate lean “pull” systems if there is an beaver dam in lab, reroute patient to provider
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What changes were made that resulted in improvements?
Reorganized or repurposed space to limit transportation and motion of staff & clients
Eye charts or VS in all exam roomsLabs in exam roomsCreate more than one space for tasks
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Patient & Staff Satisfaction after implementation not yet available
“You mean I can leave now, we’re finished?”“The forms were easy to finish”“I like the new forms, this is taking less time!”
What was the response from staff & clients?
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Ongoing monitoring of engagement of patients and families
During the past 12 months, how would you rate your satisfaction with the way your provider helps you feel like a partner in your child’s care?
How will we know we are moving toward our goal of improved child health?
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Work with AAP to support licensure for EHR and HIS CWS development
BFTRK license covers 3 CH providers for hardcopy and electronic useRowan ready to move ahead with M & MCHA will “go live” with Netsmart product July 6Work on CWS begins this monthRCHNC & Jean will soon visit agencies who are currently using an EHR to format plans
Bright Futures Updates
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Webinars in developmentHow to for HEADSSSCoding for additional screening tests such as HEADSSS, PSC and CRAFFT
Bright Futures added to this cohort of CHNT programNew Bright Futures Nutrition Manual is out
Bright Futures Updates
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Regional Meeting dates set!Region 1: September 14Region 2: September 15Region 3: September 26Region 4: September 12Region 5: September 28Region 6: September 29
Same locations as Spring Meetings
Bright Futures Updates
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Keep checking for new offerings
http://childrenyouth.brightfutureswebinar.sgizmo.com/s3/
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We have a busy summer ahead!Most agencies want to implement in the next 4 months to take advantage of slower days of summerRCHNC are busy scheduling TA and resources to assist youWe have in place tools to monitor statewide starts and completions
Moving from Pilots to statewide implementation
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Contact your RCHNC to develop an individual plan for JIT training and support for your agency & agree on an implementation monthYour RCHNC will provide you will archived QI trainings, tools, and the BFTRKCollect your baseline dataConvene your teamBegin your tests of change
Next Steps for You
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Once you have implemented the full BFTRK for at least 1 month, collect your post implementation data and share it with your RCHNCCelebrate! Share your learnings and success with your clients, leadership team and BOH
Next Steps for You
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Your RCHNC & Pilot colleagues QI webinars:
What is QI?Value Stream mapping
Data collection tools:Patient & client satisfaction surveysLead and cycle time tools
Project tracking tool: NewspaperUAP Competency Sheets (Rockingham Co)
Resources
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Return to the Bright Futures Training Page & scroll down to the June 8 WebinarUse the link to complete the evaluationThen complete and print your certificateIf you have problems, please contact Elizabeth Mizelle at [email protected]
Continuing Education
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Please type your questionsin the Question Chat Box;we will answer as many as
possible in the webinar and theremaining will be posted on the
Bright Futures website.