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Staff and Leadership EngagementPrepared by: Shannon Nielson, MHA, PCMH-CCE
Prepared for: CHAD
1.9.19
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How are you measuring value today?
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What we know…
PCMH
UDS
FTCA
Pt. Satisfaction
Surveys
HIE
ACO/APM
EMR
Meaningful Use
HEDIS
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What they hear…
PCMH
UDS
FTCA
Pt. Satisfaction
Surveys
HIE
ACO/APM
EMR
Meaningful Use
HEDIS
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Value Based Care Defined
The health outcomes of a population (population health) are driven by interventions (population health management) such as Patient Centered Medical Home concepts aimed to deliver upon improved outcomes, decreased cost, improved patient experience and provider experience (Quadruple Aim).
The measured impact on the Quadruple Aim determines your value.
Spreading value beyond your existing patients and to all eligible patients is the ultimate determination of sustainability within a value based care environment.
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Compliant Quality
• HRSA
• FTCA
• HEDIS
• CMS
• PCMH
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Meaningful Quality
Efficiency Effectiveness Quality
Quality Impact Value
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Patient Staff Engagement
• Importance
• Confidence
• Readiness
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Foundations for Engagement in Quality• Importance
• Purpose
• Data
• Confidence• Ownership
• Data
• Reward and Recognition
• Readiness• Responsibility
• Data
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First Things First…Importance
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Understanding the ‘WHY”
• There is a significant gap in the level of understanding around Health Center specific funding, compliance, regulations, documentation, data, reporting & more….
• There is also a disconnect when we talk about Value Based Care & PCMH requirements…
• Our teams will be far more likely to adhere to documentation protocols when they understand the ‘WHY’ behind them.
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Closing the ‘WHY’ Gap
• How thorough is your team trained around health center regulations, UDS data, PCMH, Value Based Care, etc?
• How frequently is training updated or
repeated?
• How familiar are your staff and
leadership with outcome
expectations?
• Is your team informed about your
Value Based contracts and
understand their role in maximizing
reimbursements?
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We have to do it for UDS…
Reason• We have to do it for UDS
Purpose• Improved documentation gives
us a better understanding of our opportunity to improve quality
• Where should we focus based on how patients utilize us
• We can identify a focused opportunity for growth/access
• Alignment with PCMH and HEDIS
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We have to do it for PCMH
Reason• For PCMH we need to huddle
• We need to pick a CM population and you have to document goals
• We need to complete PDSAs to show CQI
Purpose• Improved communication and pre-
visit planning should create efficiencies, improve pt. experience and maximize your skill set
• There is a population that is more at risk and we can provide ongoing care management support to mitigate the risk and reduce risk
• Where is there an opportunity to improve and how do you think we can do it?
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We have to do…. We need you to…
• By doing X we can improve Y
Yes, it’s that simple
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Importance: Systems Level DataLeadership/Governance
MoneyMission
Mid-level ManagementMoney
Staff SatisfactionEfficiency
Front Line StaffPatient Satisfaction
QualityEfficiency
PatientsQualitySafetyCost
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Data Usability
• Actionable• Lists
• Contact Information
• Population Based
• Team Relevant
• Realistic Measurable Outcomes• Process vs. Outcome
• Consistent
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Data Visibility
• PLAN without data is a Wish
• DO without data is Simon Says
• STUDY without data is Water Cooler Gossip
• ACT without data is Groundhog’s Day
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Data Visualization
• Consider visualization
• Transparency
• Limit data
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How We Visualize our Data
• Identify areas that need attention or improvement
• Clarify which factors influence outcomes
• Help us understand what interventions are needed
• Know your audience
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Systems Level Data Sharing
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Visualization Changes Purpose
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Confidence: Ownership
• Responsibility vs. Duties• Responsible
• Accountable
• Informed
• Consulted
• Innovation vs. Direction• Quality Teams
• Staff PI teams
• Failure is Fabulous
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Confidence: Data
• Test informed data• Can you really improve A1Cs in 2 weeks
• Qualitative Data• Patient Feedback
• Staff feedback
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Confidence: Reward and Recognition
• Reward Money• Presentation
• Announcements
• Creative incentives
• Competition Drives Engagement• Transparent Data
• Aligned Goals
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Readiness: Responsibility
• Scope of Licensure• Team Based Care
• Role purpose
• Expected Outcomes
• Purposeful Process• Skill vs. Availability
• Communication and Access
• Expected Outcome
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Readiness: Data
• Data Rules:• Platinum Rule: How will the data be used
• Golden Rule: How are the elements defined
• Silver Rule: When should you see the data change?
• Data Process:• Set your data strategy
• Define your staff engagement needs with your data strategy
• Validate and create your data
• Provide meaningful, actionable, baseline data
• Provide ongoing demonstrative, reactive data
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Employee Satisfaction vs. Employee Engagement
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Employee Engagement Surveys
• My roles and responsibilities are clearly defined
• My daily activities match my job description
• My skills/licensure/experience is used in my daily activities
• Most of the systems and processes here support us getting our work done effectively and efficiently
• I am given the opportunity to contribute my ideas and opinions on how we can improve
• I am given the opportunity to contribute my ideas and opinions on how we can improve
• Day to day decisions demonstrate that quality and improvement are top priorities
• Our organization promotes non-management employee participation in projects and committees
• What resources, tools or systems are needed to better help you do your job?
• What activities/committees/projects would you like to be involved in or see other staff members involved in?
• What would you like to most see improved upon in the organization that would result in enhanced engagement and satisfaction? (Examples include: EMR optimization, job clarification, communication, team building...)
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Motivational interviewing for you
•O: Open ended questions
•A: Affirmations
•R: Reflective listening
• S: Summarize
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UDS
• Annual Report for HRSA
• Table 6A, 6B and Table 7
• But did you know?....• Care Team Information
• Productivity
• Service Utilization
• Population Needs
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FTCA
• Compliance• Safety
• Quality
• Billing
• Coordination
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PCMH: It’s not a 4 letter word
Team Based Care
Knowing and Managing your
Patients
Patient Centered Access and Continuity
Care Management and Support
Performance Management and
Quality Improvement
Care Coordination
and Transitions
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Putting Quality into Action
Access is the
opportunity
for care
Quality is the opportunity
for cost
Cost is impactedby
“appropriateness” of access
Appropriate access is driven by your population’s
care needs
Care needsdrive a
Provider’s adoption of
quality
Adoption of qualitydrives your
population health management
activities
PCMH activities drivethe ability to improve access beyond your
patients
Spreading your value beyond your patients is VALUE BASED
CARE
Care is the
opportunity
for quality
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But I am not a Quality Person: E-I-E-I-O
• Engage (Patients)
• (Be) Informed
• (Define) Excellence
• Initiate
•Optimize
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What Should you do now?
• Identify an opportunity• Process?• Outcome?• Responsibility?
• Ask for Information• Understand performance• Assist in setting goal • Ask for alignment
• Engage• Staff
• Patients
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Organizational Alignment