Slide 1

Florida SIPP Quarterly Meeting

Presenter:

Jolene Rasmussen, MSHealthcare Analyst, PIP Review Team

March 23, 2011

Slide 2

Presentation Topics

• Collaborative Validation Results

• Statistical Testing

• Proposed PIP Topics

Slide 3

Collaborative PIP Validation Results

• Address deficiencies in next submission

– Compliance with recommendations more important than initial score

– Technical assistance available

Slide 4

FY 2011 Performance Improvement Project Validation Results

(N=18 PIPs)

Study Stage Activity Percentage of Applicable Elements

MetPartially

MetNot Met

Design

I. Appropriate Study Topic*85%

(71/84)2%

(2/84)13%

(11/84)

II. Clearly Defined, Answerable Study Question(s)100%

(28/28)0%

(0/28)0%

(0/28)

III. Clearly Defined Study Indicator(s)*69%

(41/59)22%

(13/59)8%

(5/59)

IV. Correctly Identified Study Population*87%

(26/30)7%

(2/30)7%

(2/30)

Design Total83%

(166/201)8%

(17/201)9%

(18/201)

Implementation

V. Valid Sampling Techniques (if sampling was used) Not Applicable Not Applicable Not Applicable

VI. Accurate/Complete Data Collection 51%

(73/144)30%

(43/144)19%

(28/144)

VII. Appropriate Improvement Strategies79%

(23/29)21%

(6/29)0%

(0/29)

Implementation Total*55%

(96/173)28%

49/173)16%

(28/173)

Outcomes

VIII. Sufficient Data Analysis and Interpretation* 54%

(28/52)35%

(18/52)12%

(6/52)

IX. Real Improvement Achieved † † †

X. Sustained Improvement Achieved † † †

Outcomes Total*54%

(28/52)35%

(18/52)12%

(6/52)

Overall Percentage of Applicable Evaluation Elements Scored Met68%

(290/426)*Total for activity or stage may not equal 100 percent due to rounding.† The PIP had not progressed to this point; therefore, the activity was not assessed.

Slide 5

Process for Disputing Validation Score

• The plan must submit its dispute via formal letter to HSAG and cc AHCA Contract Manager

• The letter should outline the evaluation element/comment being disputed and the plan’s rationale for why the score should be changed

• All responses should be e-mailed to ddriscoll@hsag.com no later than April 1, 2011

• The HSAG PIP Review Team will review the dispute and respond to the plan with a decision within seven (7) business days

Slide 6

Statistical Testing using GraphPad

• Refer to statistical testing document on myforidaeqro.com

• http://www.graphpad.com/quickcalcs/index.cfm

• Select -

o Categorical data Fisher's, Chi square, McNemar's, Sign test, CI of proportion, NNT (number needed to treat). o Press Continue

o Fisher's and chi-square. Analyze a 2x2 contingency table.o Press Continue

Slide 7

GraphPad Example

Numerator Denominator minus NumeratorBaseline 15 280Remeasurement 1 10 315

Select - o Fisher's exact test (recommended)

o Two-tailed (recommended) o Calculate

Slide 8

GraphPad Results

Numerator Denominator-Numerator Total=DenominatorBaseline 15 280 295

Remeasurement 1 10 315 325

Total 25 595 620

Fisher's exact test

  The two-tailed P value equals 0.2250

  The association between rows (groups) and columns (outcomes)   is considered to be not statistically significant

Slide 9

Proposed PIP Topics

Slide 10

Approved Topics

• Achieving and Maintaining a Healthy Weight in SIPP Population

Slide 11

Approved Topics with Modifications

• Decreasing Childhood Obesity While in Residential Treatment

• Enhancing the Effectiveness of our Token Economy System

• Increasing Family Participation in Treatment

• Minimizing Weight Gain of Youth in a Residential Setting

• Reducing Percentage of Overweight/Obese Patients

• Reducing Physically Aggressive Behavior in Members

• Reducing Risks from Aggressive Behavior

• Reducing Significant Weight Change Related to Medication Side-Effects

• Staff Initiated Timeouts

• Youth Satisfaction with Food During Their Stay at SIPP

Slide 12

Not Approved Topics

• Competency Based Training of Community Counselors to Carry Out the Behavioral Analysis Requested by Therapist

• Impact of Trauma Informed Care• Impact on Dietary and Nutritional Practices• Improve Standardized Method for Measuring Progress• Improving Member Satisfaction• Increasing Post-discharge Follow-up Response Rates• Increasing SIPP 60 Day Survey Completion• Nursing Recruitment and Retention• Reducing Employee Turnover• RN Satisfaction• Transition Room

Slide 13

HSAG Contacts:

For any PIP questions or to request technical assistance contact:

Christi Melendez, RN, CPHQ

cmelendez@hsag.com

602-801-6875

Denise Driscoll

ddriscoll@hsag.com

602-801-6882

Slide 14

Questions and Answers

Slide 15

Upcoming EQR Activities

Wednesday, March 23, 2011

Presenter:

Yolanda Strozier, MBA

Associate Director, State and Corporate Services

Slide 16

Upcoming EQR activities

• The next EQR Quarterly Meetings:– Wednesday, June 8, 2011 (AHCA Offices)

One-on-one TA sessions Tuesday, June 7, 2011

– Week of September 26, 2011 (Webinar)

– Wednesday, January 11, 2012 (AHCA Offices)

One-on-one TA sessions Tuesday, January 10, 2012

– Week of March 19, 2012 (Webinar)

Slide 17

Upcoming EQR activities

• Finalization of PIP Validation Reports (April 2011).

• Annual PIP Summary Report and Strategic Summary Report (April–June 2011).

Slide 18

Upcoming EQR activities

Next Steps• PIPs are submitted to AHCA/DOEA— August

2011

• MCOs will receive HSAG’s “Statement of Intent” (SOI) survey on Wednesday, August 10, 2011.

• Completed SOI’s due to HSAG on Monday, August 29th.

Slide 19

External Quality Review Quarterly Meeting

THANK YOU FOR YOUR PARTICIPATION!