Transcript Measurement!!! - Home Care Association of New Hampshire

CQI FORUM
Year II – Translate Learning Into Action!
Measurement for Quality
March 27, 2014
Objectives
• Review available data reports
• Identify methods for deciding where to focus
further measurement and improvement
• Describe how to look at data over time
Your Ground Rules
1. What happens in the group stays in the group
2. Cell phone off or on vibrate
3. All ideas are valid
4. Treat one another with respect
• Listen without interruption
• Participate
• Act in a non-judgmental manner
5. Have open, potentially challenging discussions
6. Avoid side conversations
7. Raise hand when you want to speak
8. Consider alternative technologies & room arrangements for the
meeting
MEASUREMENT FOR
QUALITY
Karen Parker
Carolyn DeMark
Rachel Trombly
Cheryl Gonzalo
Management of
Medications
Karen Parker, RN
Situation
 Review of Oasis Outcome data on Home
Health Compare

Outcomes and process Measures
 Daily QI review of Charts
 Patient satisfaction reports
Problem
 Medication reconciliation was inconsistent
 Notification to MD in 1 day for significant
issues not timely
 Patient satisfaction numbers for review of
medications although above state and
National levels was trending downward
Solution
 Survey Monkey to Clinical Staff to determine barriers
to medication reconciliation
 Disease Management team meeting to discuss the
process in detail and determine best practices by
each discipline
 Development of Medication Management tools
 Development of specific Medication education for
Clinical staff done for all current staff and added to
the orientation program for new staff
EvaluationImprovement Oral Medications ytd 2012- 2013
SHP data
Patient Satisfaction data- Fazzi
 In review of Outcome reports and patient
satisfaction we identified that the new
medication process is working and our
outcomes have improved.
CASE STUDY
Carolyn DeMark, RN
REVIEW PREREADING(S)- KEY
POINTS
Rachel Trombly
Cheryl Gonzalo
A comprehensive quality assurance
program is:
• Proactive.
• Educational.
• Realistic, scalable, and financially feasible.
• Simple and easy to implement.
• Secure and confidential
• Inclusive of all aspects of the author-to-text process.
• Reportable for tracking and trending purposes.
• Timely
Using HHCAHPS to Monitor and
Improve Quality – an Example (C. G.)
Run your HHCAPS report. Find the top 3-4 lowest scores or
problem areas for your agency. (I picked 5 because they go
together).
• Example:
• Talk about medications you are taking (% yes) 73.3
• Ask to see medications (% yes) 54.0
• Talk about purpose for medications (% yes) 66.7
• Talk about when to take medications (% yes) 66.7
• Talk about side effects of mediations (% yes) 47.4
• Identified our quality problem area as medications in general.
HHCAHPS report.
• Discussion:
• Improvement:
ADDITIONAL
THOUGHTS
Polly Campion
Let’s Look at Your Data
• To what reports do you have access?
• CASPER (Certification and Survey Provider Enhanced Reports)
• Fazzi
• Home Health Compare
• Others?
CASPER Reports
66%
Let’s Look at Data Over Time
Run Chart Template
Developed by Richard Scoville, PhD. ([email protected])
Vertical Axis Label Percent
Graph Label Improvement in Ambulation
Date /
Observation
Enter dates or observation
numbers into the green cells
at right. (clear the sample
data before you begin)
Enter your data values into
the blue cells. Goal values
are optional.
Don't leave any blank cells
in the Date/Observation
column.
Enter an 'X' into the End
Median column to mark the
last row to be included in the
median
Goal
Improvement in Ambulation
Percent
70
60
Median
50
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10
0
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End
Median
13Jul
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13Apr
See sheet 'Rules for
Interpreting Charts' for
information about interpreting
charts
Median
58
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66
13Jan
Use regular Excel commands
to configure the graph.
Value
12Oct
Enter your graph title and y
axis label into the cells
provided.
12-Oct
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14-Jan
14-Apr
How Are We Doing?
Improvement in Ambulation?
66%
Measurement!!!
Why Measure?
• How else will you know that the change you made
resulted in improvement?
Measurement for Measurement for
Reporting
Improvement
Used to judge
Used for learning
Source: IHI, Simplifying
Measurement, 2012
If both types of measures are required,
where do you start?
• Reporting:
• OBQI
• Improvement
• OBQI
• HHCAHPS
• Internal data
Ask of your data
• Where are the opportunities?
• Not meeting standard?
• Lowest performance?
• Most important aspects of care/service?
• Greatest impact on clients?
• Of interest to passionate leader?
Aim Statements
Aim Statements
PDSA Worksheet
Small Group Work
• In twos or threes
• What resonated with you?
• Identify one action to test at your agency
• Report out
Next Steps
• Determine content for next meeting
• What do you want the focus of April’s meeting to be?
• Identify actions:
• What
• Who
• When
Evaluation
• What worked well?
• What could be improved?
Next Meeting – April 24, 2014
• Agenda:
• To be determined (by group)