2012 Annual Meeting Annual Business Meeting Where We Are - - PowerPoint PPT Presentation

2012 Annual Meeting

Annual Business Meeting

Where We Are – President’s Address

Judy Romano, MD Chapter President

The Four Pillar Approach

Chi hild ld Hea ealth lth Pedia iatric tric Practi ctice Adv dvoc

• cacy

Operati tions

• ns

3

Child Health

Child Health represents all areas of care of children but with the priority to have an overall shift in approach from treatment-focus to child wellness.

Pediatric Practice

Pediatric Practice represents all areas that relate to practitioners, such as coding, billing, and ACO’s. Also outreach to specific populations of pediatricians such as hospitalists, sub-specialists and young physicians.

Pediatric Care Council - The Pediatric Care Council maintains a dialogue between pediatricians and insurance plans, bringing to light administrative "glitches" or "kinks" in coverage or in the provision of pediatric care. The Chapter's work in this area has already resulted in Ohio pediatricians receiving thousands of dollars in denied claims.

Advocacy

The Ohio AAP has a long and successful history

• f advocating for children and pediatricians. The

Chapter has advocated for such topics as bike helmet legislation, Medicaid reimbursements for primary care codes, childhood obesity prevention and nutrition standards.

Operations

The Chapter’s Maintenance of Certification programs, and relationship to the Ohio AAP Foundation, as well as fiscal responsibility to the

• rganization, are examples of Operations.

Quality Improvement (QI) / Maintenance of Certification (MOC) - Certified pediatricians are knowledgeable and motivated by a desire to provide the best possible care. Pediatricians who participate in our QI/MOC programs learn how to measure quality of care and effectively fill the gaps in their own practice. The Chapter currently runs QI/MOC programs in asthma, injury prevention, mental health, and obesity prevention and management.

Who We Are – Membership Update

Judy Romano, MD Chapter President

Your Board 2012-2013

Judith Romano, MD, President Gerald Tiberio, M.D., Past President Andrew Garner, M.D., Vice President Robert Murray, M.D., Treasurer Allison Brindle, M.D., Delegate Mike Gittelman, M.D., Delegate Jill Fitch, M.D., Delegate

Board of Directors: Judith Romano, MD, President Gerald Tiberio, M.D., Past President Andrew Garner, M.D., Vice President Robert Murray, M.D., Treasurer Allison Brindle, M.D., Delegate Mike Gittelman, M.D., Delegate Jill Fitch, M.D., Delegate

Organizational Chart

Ohio AAP Membership

6% 1% 5% 4% 72% 7% 5% Affiliate Associate Member, Honorary Member, Retired Fellow Candidate Member Emeritus Fellow Fellow Resident Member and Post Residency Training Member Specialty Fellow

Over 3,000 Members

What We Are a Part of : National AAP

Judy Romano, MD Chapter President

60,000 Voices for Children

Over 77% of Board Certified Pediatricians are national members of the AAP Over 25% of Fellows are Sub-Boarded Pediatric Subspecialists or Pediatric Surgical Specialists Over 40% of Members are Under the Age of 40. Over 95% of Residents are AAP members

National AAP Membership

International Member Associate and Affiliate Members In Training Members Fellow and Specialty Fellows Candidate Members Emeritus/Retired Fellows

Mar 12

15

Mar 12

15

63,149 Members

16

National Structure

 Districts-Regional organizational centers  Chapters-State organizational centers  Sections-Subspecialty and special interest

• rganizational centers

 Committees-Policy development centers  Councils-Policy and education centers

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What We Are Doing Now: Program Update

Kate Krueck, MD & Robert Murray, MD Planning, Implementation, and Performance Committee Co-Chairs

What We Are Doing Now: Program Update

Kate Krueck, MD & Robert Murray, MD Planning, Implementation, and Performance Committee Co-Chairs

Maintenance of Certification – Part 4

The Ohio Chapter has been named a Portfolio Sponsor for MOC activities by the American Board of Pediatrics.

• Only 17 Portfolio Sponsors in the nation
• Ohio AAP is the ONLY AAP Chapter with the designation

Current QI/MOC Programs run by the Chapter

Building Mental Wellness – 25 points Chapter Quality Network Asthma Project – 40 points Injury Prevention – 25 points Pound of Cure – 25 points

Building Mental Wellness

Through the Building Mental Wellness Learning Collaborative...

Primary care providers are trained to promote protective skills, screen and identify mental health issues earlier, provide office-based interventions, link with community resources, and appropriately use psychotropic medication by:

• Enhancing anticipatory guidance for building mental wellness through

protective skills

• Improving behavioral and psychosocial screening in early childhood, and

alcohol and depression/anxiety screening in adolescence

• Improving child and/or parent perceptions of support around mental health

issues

Building Mental Wellness

Through the Building Mental Wellness Learning Collaborative...

Primary care providers are trained to promote protective skills, screen and identify mental health issues earlier, provide office-based interventions, link with community resources, and appropriately use psychotropic medication by:

• Increasing the use of practice-based interventions to address anxiety and

depression in children and adolescents

• Improving resources available to practices, including the Pediatric

Psychiatry Network, community resources, and a mental health tool kit

• Improving diagnosis and medical management of anxiety and depression in

children and adolescents.

Accomplishments

• Wave 1 of the BMW Learning Collaborative

launched June 2012; the collaborative will run through February 2013

– Practices participating in Wave 1: 8

• Recruitment has begun for Wave 2 which will

launch in November 2012

– Looking for 12-20 practices to participate in this 8- month collaborative

Goals for the Future

• The BMW project team is soliciting feedback to target

areas for improvement in Wave 2.

• We are currently recruiting at least 12 practices to

participate in Wave 2 of the project. – We are actively recruiting practices from a geographically diverse area.

• The Learning Session for Wave 2 will kick off on

November 14-15.

Asthma Project

The CQN Asthma Project works at the practice, state, and national levels to build a network of AAP Chapters with the ability to lead quality improvement collaboratives to achieve measurable improvements in the health outcomes

• f children. Participation in this project will provide you

with 40 MOC points!

Asthma Project

In addition to educational resources, support for the program includes:

Access to a Quality Improvement Consultant (QIC). The QIC helps Chapters assist practices in making system-based changes that improve care for children with asthma within a medical home.  Access to the Academy’s Education in Quality Improvement in Pediatric Practices (EQIPP) asthma module, as the data collection

• tool. The national office provides monthly data reports to Chapters

and practices to provide feedback on practice performance.  Participation in the learning sessions (as part of the learning collaborative) will help you earn CME/CIVE credits.

CQN Wave 3

• The Ohio Chapter was awarded a $75K grant

from CareSource to continue our goal of

• ptimal asthma care in Ohio
• Recruitment begins this fall; learning

collaborative expected to start in January/February 2013

─ Looking to recruit an additional 10-15 teams

• The Ohio Chapter is partnering with Partners

for Kids (PFK) to create one unified Ohio team for Wave 3

CQN3 Project Team

Kimberly Giuliano, MD Medical Director Bill Long, MD Co-Lead PFK Kimberly Spoonhower, MD Asthma Expert Elizabeth Dawson Project Manager Christine O’Connor Project Manager for PFK

Accomplishments for CQN Wave 2

• 17 practices and 94 clinicians participated in CQN2
• The Ohio Chapter had more practices and clinicians

enrolled than any other chapter in CQN

• Data from 5,513 unique asthma encounters were recorded

using a standardized encounter form

• Optimal asthma care rose from 51% to 80% during the 12

month collaborative

• Use of asthma action plans rose from 58% to 84%
• 100% of practices felt participation was valuable
• 67% of enrolled clinicians were awarded 40 MOC points

Goals for CQN Wave 3

• Recruit 10-15 practices for CQN3
• Support CQN1 and CQN2 practices in sustaining improvements in

asthma care

• Support all practices in building a sustainable QI infrastructure
• 100% of practices will form a QI team
• 100% of practices will meet at least monthly to review data and

implement QI changes

• 100% of practices will have representation on monthly calls
• 100% of practices in CQN3 will use an asthma registry
• 90% of asthma encounters will provide optimal care by the end of

CQN3

• 90% of asthma encounters will provide patients with an updated

asthma action plan by the end of CQN3

Injury Prevention

• The Injury Prevention Learning Collaborative offers

pediatricians a tool that enables them to screen families for the greatest injury risks at every well-child visit from newborn to 1 year, and that also allows them to address targeted, individually pertinent issues with families.

• Healthcare providers will be trained in appropriate

injury prevention strategies, and will be given talking points on items to address with families on topics such as car safety, sleep safety, fire/burn safety, family interactions, fall prevention, water safety, choking, unintentional ingestions, play safety, and home safety.

Team

Sarah Denny, MD Medical Director Michael Gittelman, MD Medical Director Samantha Anzeljc, PhD Candidate Quality Improvement Consultant Sean O’Hanlon Project Manager

Accomplishments

• The Injury Prevention Learning Collaborative

has received start up funding from Emergency Medical Services for Children, a program of the Ohio Department of Public Safety

• The Learning Collaborative launched at the

beginning of Annual Meeting on Thursday

• Have 6 confirmed practices participating in this

pilot

Goals

Specifically, from September 2012 through March 2013, each practice will implement the Injury Prevention Screening Tool at well child visits from birth through the 1 year visit to measurably increase the parent’s injury- related conversations with the physician. The tool will contain questions pertaining to preventative injury, and encourage parents to ask their physician questions of relevance to their personal interests and concerns. Measures include: 1.90% of patients 1 year of age and younger will have documentation of using the Injury Prevention Screening Tool at all well child visits. 2.90% of parents with children 1 year of age and younger will identify at least one topic for discussion with their physician at all well child visits. 3.90% of well child visits by the physician will cover all age appropriate injury counseling identified during the visit.

Obesity Prevention & Management

An Ounce of Prevention/A Pound of Cure

• In 2007, The American Academy of Pediatrics, and 14 other

collaborating organizations, provided Expert Committee Recommendations Regarding the Prevention, Assessment, and Treatment of Child and Adolescent Overweight and Obesity that guide clinicians in very specific terms about how to screen for, assess, and manage excess weight that may occur in the early years

• f life.
• The same year, the Ohio Chapter, American Academy of Pediatrics

and the Ohio Department of Health adopted the ECRs and developed an obesity prevention program called An Ounce of Prevention is Worth a Pound.

An Ounce of Prevention

The Ounce of Prevention toolkit gives primary care providers tools to educate parents about making good nutritional and physical activity decisions for their children. Ounce of Prevention starts at the first well child visit, and provides age-appropriate tools through 18 years. The complete toolkit includes:

• BMI wheel
• age specific parent handouts
• anticipatory guidance charts for providers
• healthy serving size handouts
• snack suggestions
• sports nutrition information
• calcium information
• handouts for tweens and teens

A Pound of Cure

• A Pound of Cure is a training program for obesity

counseling in primary care which offers resources to aid clinicians in evaluating, interviewing, educating, tracking, and following up with overweight and obese children and families.

• The modules are structured to guide physicians in

identifying a child’s overall obesity-related health risk by collecting a comprehensive history – including family, diet, and physical activity – as well as a physical exam and laboratory evaluation.

• This information is used to prompt physicians to address

fundamental behaviors that fuel excess weight gain.

Team

Robert Murray, MD Medical Director Amy Sternstein, MD Medical Director Samantha Anzeljc, PhD Candidate in Nutrition Project Manager Elizabeth Dawson Project Manager Heather Hall BEACON Quality Improvement Coordinator Mary Ann Swank, MSN/ED, RNC- OB BEAON Quality Improvement Coordinator

Accomplishments

• The Ohio Chapter has trained over 400 health

care providers in more than 50 practices in the Ounce of Prevention obesity management program

• Trainings occur through in-office trainings,

grand rounds, regional trainings and webinars

• Ounce of Prevention provides 1.0 CME credits

for providers participating in the training

Accomplishments

• The Pound of Cure Learning Collaborative

coordinated Wave 1 from January through June 2012 with 10 practices registered

• Wave 2 launched in July with an additional 14

practices registered

– 5 practices from Wave 1 remained in the collaborative – 9 new practices are participating

• One practice from Wave 1 reported a mean

decrease in all collaborative patients BMI of .04 points over 3 months

Goals

• Ounce of Prevention Goals for 2012-2013

– 5 regional trainings during grand r0unds – 5 webinar trainings – 5 office-based trainings

Pound of Cure Goals

From July, 2012 through June, 2013, each practice will implement the Pound of Cure counseling strategy to measurably improve the clinical health care of overweight and/or obese children ages 2-18 years old.

1. 90% of patients who attend the initial Pound of Cure visit, will return for his/her first follow up visit.

• 2. 90% of patients will have documentation of Body Mass Index (BMI) and

blood pressure at all Pound of Cure office visits (initial and all follow up visits).

• 3. 90% of patients identified with BMI >85% will have documentation of

medical risk assessment (history of family, nutrition, physical activity, labs) at the initial Pound of Cure visit.

• 4. 90% of patients with a BMI >85% have documentation of counseling

(nutrition, physical activity) at each Pound of Cure visit.

• 5. 90% of patients complete the behavioral index at initial Pound of Cure visit.
• 6. 75% of patients complete a post counseling behavioral index at the last

Pound of Cure visit.

Future QI Programs for Ohio AAP

• Safe Sleep
• Immunizations
• Vision Screening

Where We Are Going: Foundation Update

James Duffee, MD President, Ohio AAP Foundation

Ohio AAP Foundation – The Charitable Arm of the Chapter

The Ohio AAP Foundation was established in 2000 as a 501 (c) (3) tax- exempt foundation to support the Ohio Chapter, American Academy of Pediatrics (AAP) to advocate for the physical health, mental health, safety and education, and prevention of cruelty of Ohio’s infants, children, adolescents and their families; and to advance education and research to benefit infants, children, adolescents and their families.

Program Initiatives

• Injury Prevention
• Ounce of Prevention is Worth a

Pound

• Early Literacy
• “My Story” Foster Care Program

My Story Foster Care Program

Provides medical care providers with information about caring for foster children, plus provides a variety of personal items in backpacks for the foster children to help them feel more comfortable in their new environment.

Early Literacy Initiative

The Foundation is in the process of evolving this program. The Chapter continues to support those members with Reach Out and Read sites and emphasizes early literacy as a main priority.

My Story Foster Care Program

Provides medical care providers with information about caring for foster children, plus provides a variety of personal items in backpacks for the foster children to help them feel more comfortable in their new environment.

Pound of Cure

This program was created on the basis of Ounce of Prevention, and offers training and resources to aid clinicians in evaluating, interviewing, educating, tracking and following up with overweight and obese children, primarily 2-11 years old, and their families.

Put A Lid On It!

The Chapter’s safety awareness campaign promotes the message of wearing a helmet while biking, skating, and sledding for both children and parents.

This year, the Foundation hosted Ohio Bike Helmet Safety Awareness Week May 7–11, 2012, which included distribution of 2,600 bike helmets and stickers, and bike helmet safety events throughout the state.

Where We Are Going: Chapter

Judy Romano, MD Chapter President

OH! THE PLACES YOU'LL GO! You'll be on your way up! You'll be seeing great sights! You'll join the high fliers who soar to high heights.