Ohio AAP Brush, Book, Bed Pilot QI Program Action Period Call 1 - - PowerPoint PPT Presentation
Ohio AAP Brush, Book, Bed Pilot QI Program Action Period Call 1 January 15, 2020 Welcome and Practice Introductions Roll Call Question: How has your implementation been going over the past month? Which topic in the BBB program do you
– How has your implementation been going over the past month? – Which topic in the BBB program do you feel is the strongest in your practice?
– Which topic has the most room for improvement?
MEASURE NAME TARGET CALCULATION Participant Confidence Increase 85% of providers enrolled will report an increase in confidence in discussion of each individual BBB topic Change in confidence score from pre-work to post-project repeat survey collected by conducting pre-work surveys at kick-off trainings and final surveys at exit interviews Oral Health Discussion Attempted 80% of caregivers will have a discussion attempted Charts with 1 of 2 oral health items documented / total charts reviewed Early Literacy Discussion Attempted 80% of caregivers will have a discussion attempted Charts with 1 of 2 early literacy items documented / total charts reviewed Sleep Routine Discussion Attempted 80% of caregivers will have a discussion attempted Charts with 1 of 2 sleep routine items documented / total charts reviewed Resource Provision 80% of caregivers will be offered resources Charts with provision of resources documented / total charts reviewed Family Knowledge Increase 50% of families will report learning something new about one BBB topic during the visits Collected on family feedback surveys
BBB Learning Collaborative
From December 2019 through June 2020, participants in the BBB program will:
knowledge and confidence from pre-test to post-test
discussions on BBB topics at WCV 6 months-6 years
in activities on the 3 month post project survey
Key Drivers Interventions AIM
Data Measurement Resources Education Environmental Factors
discussion, fluoride varnish and oral health/early literacy supplies provided
toothbrushes, etc.)
project team
collaboration
The Global Aim of the BBB project is to improve health for Ohio children by changing behaviors of pediatric healthcare providers around
sleep routines.
0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1 Baseline Month 1
Core Measures: Discussions
Goal Early Literacy Oral Health Sleep BBB
0.2 0.4 0.6 0.8 1 1.2 Baseline Month 1
Secondary Measures: Discussions
Relationships Flouride Varnish Safe Sleep Bedtime Routines
0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 Baseline Month 1
Supplies Provided: Overall
Supplies Offered No Supplies Offered Goal
0.1 0.2 0.3 0.4 0.5 0.6 Baseline Month 1
Supplies Provided: By Type
Book Oral Health Handouts
Aim
Model for Improvement
What are we trying to accomplish? How will we know that a change is an improvement? What change can we make that will result in improvement?
Plan Do Study Act
Langley GL, Nolan KM, Nolan TW, Norman CL, Provost LP. The Improvement Guide: A Practical Approach to Enhancing Organizational Performance (2nd edition). San Francisco: Jossey- Bass Publishers; 2009.
Measures
Model for Improvement
What are we trying to accomplish? How will we know that a change is an improvement? What change can we make that will result in improvement?
Plan Do Study Act
Langley GL, Nolan KM, Nolan TW, Norman CL, Provost LP. The Improvement Guide: A Practical Approach to Enhancing Organizational Performance (2nd edition). San Francisco: Jossey- Bass Publishers; 2009.
Measures facilitate learning – Starting point to recognize areas for improvement:
– Provide feedback as a means to evaluate:
– Characterize the robustness of change:
changes we’ve made? – Yield evidence that efforts are meaningfully worthwhile
Ideas for Changes to reach Goals
Model for Improvement
What are we trying to accomplish? How will we know that a change is an improvement? What change can we make that will result in improvement?
Plan Do Study Act
Langley GL, Nolan KM, Nolan TW, Norman CL, Provost LP. The Improvement Guide: A Practical Approach to Enhancing Organizational Performance (2nd edition). San Francisco: Jossey- Bass Publishers; 2009.
BBB Learning Collaborative
From December 2019 through June 2020, participants in the BBB program will:
knowledge and confidence from pre-test to post-test
discussions on BBB topics at WCV 6 months-6 years
in activities on the 3 month post project survey
Key Drivers Interventions AIM
Data Measurement Resources Education Environmental Factors
discussion, fluoride varnish and oral health/early literacy supplies provided
toothbrushes, etc.)
project team
collaboration
The Global Aim of the BBB project is to improve health for Ohio children by changing behaviors of pediatric healthcare providers around
sleep routines.
PDSA Cycle
Model for Improvement
What are we trying to accomplish? How will we know that a change is an improvement? What change can we make that will result in improvement?
Plan Do Study Act
Langley GL, Nolan KM, Nolan TW, Norman CL, Provost LP. The Improvement Guide: A Practical Approach to Enhancing Organizational Performance (2nd edition). San Francisco: Jossey- Bass Publishers; 2009.
Take ideas, properly test for improvement and feasibility to make change easier and for sustainability ¤Increase Confidence ¤Find Flexibility ¤Identify Side-effects ¤Minimize Resistance
https://www.nichq.org/insight/4-benefits-testing-implementing-changes
learning
real environments
project’s aims
Langley GL, Nolan KM, Nolan TW, Norman CL, Provost LP. The Improvement Guide: A Practical Approach to Enhancing Organizational Performance (2nd edition). San Francisco: Jossey-Bass Publishers; 2009.
knowledge
–PLAN – Very focused, directed at an immediate test of change (related to project aim) –DO – Carry out the test and document observations –STUDY - Analyze data, compare to predictions –ACT – Determine consequences of change and next steps (future PDSAs)
increases and lead to embedded practices
within your specific environment.
Im Implem lemen enta tatio tion – after many tests, integration of the
change into day-to-day operations
More tests over wide range
https://www.nichq.org/insight/5-tips-testing-optimize-your-next-pdsa
Creating A Relationship with a Dental Home Questions to Ask When Calling a Dental Provider PREFERRED REFERRAL MODALITY PREFERRED REFERRAL FORMAT Phone Y / N #_______________________________ Physician Form ................................Y/ N Fax Y / N #_______________________________
Email Y / N ________________________________ Dental Provider Form ..................Y/ N QUESTIONS FOR DENTAL PROVIDER (Can be asked by staff or Clinician) How soon can a patient be seen for routine evaluation? ________________________________ At what age does your office begin care for children? Sick __________ Well ___________ Does your office offer conscious sedation or anesthesia in office? .............................Y / N Does your dentist have inpatient privileges? .....................................................................Y / N Where? _________________________________________________________________________________ Do they need pre-op consult for inpatient oral rehabilitation? ..................................Y / N How best coordinated? _______________________________________________________________ Does your dentist apply fluoride varnish at all visits? .....................................................Y / N Does your dentist apply sealant? ..............................................................................................Y / N How often and to whom?_____________________________________________________________ What insurances does your office accept? ___________________________________________________________________________________________ Would your dentist be willing to speak to our physician to talk about referring patients to them? (If yes, get time and number or give direct number for our physician.) ...........................................................................................................................................Y / N
patients to them? (If yes, get time and number or give direct number for our physician.) ...........................................................................................................................................Y / N OTHER QUESTIONS FOR DENTIST TO BE ASKED BY PRIMARY CARE PROVIDER How would you like our office to refer children with: Severe chronic oral health problems (i.e. gingival hyperplasia)? Acute oral health problems (i.e. caries)? What is the youngest age patient that you are comfortable managing? And for what services?
Adapted from Eve Kimball, MD, FAAP, All About Children Pediatric Partners, PC http://www.aacpp.com/.
initiatives/Oral-Health/Pages/Oral-Health-Practice-Tools.aspx
initiatives/Oral-Health/Pages/Oral-Health.aspx
– http://ohioaap.org/bbbqidata/ – 5 charts/month per provider seeking credit (random selection) – February 3, 2020 - January data and any previously unsubmitted data
– February 3, 2020 - 1st PDSA Cycle worksheet
– February 12 – Reach Out and Read/Early Literacy Resources
– Scan and Email – Fax to 614-846-6258
– Email when more needed
– Idea: Using books/toothbrushes as a reminder to discuss topics