Pilot QIA (PHFPQ) Quality Improvement Activity Brittney Jackson, - - PowerPoint PPT Presentation

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Pilot QIA (PHFPQ) Quality Improvement Activity Brittney Jackson, - - PowerPoint PPT Presentation

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2018 Population Health Focused Pilot QIA (PHFPQ) Quality Improvement Activity Brittney Jackson, LMSW, MBA Patient Services Director February 20, 2018 Agenda Topics PHFPQ Background Inclusion Criteria Project Goals

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2018 Population Health Focused Pilot QIA (PHFPQ) Quality Improvement Activity

Brittney Jackson, LMSW, MBA Patient Services Director February 20, 2018

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Agenda Topics

  • PHFPQ Background
  • Inclusion Criteria
  • Project Goals
  • Network and Facility Roles & Responsibilities
  • Project Timeline
  • Tools and Resources
  • Closing Comments
  • p. 2
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Learning Objectives

  • Learn about the history of ESRD Network Program and Network

roles/responsibilities

  • Gain an understanding of the projects purpose, goals, interventions, and

resources

  • Learn about the requirements and purpose of the Root Cause Analysis

Questionnaire

  • p. 3
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Brittney Jackson, LMSW, MBA Patient Services Director 203-285-1213 bjackson@nw1.esrd.net Merari Rosario, MHA Community Outreach Coordinator 203-285-1223 mrosario@nw1.esrd.net

1952 Whitney Avenue, 2nd Floor, Hamden, CT 06517 Phone: (203) 387-9932 Fax: (203) 389-9902

Network Staff Patient Services Department

  • p. 4
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Island Peer Review Organization Background

  • Founded in 1984, IPRO, a national independent, not-for-profit organization,

holds contracts with federal, state and local government agencies as well as private-sector clients nationwide.

  • Provides a full spectrum of healthcare assessment and improvement services

that enhance healthcare quality to achieve better patient outcomes and foster more efficient use of resources.

  • Headquartered in Lake Success, NY and also has offices in Albany, NY,

Hamden, CT, Camp Hill, PA, Morrisville, NC, Princeton, NJ, San Francisco, CA and now, Beachwood, Ohio.

  • p. 5
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ESRD Network Roles/Responsibilities

  • Improve quality of care for ESRD patients
  • Encourage patient engagement
  • Support ESRD data systems and data collection
  • Provide technical assistance to ESRD patients and providers
  • Evaluate and resolve patient grievances
  • Support emergency preparedness and disaster response
  • p. 6
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Population Health Focused Pilot QIA (PHFPQ) Vocational Rehabilitation

Criteria

  • Select at least 10% of facilities in the Network service area (~20 facilities)

Project Period

  • Baseline: October 2016 – June 2017
  • Re-measurement: September 30, 2018

Requirements

  • Patient SME
  • NCC PHFPQ LAN participation
  • p. 7
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Population Health Focused Pilot QIA (PHFPQ) Vocational Rehabilitation

Goals

  • Demonstrate at least a five (5)

percentage point increase in referrals to the identified Employment Network (EN) and/or Vocational Rehabilitation (VR) agencies

  • Demonstrate at least a two (2)

percentage point improvement in the number of patients receiving EN and/or VR services Data Source

  • CROWNWeb
  • p. 8
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Population Health Focused Pilot QIA (PHFPQ) Disparity Assessment

Disparity defined by CMS in the 2018 Statement of Work as:

  • Differences in the delivery of health care, access to health care

services and medical outcomes based on ethnicity, geography, gender and other factors. The Network will be reporting to CMS the identified disparities as part of this project with the goal of reducing identified disparities

  • Age **
  • Ethnicity
  • Facility Location (Rural vs. Urban),
  • Gender
  • Race
  • p. 9
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Root Cause Analysis and Plan-Do-Study-Act Vocational Rehabilitation

RCA

  • RCA utilized to

identify the barriers to prevalent patients not being referred for VR/EN services PDSA

  • Utilize the PDSA

cycle to test the processes initiated to

  • vercome barriers
  • p. 10
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Root Cause Analysis and Plan-Do-Study-Act Barriers

Barrier 1: Patient Not Interested

  • Patients do not want to

return to work.

  • Patients don’t want to lose

their disability benefits.

  • Patients have other
  • bstacles in their life such as

limited time, family

  • bligation, and lack of

transportation.

  • Patients feel that employers

might think he/she is too sick to work.

  • Patients have multiple

medical issues occurring.

  • p. 11

62.50% 31.30% 6.30%

Facility Percentage Breakdown of Number One Barrier

Patient Not Interested Patients Feel Too Ill or Sick Other

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Root Cause Analysis and Plan-Do-Study-Act Barriers

Barrier 2: Patient Feels Too Ill/Sick

  • Dialysis may replace kidney

function, but not perfectly.

  • Patients feel too overwhelmed

with thought of working and dialysis.

  • Patient do not feel that they can

work in their previous or related

  • ccupation (manufacturing,

laborer, etc.) due to physical limitations and maintain their dialysis schedule and ancillary appointments.

  • Patients felt that other medical

conditions contribute to not being able to work.

  • Deterioration of health status due

to chronic illness.

  • p. 12

20% 20% 60%

Facility Percentage Breakdown of Number Two Barrier

Patient Not Interested Patient Treatment Schedule Patient Feels Too Ill or Sick

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Root Cause Analysis and Plan-Do-Study-Act Barriers

Barrier 3: Transportation

  • Patient does not have

access to services to that will allow them to utilize vocational rehabilitation services or work.

  • Some patients do not
  • wn a car.
  • Patient has low income

due to disability and limited work history.

  • Systemic intersectional

poverty.

  • Friends and Family are

not a reliable source for transportation needs

  • p. 13

40% 40% 20%

Facility Percentage Breakdown of Number Three Barrier

Patient Not Interested Transportation Other

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Population Health Focused Pilot QIA (PHFPQ) Vocational Rehabilitation: Interventions

Provider

  • Assessment of current referral process in the dialysis facility
  • Evaluate changes in life events that could change receptiveness to

vocational rehabilitation Patient

  • Increase awareness of vocational rehab and change dialysis facility culture
  • Support patients with resources and goal setting tools

Employment Network and Vocational Rehabilitation

  • Collaborate with vocational rehabilitation resources to advocate for the

needs of ESRD patients

  • p. 14
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Population Health Focused Pilot QIA (PHFPQ) Interventions: Your Life. Take Charge!

My Goal, My Roadmap, My Action Plan

  • Find your goal
  • Assess and plan
  • Take Action
  • Evaluate
  • Achieve and sustain
  • p. 15
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Population Health Focused Pilot QIA (PHFPQ) Interventions: Your Life. Take Charge!

  • p. 16
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Population Health Focused Pilot QIA (PHFPQ) Interventions: Your Life. Take Charge!

  • p. 17
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Population Health Focused Pilot QIA (PHFPQ) Interventions: Your Life. Take Charge!

  • p. 18
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Population Health Focused Pilot QIA (PHFPQ) Interventions: Your Life. Take Charge!

  • p. 19
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ESRD Statement of Work December 2017 - November 2018

Learning & Action Networks (LANs)

  • Patient Experience of Care
  • Healthcare Associated Infections (HAI)
  • Home Dialysis
  • Patient and Family Engagement (PFE)
  • Transplant
  • Population Health Focused Pilot QIA (PHFPQ)
  • p. 20
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Common Scenarios - Vocational Rehabilitation

CROWNWeb Category Scenario:

Referred to VR Social worker gave patient phone number for VR Referred to VR Patient is being recommended for VR, but has not agreed to participate Currently in VR Patient went to VR orientation and was assigned a counselor Currently in VR Patient filled out an application Declines VR Patient went to VR orientation and did not follow up after the orientation Declines VR Patient has indicated they do not want to participate in VR program Not Eligible for VR Patient has co-morbid conditions that prevent them from being able to work Not Eligible for VR Patient is undocumented and does not have a legal right to work in the US Completed VR Patient went through VR program and achieved their VR goals (got job, completed college, etc.)

  • p. 21

CROWNWeb Definitions Vocational Rehabilitation

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CROWNWeb Reporting Vocational Rehabilitation

  • p. 22
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Patient Subject Matter Experts (PSMEs) How PMSEs Support QIAs

  • Involved in the development of QIA interventions

and resources

  • Encouraged to participate in intervention

implementation at the facility

  • PSMEs are asked to:

–Consider becoming a Peer Mentor –Joining the Network Patient Advisory Committee –Share their ESRD journey story with others –Attend meetings led by the Network –Participate in national meetings and technical expert panels

  • p. 23
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eNewsletter

  • Provider audience
  • Sent monthly
  • Contact list from CROWNWeb
  • Project Updates

–Intervention Material –Patient Resources –Data –Best Practices

  • p. 24
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  • The Network sponsors educational opportunities

–Face-to-Face Meetings –Webinars –Conference Calls

  • The Network shares data

–Comparative Network, state, and facility level –Incidence, prevalent, and demographic statistics –Annual Report

  • p. 25

Technical Assistance We’re Here to Help

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Questions? Comments?

  • p. 26
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ESRD Network of New England Website http://network1.esrd.ipro.org

  • p. 27
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Presentation Template Draft for Review

April 6, 2017

  • p. 1

Corporate Headquarters 1979 Marcus Avenue Lake Success, NY 11042-1002 www.ipro.org

For more information:

Danielle Daley, MBA Jaya Bhargava, PhD, CPHQ Executive Director Operations Director (203) 285-1212 (203) 285-1215 ddaley@nw1.esrd.net jbhargava@nw1.esrd.net Sarah Keehner, RN, BSN, CNN Brittney Jackson, LMSW, MBA Quality Improvement Director Patient Services Director (203) 285-1214 (203) 285-1213 skeehner@nw1.esrd.net bjackson@nw1.esrd.net