The New Agenda: Patient Centered Strategies for the Exam Room - - PowerPoint PPT Presentation

The New Agenda: Patient Centered Strategies for the Exam Room

Kickoff Webinar March 28, 2016

Special thanks to

• ur funders:

New Agenda Team

Tammy Fisher CCI, Senior Director Meaghan Mallari CCI, Program Coordinator Rich Frankel University of Indiana, Professor

• f Medicine, Research Scientist
• Co-developed Four Habits
• Model. Content expert for

program & trainer Jennifer Wright CCI, Improvement Advisor

• Program Coach

Hunter Gatewood Signal Key, Consultant

• Program Coach

Agenda

• Introductions
• Why focus on communication?
• Skills & strategies – what you will learn
• Who will get trained– selecting pilot clinicians
• Learning opportunities – how you will learn
• Collecting data to learn what works
• Key program dates
• Wrap up – action items

New Agenda Grantees

Watts Healthcare Corporation Chinese Community Health Services Sacramento Native American Health Center MayView Community Health Center Community Medical Centers, Inc. Tiburcio Vasquez Health Center Universal Community Health Center LifeLong Medical Care Kokua Kalihi Valley Comprehensive Family Services

• Tell us something that is unique or special about

your organization.

Grantee Introductions

Why are we focusing on communication?

• Communication with clinician is the strongest predictor of patients’ ratings of

their overall experience with care

• Most patients seeking care are “healthy” - biopsychosocial approach is ideal as

framework for care

• A lot of time interacting with the EHR in the exam room leads to lower patient

experience scores and patient outcomes of care

• Research demonstrates effective, patient centered communication care results in

positive functional and biomedical outcomes

• The time cost to be patient or relationship centered is no more than one additional

minute

• Clinicians who are perceived to be brusque and hurried are at greater risk for

malpractice in the event of an adverse outcome

• Effective communication skills, including empathy, can be learned and put into

practice with little time cost

Model for Change: Four Habits

SHARED PRESENCE

2 3 4 1

Questions?

Start with the ready and willing: Selecting Clinicians

• POLL: Who has already selected their

participating clinicians?

• How did you determine which clinicians should

participate in this program?

Start with the ready and willing: Selecting Clinicians

• Going from good to great communicators
• Well-respected by colleagues and liked by

patients

• Excited about this program, ready to experiment

and learn

• Early adopter, early majority, socially connected
• Champion, willing to help spread skills to others

later

Learning Opportunities

Trainings Coaching Webinars Resource Website

Trainings

May 5th: Berkeley City Club, Berkeley, CA

• Learn the Four Habits
• Understand aim statements and measurement for learning

June 15th: Sacramento, CA (venue TBD)

• Share experiences testing skills
• Share data collected
• Leverage the care team to optimize skills use

 Who should attend the trainings?

• Pilot Clinicians
• Project team lead for this grant
• Senior clinical leader or other senior leader/operations staff on this grant

Coaching Calls (1-1 w/ each grantee): at least once per month with Jennifer

• r Hunter
• Support the project team and clinicians in testing the Four Habits and

learning about their effects  Who attends: all members of project team, including at least one pilot clinician Case Conference Calls (all clinicians): occurs twice, following each training with Rich

• Support clinicians in using the Four Habits skills; identify and problem solve

together on challenges  Who attends: all clinicians participating in the New Agenda program;

• ther members of the project team are welcome as observers

Coaching

Share & Learn Webinars

• 3 webinars during program
• Hear from each other about best practices and challenges
• Who attends: all project teams, clinicians optional

Sustainability & Spread Webinar

• 1-2 webinars
• Review principles of sustainability/spread/scale; share data; share learnings
• Who attends: everyone

Outcomes Celebration Webinar

• 1 webinar
• End of program celebration; teams share their journeys through storyboards
• Who attends: everyone

Webinars

www.new-agenda.com

Resource Website

What is working?

• 1. Collecting data for learning
• 2. Collecting data for spread and scale

Data for Learning

Rapid experimentation

• Patient voice: Comment cards, exit interviews, patient
• bservation, other ideas?
• Clinician voice: regular check-ins, monthly reports

Report results from rapid experiments in coaching calls. Monthly narratives: Due the last day of each month, reporting

• n that month’s progress
• 4-questions – what are you testing and how is it going?
• Data informs coaching and case conference calls
• Completed by each clinician

How to run a rapid experiment in 6 steps

Data for Learning

Write out your idea / solution.

1

Tip: Select only one idea or element of a solution and keep it simple!

Write out your key assumptions about the idea.

2

Tip: Keep the assumption small and ‘right scoped’!

Brainstorm how you will test your assumptions.

3

Tip: Do this with others-it is not a solo mission!

Select one experiment that you can test fast.

4

Tip: Vote and Prototype as a team-2 people count as a team!

6

Tip: Modify your next experiment based on what you heard + observed!

Reflect on what you learn and ‘build or kill’.

5

Put your experiment to the test in the real world.

Tip: It should take minutes, hours, days- not weeks or months!

Data for Spread and Scale

• Patient Experience Data Pre- and Post-program:

– Conducted in April and December – IVR or other clinic-selected method

• Skills Assessment:

– pre (April 15) and post (Dec 31) assessments – Evaluate the capability and use of the Four Habits’ 23 skills – Completed by each clinician participating

• Clinician Experience Report:

– Due end of June, August, October, November – 3-question narrative report about clinician experience during this program – Completed by each clinician

Report in final narrative – January 31, 2017 And, please submit your financial report too!

Reporting deadlines

• Baseline patient experience data collected by April 29th
• Clinician skills assessments – April 15th, Dec 31st
• Monthly clinician narratives - due the last day of each month
• End of program patient experience data collected by Dec 31st
• Final narrative report – Jan 31, 2017
• Final financial report – Jan 31, 2017

Program Timeline

Month Learning Opportunities Reporting

March

• First Coaching Call
• Kickoff Webinar – March 28
• Submit IVR data if possible

April

• Coaching Calls
• April 8 (latest date): submit IVR data
• April 15: skills assessment due (pre-assessment)
• By April 29: baseline data on patient experience has been

collected May

• Skills Training: May 5 (Berkeley, CA)
• Case Conference Call
• Coaching Calls
• May 31: monthly report due

June

• Skills training: June 15 (Sacramento, CA)
• Share & Learn Webinar
• Coaching Calls
• June 30: monthly report, including clinician experience

reported questions due July

• Case Conference Call
• Coaching Calls
• July 31: monthly report due

August

• Coaching Calls
• August 31: monthly report, including clinician experience

reported questions due September

• Share & Learn Webinar
• Sustainability & Spread Webinar
• Coaching Calls
• Sept. 30: monthly report due

October

• Share & Learn Webinar
• Coaching Calls
• Oct. 31: monthly report and clinician experience report due

November

• Coaching Calls
• Nov 30: monthly report due and clinician experience report

due December

• Outcomes Celebration Webinar
• Dec 31: post-program skills assessment due
• Dec 31: final collection of patient experience data

January

• Jan 31, 2017: Final narrative and financial grant reports due

Next Steps

• Select participating clinicians ASAP. Meaghan will reach out to confirm

each team’s selected clinicians and their contact information.

• Set up April coaching calls with coach.
• By April 8th: If participating in IVR, submit data directly to vendor (look for

more emails with more info from Meaghan and your coach).

• If not using IVR, work with coach to determine method for collecting

baseline and post patient experience clinician level data.

• April 15th: Clinicians submit skills assessment (pre-assessment). Meaghan

will email instructions and assessment today or tomorrow.

• April 29th: complete collection of baseline patient experience data (for those

participating in IVR, this will be completed by the vendor).

Questions?

Tammy Fisher: tammy@careinnovations.org, 415-426-4887 Meaghan Mallari: meaghan@careinnovations.org, 415-561-6393