JPS HEALTH NETWORK • 537 bed hospital, Level 1 Trauma Center
Transcription
JPS HEALTH NETWORK • 537 bed hospital, Level 1 Trauma Center
5/27/2015 Improving the Patient Experience Alignment Strategies at the JPS Health Network JPS HEALTH NETWORK • • • • • • • • 537 bed hospital, Level 1 Trauma Center Tarrant County’s Safety Net Hospital 15 primary care clinics 20 school‐based clinics 8 specialty clinic sites 338 active medical staff 100 primary care providers 6000 employees 1 5/27/2015 Healthcare in a Safety Net System • Ever increasing population of underinsured/uninsured patients • Aging population with increasing chronic conditions • More to know, more to do, more to manage, more to watch, more people involved than ever before!! ORGANIZATIONAL ALIGNMENT • Patient Quality, Satisfaction & Safety starts with Culture • Physician alignment is the key to changing culture • Improvement in patient, provider and employee satisfaction is a journey • Engage Providers as stakeholders • Envision a culture of excellence 2 5/27/2015 Where did our journey begin? • Establishing vision • Reviewing current state » » » » » Physician compensation was fee for service Quality assumed but not measured High ED utilization Barriers to access Patient satisfaction in the less than 5% Developing a Strategic Plan: 7 steps 1. The Organization would need to develop a Strategic Initiative Plan 2. Adopt an EMR platform 3. Develop Departmental Metrics that aligned with the JPS Strategic Initiatives 4. Transparency with the Data 5. Engage Physicians Directly with action planning to achieve metrics 6. Establish a PCMH as a care delivery model 7. Develop a compensation plan that incentivizes outcomes 3 5/27/2015 1. JPS Pillars – A good starting place Hurdle 1 Developing Strategic Initiatives • Service • Quality • Stewardship • People Engagement • Population Health • Academics Hurdle 2 Aligning Initiatives with Medical Staff 2. Adopt an EMR platform 4 5/27/2015 3. Developing Clear Measures • Metric alignment with JPS Strategic Initiatives • Relevant and Achievable • Communicate results regularly 4. TRANSPARENCY 5 5/27/2015 6. Provider Feedback System • Physicians are data driven driven • Providing high quality care to patients • Accomplishing organizational objectives 6 5/27/2015 Accountability: #1 reason why execution is not accomplished Chairman • Share the vision, set the tone and pace • Meet quarterly with regional directors • Meet monthly with all medical directors for larger strategy Regional Directors • Meet monthly with operational and medical leaders • Discussion and action planning • Translate the vision Site Directors • Create transparency for patients and staff • Further refine action planning for unique sites • Display data on the Strategic Initiative Board 6. PCMH Care Delivery Model 7 5/27/2015 PCMH Care Delivery team: Diabetes Action Plan Population Care Manager to Classify patient zone Schedule visit with Health Care Coach 1.HGBA1C greater than 12 2. Those patients recommended by pcm that need coaching Enroll in Diabetic Group Classes. Health Care Coaching as trained. Ensure that patient has glucometer and supplies. Assess readiness for change, develop care plan. Affordability an issue ? Visit with Social Worker. Consider appointment with Pharm D. Follow up Q 3 month visit or at PCP discretion Ensure that patient has BS log and will check BS regularly Short interval visits with Health Coach as indicated, report glucose results to pcp for med. adjustments. App. With pcp every 3 months or with PCP till patient in yellow zone or sooner appointment if patient with excessive high or low glucose readings. 7. COMPENSATION PLAN • Competitive compensation plan, 50% MGMA mean • Compensation is salary based, signing into a culture • 10% of compensation is at risk, based on achieving 3/5 metrics in each Strategic Pillar. • Pillars are weighted based on Organizational priorities • Bonus based on excelling with 5/5 metrics • Medical Directors with 50% of the at risk salary based on Clinic performance. 8 5/27/2015 RESULTS Service: Average days to 3rd next available new patient appointment Target is 30 days 70 60 Good 50 40 Average 3rd Next New Patient Appointment 30 20 10 Apr‐15 Mar‐15 Jan‐15 Feb‐15 Dec‐14 Oct‐14 Nov‐14 Sep‐14 Jul‐14 Aug‐14 Jun‐14 Apr‐14 May‐14 Mar‐14 Jan‐14 Feb‐14 Dec‐13 Nov‐13 0 Updated: 5/01/2015 9 5/27/2015 Service Pillar: Patient Satisfaction Feb Mar April May June July 72.7 70 77.6 77 72 Aug 73.7 Sep Oct 72.5 77.6 Nov 74.9 75 Dec‐13Jan Feb Mar 72 73.1 74.7 April May Sept Oct 75.8 79.5 78 Nov 74 76.9 80.7 Dec‐14Jan 76.2 80.1 82 80 78 76 74 72 Series1 70 68 66 64 Updated: 4/1/2015 Quality Pillar: Pneumococcal Vaccine Pneumococcal Vaccinations (Higher is better) 90 Good 85 80 Pneumococcal Vaccinations (Higher is better) 75 70 Updated: 5/01/2015 10 5/27/2015 Quality Pillar: Colorectal Screening Colorectal Cancer Screening (Higher is better Target 60) 60 Good 55 50 45 40 35 30 Colorectal Cancer Screening (Higher is better) 25 20 15 10 5 0 Updated: 5/01/2015 Quality: Cervical Cancer Screening Cervical Cancer Screening (Higher is better Target is 70) 70 68 66 64 62 60 58 56 54 52 50 Good Cervical Cancer Screening (Higher is better) Updated: 5/01/2015 11 5/27/2015 Population Health: Diabetes B/P Blood Pressure Good Control (<140/90) (Higher is better Target is 68) 70 Good 65 60 55 Blood Pressure Good Control (<140/90) (Higher is better) 50 45 40 Updated: 5/01/2015 Population Health: Diabetes eye exam Retinal Eye Exam (Higher is betterTarget is 52%) 70 60 Good 50 40 30 Retinal Eye Exam (Higher is better) 20 10 0 Updated: 5/01/2015 12 5/27/2015 Population Health: Diabetes foot exam Foot Exam (Higher is better Target is 58) 80 70 Good 60 50 40 Foot Exam (Higher is better) 30 20 10 0 Updated: 5/01/2015 Population Health: Diabetes HGBA1C A1C Poor Control (Lower is better Target is 43) 44 42 Good 40 38 36 34 32 30 **A1C Poor Control (>9.0%) (Lower is better) 28 26 24 22 20 Updated: 5/01/2015 13 5/27/2015 Lessons Learned Nothing ventured, nothing gained Start with data that is readily available Metrics need to be RELEVANT and ACHIEVABLE Transparency as the goal for all data Communicate ahead of time proposed changes to those effected downstream. Allow plenty of time for discussion with stakeholders. • Medical Director’s need to be leaders & coaches • • • • • Contact Info • Dr. Robert Richard, Chairman Community Medicine » [email protected] • Dianna Prachyl, VP Community Health » [email protected] 14