2015 Workplan

Greater Oregon Behavioral Health, Inc.
2015 Quality Assessment & Performance Improvement Plan
Performance Objectives
aimed at improving
services:
Objective 1: Access
GOBHI’s contracted
providers will collect data
on member’s ability to
access at least two
services within the first 30
days from start of
services. Research has
shown that the quicker
someone engages in
treatment the more likely
they will continue and/or
complete treatment.
Strategies designed to meet the performance
objectives and measure progress and/or
monitor status:
Strategies:
The provider’s will track the number of
encountered services within the first 30 days of
start of service. GOBHI will require providers to
submit data that details the number of
encountered services from initial screening and
the first 30 days of service.
GOBHI will review 100% of all data submitted
annually.
Objective 2: Access
To ensure network
accessibility in terms of
timeliness of response to
routine, urgent, and
emergent requests for
behavioral health
services.
Strategies:
Evaluate adherence to access to care standards:
- Routine care within 14 days
- Urgent care within 48 hours
- Emergent care within 24 hours
Identify ongoing opportunities for improvement in
access.
Anticipated Outcomes
At least 2 encountered services will be
recorded within the first 30 days of a
member’s start of services in 70% of
GOBHI providers.
All access standards will be measured at
100%
Objective 3: Member’s
Experience
Monitor member
satisfaction with care and
services provided by
contracted providers.
Strategies:
Objective 4: Quality of
Clinical Care
Adopt and disseminate
evidence-based nationally
recognized clinical
guidelines that promote
prevention and/or
recommended treatment.
Strategies:
Objective 5: Quality of
Clinical Care
Discharges from the
Oregon State Hospital are
performed in a timely
manner.
Strategies:
Objective 6: Quality of
Clinical Care
Promote health equity and
eliminate health avoidable
health gaps and health
disparities.
Strategies:
Review and analyze administered surveys on an
annual basis. Identify improvement opportunities
and develop intervention strategies as indicated.
Clinical guideline review and approval/adoption by
QIC/BOD.
Clinical guidelines disseminated to providers and
made available to members.
GOBHI and CMHP’s will work collaboratively with
the Oregon State Hospital to identify each
patient’s post-discharge needs and provide those
programs and services within 30 days.
Increase knowledge and demonstration of cultural
responsiveness among GOBHI and GOBHI
contracted provider’s staff through health equity
and cultural competency trainings.
Measure member satisfaction with care
and services.
A minimum of 3 clinical guidelines will be
adopted and disseminated to providers
and made available to members.
90% of patients who are Ready to
Place/Ready to Transition are
discharged within 30 days of placement
on that list.
70% of GOBHI and GOBHI contracted
providers will be trained in health equity
and cultural competency trainings.
Objective 7: Quality of
Service
Evaluate network
adequacy based on
established standards and
goals.
Strategies:
Objective 8: Quality of
Service
Integrated Care
Programs: To develop and
implement programs to
improve coordination of
care between physical
and behavioral health
providers.
Objective 9: Quality of
Service
It has been identified that
Notices of Action (NOA)
are not being distributed
to members appropriately.
95% of all denials,
suspensions, and
reductions in services will
trigger a NOA from
GOBHI contracted
providers.
Strategies:
Gather information on types and numbers of
practitioners by credential in service regions, types
and numbers of facilities, out-of-network activity,
and demographic information.
Utilize the PHQ-9 in all CMHP’s and screen all
members age 12+ during initial mental health
assessment.
Screening results will be shared between physical
and mental health entities for purposes of
assessing inter-rater reliability and service needs.
Assess network patterns and structure
to identify gaps and opportunities for
network expansion or reconfiguration.
Maintain a provider network that
correlates with local member
demographics to optimize choice.
100% of members age 12+ will be
screened using the PHQ-9.
Strategies:
GOBHI providers will submit all Notices of Action
on a quarterly basis. These notices of actions will
be monitored through comparing the grievance log
and NOAs to determine if there were times when
an NOA should have been submitted.
GOBHI will train providers during the Outpatient
Clinical Provider Trainings on NOAs.
GOBHI contracted providers will
increase the NOAs submitted quarterly
by 5%.
Objective 10: Safety of
Clinical Care
Performance Measures:
Analyze trending and
implement improvement
strategies as needed in
relation to established
performance measures.
Strategies:
Objective 11: Evaluation
of QI program
Conduct an annual written
evaluation of the QI
program.
Strategies:
Performance Measures:
1. Follow-up after hospitalization for mental
illness within 7 days of discharge.
2. Children entering foster care for the first
time will receive a physical, mental, and
dental assessment within 60 days.
Include in the evaluation:
1. A description of completed and ongoing QI
activities that address quality and safety of
clinical care and quality of service.
2. Trending of measures to assess
performance in the quality and safety of
clinical care and quality of service.
3. Analysis and evaluation of the overall
effectiveness of the QI program, including
progress toward influencing network-wide
safe clinical practices.
1. GOBHI will meet or exceed the
state benchmark of 68.8%.
2. GOBHI will meet or exceed the
state benchmark of 90%.
Completed evaluation by 01/31/16.
Overview of 2015 Performance Improvement Projects (PIP):
PIP #1(clinical):
Study Question: Can a three-day intensive, alternative healing experience, focused on the issue of childhood sexual
abuse, (VOCA Camp) help participants (child and adult survivors of childhood sexual abuse) increase resiliency by
reports of a greater sense of relatedness? This will be evidenced by a participant establishing a therapeutic alliance with a
supportive adult and increasing their Sense of Relatedness Scale scores.
This PIP will not continue. GOBHI is currently working with Mid-Columbia Center for Living (has a majority of MHO only
members) on developing a clinical PIP with a focus on local needs for their SPMI population.
PIP #2(non-clinical):
Study Question: Will the provision of mental health first aid training result in a higher percentage of children, age 6-18,
utilizing mental health services?
Mental Health First Aid (with a rural focus) is an innovative program that provides a solution to one of the most basic steps
in addressing the problem of children and adolescents not receiving mental health services which is the identification of a
mental health issue. Seeing that children spend a significant amount of time at school it seems appropriate that school
staff and teachers are informed about the signs of mental illness and have the ability to identify, understand, and respond.
In coordination with various school districts and community mental health programs, GOBHI plans on offering Mental
Health First Aid workshops to school staff and teachers. These workshops will assist with increasing mental health
literacy, expand knowledge on how to help someone that’s in crisis, help connect people to services, and reduce stigma
that is often associated with someone accessing or receiving mental health services.