Care Process Improvement

This track is dedicated to sharing innovations developed by healthcare organizations for improving health outcomes, lowering the cost of care, and increasing patient and provider satisfaction. Healthcare leaders and directors involved with quality management should attend these sessions, hear about the solutions, and build upon these innovations by continuing the quality improvement cycle at their organizations.

Friday, March 19, 2010
2:00 p.m. – 3:15 p.m.

Improving Patient Safety in the Outpatient Office Setting
Kenneth A. Lombard, M.D., Chief Medical Officer; and Jacqueline Mador, R.N., M.H.A., CEN, CCRN, Director of Quality & Patient Safety, Maine Medical Partners
Patient safety initiatives have long been associated with the inpatient setting. Learn how one multispecialty medical group embarked on a journey to transform its culture and embraced accountability for providing a safe environment for care delivery. During this interactive session, you will hear personal accounts of “learning moments,” learn concrete steps for changing the culture, and see actual data utilized for informing improvement efforts.
Upon completion of this session, participants should be able to:

Define a patient safety event
Identify the relationship between human factors and events
List the steps for creating a culture of safety
Expound on the value of data transparency

Introducing the Health Coach: Transforming the Management of Chronic Disease
Gary Piefer, M.D., M.S., FACPE, FAAFP, Chief Medical Officer, Carlos Hernandez, M.D., President, and Michelle Henry, M.S.N., R.N., Vice President Clinical Program Administration, WellMed Medical Group
Effectively managing chronic disease to improve clinical outcomes, patient satisfaction, and medical economics requires a transformation of the traditional clinical practice. Learn the value of incorporating a health coach into a clinic delivery model to create a more productive patient-physician interaction. Find out how utilizing motivational interviewing can develop patients’ knowledge and involvement in their own care. Presenters will also discuss an action plan to introduce a health coach to your care management team.
Upon completion of this activity, participants should be able to:

Define their group’s readiness to manage chronic disease
Describe the key components of a productive patient interaction
Conduct a motivational interview
Implement an action plan to introduce a health coach to their care management team

Patient Satisfaction Dashboards: Transitioning Accountability
Glen Halverson, M.B.A., M.S., CHE, Chief Operating Officer; and Richard Buchler, M.H.A., Senior Analyst, Sutter Gould Medical Foundation
Sutter Gould Medical Foundation has used various strategies to become more patient-focused and move the foundation from the 26th percentile for patient satisfaction to the 70th (and rising). A central element is a patient satisfaction dashboard with a priority matrix that helps managers focus their energy and resources on issues that will have the greatest impact on a patient’s overall experience. Presenters will describe how to guide improvement activities and use patient satisfaction dashboards to evaluate success.
Upon completion of this activity, participants should be able to:

Describe a patient satisfaction dashboard and priory matrix
Evaluate the use of these tools in their organization
Guide improvement efforts using patient satisfaction dashboards

Friday, March 19, 2010
3:45 p.m. – 5:00 p.m.

Creating the Lean Ambulatory Healthcare Facility of the Future
Randall D. Huss, M.D., President; and Gerald Dowdy, M.H.A., Vice President, Operations, St. John’s Clinic – Rolla Division; and Miguel Burbano de Lara, NCARB, AIA, Senior Vice President, Healthcare, The Neenan Company
When given the opportunity to design a new ambulatory facility to house a multispecialty medical group, ambulatory surgery center, and other outpatient services to be completed a year after implementation of their EHR, the St. John’s Clinic-Rolla team partnered with a progressive architectural firm to design and build a facility around the new electronic workflows. The presentation will explore how they integrated Lean workflow redesign and Lean facility design elements to achieve a facility capable of supporting the digital, paperless, ambulatory practice of the future.
Upon completion of this activity, participants should be able to:

Discuss application of Lean principles to ambulatory care workflow redesign in order to leverage the capabilities of a robust electronic health record and produce a model of patient care that is both patient-centric and physician-efficient
Describe how form follows function in Lean-inspired new facility design features that derive from the new electronic workflows and achieve significant efficiencies in space and facility construction cost
Implement lean principles to workflow redesign and facility design for upcoming building projects in their organizations

Our Experience with Medicare’s Care Management for High-Cost Beneficiaries Demonstration Project
Peter Rutherford, M.D., Medical Director, Health Buddy Program; and Lori Smet M.N., R.N., CCM, Case Manager Coordinator, Health Buddy Program, Wenatchee Valley Medical Center
This presentation is an in-depth summary of the experience and insights gained from the participation of physicians and care managers of a rural Washington group practice in a Medicare Care Management for High Cost Beneficiaries Demonstration Project, using a physician-based approach to care management assisted by remote patient monitoring technology. Presenters will examine how a physician-based approach to care management can lower costs and improve outcomes in a vulnerable, high-risk, elderly patient population.
Upon completion of this activity, participants should be able to:

Delineate the purpose of Medicare’s Care Management for High Cost Beneficiaries Demonstration Project and specifically, the design and intent of the “Health Buddy Program”
Describe the factors for success in implementing a physician-based approach to care management focused on reducing exacerbations of chronic illness and avoidable hospitalizations
List the pitfalls and challenges in implementing a physician-based approach to care management focused on reducing exacerbations of chronic illness and avoidable hospitalizations
Describe how a physician-based approach to care management supported by remote patient monitoring can improves access to and coordination of care for rural patients
Describe how a physician-based approach to care management can lower costs, and improve outcomes in a vulnerable, high risk, elderly patient population

High Reliability in Preventive Services
Kathleen Yaremchuk, M.D., Chair of Otolaryngology – Head & Neck Surgery and Vice President, Office of Clinical Practice Performance, Henry Ford Medical Group
Much pressure is put on primary care providers (PCPs) to increase preventive health measures. Henry Ford Medical Group has created a process that assists PCPs in reaching out to patients who are identified as having gaps in preventive care and chronic disease management. Participants will learn how to initiate a patient outreach program that will enable them to improve their ambulatory quality scores and increase patient satisfaction.
Upon completion of this session, participant group practices should be able to:

Initiate a patient outreach program that will enable them to improve their ambulatory quality scores and increase patient satisfaction.

Saturday, March 20, 2010
11:00 a.m. – 12:15 p.m.

Caring for the High-Risk Patient: A Model to Improve Outcomes and Efficiency
Lorrie J. Melby, M.D., Lead HomeCare Physician, High Risk Programs, HealthCare Partners Medical Group; and Mary J. Witt, MSW, Vice President, The Camden Group
Healthcare Partners (HCP) has implemented a home care program designed to improve the care, outcomes, and resource consumption of its high-risk patients. The care model combines the talents of physicians, nurse practitioners/physician assistants, social workers, and medical assistants as a team to care for a group of high-risk patients in their homes. The session will examine key program elements that improve patient outcomes and efficiency of resource utilization, including the organizational structure, relationship to the patient’s PCP, operational requirements, and team member composition. Presenters also will share the results of the study on the program’s impact on patient care.
At the completion of this activity, participants should be able to:

List reasons why a care model addressing the needs of high risk patients is an effective approach to improving care and efficiency of resource utilization
Describe a care model for high risk and frail elderly patients
Describe the potential outcomes of an effective approach to the care of high-risk patients
Identify the critical success factors for the model
Explain the key elements an organization would require to implement a similar care model

Improving the Management of Hypertension Through Positive Deviance
Eric Saberhagen, M.D., Staff Physician, Department of Internal Medicine; and Carlos R. Arce, M.Ed., Director, Organizational and Leadership Development, Billings Clinic
Positive deviance (PD) is a powerful, proven change methodology that uncovers existing, but uncommon, organizational behaviors. In this interactive session, PD methodology will be described and experienced through audience participatory examples. Improving hypertension management through PD, including specific tools and examples from AMGA’s Hypertension Learning Collaborative Project, will be presented. Participants will discuss how to identify projects appropriate for the PD approach; maintain and accelerate momentum; coach leaders to elicit staff ownership; and apply PD to other healthcare issues, problems, and conditions
Upon completion of this activity, participants should be able to:

Describe the positive deviance methodology
Explain the processes involved in the application of positive deviance to the management of hypertension in the primary care setting
Identify projects appropriate for the positive deviance approach
Support bottom-up discovery and action in positive deviance projects, maintain and accelerate momentum, and coach leaders to elicit staff ownership
Apply positive deviance to other healt care issues/problems/conditions

Addressing Disruptive Physician Behaviors to Improve Relationships, Process Flow, and Patient Outcomes
Alan Rosenstein M.D., M.B.A., Medical Director, Physician Wellness Services; and David G. Danielson, J.D., C.P.A., Senior Executive Vice President and Chief Administrative Officer, Sanford Clinic
Disruptive physician behaviors impact staff relationships, communication efficiency, and patient care. This presentation will address the causes and consequences of these behaviors, while offering the audience a developmental approach for effectively assessing and managing problems within their organizations, including constructive processes that provide physicians with the support they need.
Upon completion of this activity, participants should be able to:

Describe the initiating factors and negative downstream impact of disruptive physician behaviors on staff relationships, communication efficiency, and patient outcomes of care
Describe how to implement appropriate policies, procedures, reporting and assessment structures, and processes that hold individuals accountable for their behaviors.
Discuss appropriate education and training programs that teach skill sets that address conflict management and promote effective communication and team collaboration.
Describe how to implement an early physician intervention program that emphasizes a positive supportive rather than crisis invoked punitive approach to physician interventions with a focus on physician stress reduction, satisfaction, retention, and productivity.
Explain the ins and outs of how to implement an effective program at your own organization.

Saturday, March 20, 2010
2:00 p.m. – 3:15 p.m.

SameDay Care: Not an Urgent Care Center, but an Extension of Primary Care
Michael C. Ashanin, Chief Operating Officer; and J. William Wulf, M.D., Corporate Medical Director, Central Ohio Primary Care
Central Ohio Primary Care established SameDay Care, a new service for its patients so they could avoid the high co-pays of traditional convenient care options, maintain continuity of care through the use of the group’s EHR, and keep their “primary” physician connected to their care via other members of the medical group. This has resulted in higher patient satisfaction, lower cost, and improved quality. Presenters will help you determine if establishing a SameDay Center as part of your medical group makes financial, clinical, and operational sense; and offer useful tools for approaching insurance companies for financial support of the initiative.
Upon completion of this activity, participants should be able to:

Evaluate if establishing a SameDay Center as part of their medical group makes financial, clinical and operational sense
Utilize tools, to approach insurance companies for financial support of the initiative
Explain the clinical and financial value such a Center will have for the group’s patients
Offer triage for patients who desire to be seen on a same-day basis

Satisfaction Stakeholders: The Three Levels of Satisfaction Every Practice Should Know About
Robert B. Hauger, M.D. FACP, Physician, Internal Medicine, The Warren Clinic; and Michael Six, Primary Consultant, Press Ganey Associates, Inc.
Do sinking profits, low staff morale, and abysmal patient satisfaction sound like common problems in your practice? This session describes one group’s experience in addressing these problems by focusing on the three “satisfaction stakeholders”: physicians, staff, and patients. Participants will learn about the process used by the Warren Clinic to improve all three areas of satisfaction, and most importantly, boost productivity.
Upon completion of this session, participants should be able to:

Identify the factors that lead to positive behavior change
Explain the link between the three satisfaction stakeholders at any practice
Explain the link between these levels and productivity
Diagnose the warning signs of lowering stakeholder levels
Implement strategies to improve the three satisfaction stakeholders, and productivity

Traversing the Obstacle Course to Medication Reconciliation
Kathleen B. Orrico, Pharm.D., BCPS, Health Sciences Assistant Clinical Professor of Pharmacy, University of California San Francisco, School of Pharmacy, and Clinical Pharmacist – Palo Alto Medical Foundation; and Annie Wong, Pharm.D., Patient Safety Pharmacist, Palo Alto Medical Foundation
The presentation will review several rapid-cycle quality projects aimed at improving the medication reconciliation process at the Palo Alto Medical Foundation. Successes and obstacles, as well as lessons learned from improving office visit procedures and care transitions will be discussed. Presenters will describe the differences among medication list verification, validation, and reconciliation, and how to select the most appropriate provider to conduct each level of the medication reconciliation process. Attendees will learn how to identify patient populations most vulnerable to medication list mishaps.
Upon completion of this activity participants should be able to:

Describe the difference between medication list verification, validation, and reconciliation and to select the most appropriate provider to conduct each level of the process
Identify patient populations most vulnerable to medication list mishaps
Consider some of the successes and failures derived from quality projects conducted at PAMF

Website Terms and Conditions of Use and Privacy Policy