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Chapter Quality Network (CQN) Asthma Pilot Project Team Progress Presentation

State Name: Ohio Practice Name: Pediatric Associates of Mt. Carmel, Inc. Team Members: Jennifer Richard, MD; Maryjane Fee. Chapter Quality Network (CQN) Asthma Pilot Project Team Progress Presentation. Progress Summary Since Learning Session 1. Key Driver Engaging QI Team/Practice

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Chapter Quality Network (CQN) Asthma Pilot Project Team Progress Presentation

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  1. State Name: Ohio Practice Name: Pediatric Associates of Mt. Carmel, Inc. Team Members: Jennifer Richard, MD; Maryjane Fee Chapter Quality Network (CQN) Asthma Pilot Project Team Progress Presentation

  2. Progress Summary SinceLearning Session 1 • Key Driver • Engaging QI Team/Practice • Very Good Progress • QI Team Established • All physicians completed QI Basics • Performance data reviewed • Meetings/Conferences attended • Using a registry • Little Progress • Practice wants to wait until EMR utilized • Planned Approach • Good Progress • Encounter form used with all asthma patients • Established protocols (next slide) • Self Management Approach • Fair Progress • Education materials provided • Patient progress monitored

  3. Most progress in our office has been achieved in providing more consistent care by all physicians by establishing standard office protocols. • Protocols Established • Asthma patient follow-up visits: • 24 hours of Urgent Care/ER visit • 72 hours of starting oral steroid in office • 2-4 weeks of starting controller medications • Six month follow-up from well child care visit • Asthma Acton Plan Initiated • All well child visits all asthma patients • Instituted at first follow-up visit for asthma exacerbations • Peak Flow Meter use for all age appropriate patients • Demonstrated at time of asthma action plan • RX given and PFM numbers reviewed at one or six month visits • Educational Materials • Asthma “tool box” at each office to review inhaler use and written educational materials • Given at initial visit

  4. Follow-up Visit Recommended

  5. Asthma Action Plan

  6. Educational Materials Provided

  7. Optimal Asthma Care

  8. PDSA Title: Plan: Do: Study: Act: PDSA Cycles

  9. P P P P P P P P P P P P D D D D D D D D D D D D S S S S S S S S S S S S A A A A A A A A A A A A PDSA Ramps TEST 4 What: Who (population): Who (executes): Where: When: TEST 4 What: Who (population): Who (executes): Where: When: TEST 4 What: Who (population): Who (executes): Where: When: TEST 3 What: Who (population): Who (executes): Where: When: TEST 3 What: Who (population): Who (executes): Where: When: TEST 3 What: Who (population): Who (executes): Where: When: TEST 2 What: Who (population): Who (executes): Where: When: TEST 2 What: Who (population): Who (executes): Where: When: TEST 2 What: Who (population): Who (executes): Where: When: TEST 1 What: Who (population): Who (executes): Where: When: TEST 1 What: Who (population): Who (executes): Where: When: TEST 1 What: Who (population): Who (executes): Where: When: PDSA Title PDSA Title PDSA Title

  10. Front office receptionist identifies asthma patient through problem list or chief complaint CQN encounter from given to parent to complete Office Flow Diagram Well Visit Physician review questionnaire In room. Reviews medications and any concerns. Asthma action plan completed or revised. Education materials given. CQN encounter form given to Front Office Coordinator to be entered into EQIPP MA/Nurse reviews chart before patient in room parent given encounter form if not already done Asthma Sick Visit Symptoms and medications reviewed Appropriate RX given Educational Materials given Follow up visit scheduled to have Asthma action Plan completed Educational Materials Reviewed Encounter not always completed by time physician in room Encounter may be put on chart not given to parent Parent may not stop to schedule follow-up visit

  11. Copy of Your CQN Encounter Form

  12. Encounter form page 2

  13. Establishing protocols increased consistency among doctors Scheduling follow-up visit at time encounter increased compliance Short term follow-up (ie. 3-7 days) increased compliance with medication/asthma regimens Providing educational materials facilitated discussions at follow-up visit Testing small changes in office procedure easier to track progress Challenging to sustain interest in long term projects Key Learnings

  14. Barriers and Successes • Barriers • Large group practice • Communications • Time Constraints • Sustaining interest • Delegating PDSA Cycles • Successes • Data collections • Asthma action plans

  15. Future Plans • Choose another validated instrument to assess asthma control ie. ACT • Investigate use of spirometry in office • Investigate registry options with EMR

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