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Systems Change, Keeping It Simple

This presentation focuses on implementing sustainable systems change to enhance cancer control and improve patient outcomes. It emphasizes the importance of proactive participation in healthcare systems to meet policy requirements, increase revenue, and prepare for changing demographics, particularly with the aging Baby Boomer population. Key strategies include setting clear policies, gathering champions, determining baseline data for screening rates, and utilizing evidence-based strategies to drive improvement. By collaborating across sectors and engaging community resources, healthcare providers can better serve patients and address health disparities.

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Systems Change, Keeping It Simple

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  1. Systems Change,Keeping It Simple Virginia Warren Office Chief, Cancer Control Programs Arizona Department of Health Services Systems Change=Improving Patient Outcomes June 27, 2014

  2. Systems Change • The process for sustainable change in policy, program and resource allocation • The process of improving the capacity of the public health system to work with many sectors to improve the health status of all people within a community.

  3. Your Community • Community is defined as your geographic area with a strong focus on those using services from your providers

  4. Why Participate in Systems Change? • Proactively serve your patients • Prepare for environmental changes • Affordable Care Act • CMS reimbursement changes

  5. Systems Change Participation (cont.) • Position yourself in a competitive market • Maintain/increase revenue • Prepare for the Baby Boomer Tsunami

  6. Getting Started • Success will not be achieved doing this by yourself, Gather Your Champions • Who is Involved: • Leadership, absolutely • Operations staff, yes • IT support, yes

  7. The Starting Point Start Small and Start Smart Pace Yourself • Decide on the area of focus • Prioritize the focal point through clinic policy • This is a process, it takes time, thought, planning

  8. Policy is Set • Example – “Increase breast cancer screening rates.” • Determine baseline screening rates for your clinics

  9. Policy Example • How do you do that? • How many women 40 and older have received a mammogram in the past two years? • Do you have the capacity to determine this electronically? Or is a chart audit needed? • If you have an electronic system, do you have staff to build the query?

  10. Determining Baseline • How many women 40 and older use your clinic? • At what age are you going to cap the review? 65? 70? • Are you going to look at biennial or annual mammograms?

  11. Don’t Be Surprised • There will be room for improvement 81.1% 4%

  12. Review and Discuss Baseline • Baseline results will not be what you expect • Example: HealthCheck Program baseline data compared to Healthy People 2020 Goals

  13. Provider Reactions • Providers in a large practice may believe their results will differ from others • Determine baseline rates separately: A Provider may emerge as a champion of the project

  14. Discussion and Disagreement Lead to Discovery • The results will lead to a realization that: • Screening rate leaves room for improvement • Evidence based strategies are necessary • Many insured women are not being screened • Many insured women are not even having annual visits – this is a missed opportunity

  15. Baseline Determined • Preserve Process – be careful, thoughtful • Share Results • Schedule the same process for the subsequent year • Assign responsibility for next steps • Who is driving?

  16. Evidence Based Strategies • Research Evidence Based Strategies • Community Guide To Preventive Services • Client Oriented or Provider Oriented • Decide on EB strategies providing best fit • Use them wisely

  17. Selection: Patient Reminders • How many do you send out? • What is the follow up process? • Send a letter and forget? Or follow up?

  18. Patient Reminders(cont.) • When they schedule appointment, is follow up complete? • Where are screening results recorded? • How can you improve process for the next group?

  19. Division of Responsibilities • Who does the audit? Or EHR report? • Who defines the audit/report guidelines? • Who decides on the strategy to increase screening rates?

  20. Assignment of Roles • Who tracks the women referred to mammography and navigates or “stalks” them? (Patient Navigator?) • Who is driving the bus? If you don’t have a driver you won’t get far.

  21. Critical Elements • Set the policy • Assign responsibilities • Allow discussion and debate over results • Monitor process and tweak to improve • Allow flexibility for improvements • Celebrate success! • Expand to the next topic – Colorectal Cancer Screening

  22. Will Patient Outcomes be Improved? • Regular screening • Monitoring timeliness of services provided • Receiving credit for the work that is done • Application to other measures?

  23. Breast and Cervical Cancer Treatment Program Expansion

  24. www.wellwomanhealthcheck.org

  25. My Usual Photo

  26. Daytona - 2013

  27. Hurricane Lillies - Japan

  28. Thank You Virginia Warren Virginia.Warren@azdhs.gov 602-542-1222 Emily Wozniak Emily.Wozniak@azdhs.gov 602-364-0214

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