rock hill pediatrics asthma appropriate care july 29 2012 n.
Download
Skip this Video
Download Presentation
Rock Hill Pediatrics Asthma Appropriate Care July 29, 2012

Loading in 2 Seconds...

play fullscreen
1 / 18

Rock Hill Pediatrics Asthma Appropriate Care July 29, 2012 - PowerPoint PPT Presentation


  • 90 Views
  • Uploaded on

Rock Hill Pediatrics Asthma Appropriate Care July 29, 2012. Background. June 2010 – all physicians and APPs polled to solicit feedback on metrics to be included in the Appropriate Care Measure Set for CHS Quality Goal setting

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Rock Hill Pediatrics Asthma Appropriate Care July 29, 2012' - dior


Download Now An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
background
Background
  • June 2010 – all physicians and APPs polled to solicit feedback on metrics to be included in the Appropriate Care Measure Set for CHS Quality Goal setting
  • Mirrors the core measure sets that have been in place in acute care facilities
  • Four disease states were selected: Diabetes, Ischemic Vascular Disease, Heart Failure, and Asthma
  • Consistently listed as priority areas for quality reporting by CMS, Medicaid, National Quality Forum, and others
  • Nearly all metrics presented in the poll appear on national quality indicator lists
  • Beginning in 2011, process measures for four disease states were first tracked and reported system-wide
asthma appropriate care
Asthma Appropriate Care

Metric

The percentage of patients who received appropriate ambulatory care for asthma, reported on a quarterly basis

Data Source

Abstraction of a random sample of patient charts from the five physician networks

data sampling asthma
Data Sampling – Asthma

Inclusion Criteria

FM, IM, peds, and pulm patients with age ≥ 5 years at the time of the encounter and have one of the following diagnosis codes: 493.00, 493.01, 493.02, 493.10, 493.11, 493.12, 493.20, 493.21, 493.22, 493.81, 493.82, 493.90, 493.91, or 493.92

Base Population Querying

Patients meeting above criteria that received a disease diagnosis in IDX within the previous 18 mos. and seen in the previous 3 mos. for any reason are eligible for sampling

Sampling Methodology

Representative across practices

and volume of disease states seen,

using a modified JCAHO sample size

Exclusion Criteria

Patients diagnosed with reactive airway disease, bronchiolitis, or chronic bronchitis

data collection
Data Collection

Methodology

  • Leveraged electronic information when available by pre-populating online data collection tool when possible
  • Information manually validated by auditor
  • 12,000+ charts abstracted each quarter during a 5-week time span
appropriate care all or none measurement
Appropriate Care: All or None Measurement

Rationale

  • Measure of the care a patient should receive
  • Provides a system perspective that focuses on process
  • More sensitive scale for assessing improvements
  • Mirrors acute facility measure for Core Measures

Success Factors

  • Small measure set for each disease
  • Improving processes for documentation
  • Adoption of Point of Care Reminders (Cerner EMR Health Maintenance Module)

Berwick and Nolan. 2006 American Medical Association

small measure set
Small Measure Set
  • 3 metrics
    • Controller Medication for Persistent Symptoms
    • Assessment of Daytime/Nocturnal Symptoms
    • Influenza Vaccination
  • All or None concept
improving processes for documentation
Improving Processes for Documentation
  • Physician Networks are composed of practices who are in various states of EMR migration (paper, hybrid, “fully” integrated)
  • Regardless of state, all have experienced challenges with addressing and documenting care measures
  • Flowsheets developed to assist paper-charting practices and prepare them for EMR implementation
  • Point of Care alerts released for EMR-charting practices
rock hill pediatrics success factors
Rock Hill Pediatrics Success Factors
  • Narrow focus
    • 1 disease state, 3 measures
  • Physician Champion
  • Practice Manager support
  • Standard Processes
  • Practice-based Quality Improvement
  • Culture supportive of continual learning and progress
  • COMPETITIVE!
maintenance of certification asthma appropriate care
Maintenance of Certification – Asthma Appropriate Care
  • Practice-wide improvement effort lends itself to Part IV MOC - Physician Participation in a QI Project
  • Attestations in progress for 8 physicians!