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Quality Improvement at AGCHC

Approach to the problem. Foundation initial presentation to health centerChronic care modelOrganization of health careDecision supportDelivery system designSelf-management supportCommunity networkInformation systems. The Team. The two site managers, medical director. IS support as needed..

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Quality Improvement at AGCHC

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    1. Quality Improvement at AGCHC Deborah Harrigan, MD Formerly with Avis Goodwin CHC November 4, 2004

    2. Approach to the problem Foundation initial presentation to health center Chronic care model Organization of health care Decision support Delivery system design Self-management support Community network Information systems

    3. The Team The two site managers, medical director. IS support as needed.

    4. Organization of Healthcare Addition of cholesterol testing rates and goals to our Quality Improvement committee. Disease Spread for our participation in the Chronic Disease Collaborative that was started in 2000 for improving asthma care.

    5. Decision Support ATP III guidelines form helps with interpreting cholesterol results and tailoring treatment for mixed dyslipidemias to improve treatment to goal. Form created by Dr. Michael Thompson at AGCHC and shared.

    6. Delivery System Design Posters on the back of exam room doors educating patients on cholesterol testing. Interactive waiting room education on the importance of cholesterol. Protocols in computer for cholesterol testing frequency Reminder to providers on “plan” page for patients who have LDL>100 and CAD-equivalent condition.

    7. Self-Management Support Use of cholesterol handouts Use of in-office food pyramids for diet education

    8. Community Networks Participation by the health educator in the community intervention.

    9. Information Services Logician Reports for patient letters to target cholesterol testing Reports back to providers on testing rates and treatment to goal rates (in process).

    10. Success! AGCHC is an organization that is accustomed to people coming from the outside with suggestions on how to change our care and delivery system. Seeing the numbers and detailing the providers on the numbers helped to push forward the change. The study was discussed at each provider meeting, the results shared with the Board of Directors and the QI team. The QI team was very focused on making changes and accountability.AGCHC is an organization that is accustomed to people coming from the outside with suggestions on how to change our care and delivery system. Seeing the numbers and detailing the providers on the numbers helped to push forward the change. The study was discussed at each provider meeting, the results shared with the Board of Directors and the QI team. The QI team was very focused on making changes and accountability.

    11. Difficulties TIME The changes to the computer come very slowly because of the need for buy-in at the network level. Initial contact by Foundation was not with the decision-makers of the organization. May have had better buy-in if there were incentives to participating organization and possibly an application process to participate.

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