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Patient Safety and Clinical Pharmacy Services Collaborative (PSPC) Session. QualityNet Meeting Baltimore, MD December 13, 2012. Questions to Run On. How can your QIO support both beginning and advanced PSPC teams?

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patient safety and clinical pharmacy services collaborative pspc session

Patient Safety and Clinical Pharmacy Services Collaborative (PSPC) Session

QualityNet Meeting

Baltimore, MD

December 13, 2012

questions to run on
Questions to Run On
  • How can your QIO support both beginning and advanced PSPC teams?
  • What tools and resources are available to help QIOs with the development of successful PSPC teams?
  • How can I encourage local team participation in PSPC events?
intent of today s call
Intent of Today’s Call
  • Welcome QIOs to the PSPC 5.0 Collaborative Cohort
  • Celebrate and demonstrate successful QIO strategies
  • 3. Engage all QIOs to be active in our PSPC 5.0 Campaigns
our agenda
Our Agenda

Today we want to discuss three major topics:

  • The PSPC Campaigns for beginning teams and advanced PSPC teams
  • QIO Resources for a successful 5.0
  • PSPC Team Optimization Strategies
how we will work today
How We Will Work Today
  • You will hear brief presentations on discussion topics
  • You will hear practical examples of QIOs that have been successful in these areas
  • Listen for what insights you heard
    • How can you incorporate shared strategies in your work?
    • What can you add to the QIO examples?
  • Be prepared to share your insights!
pspc 5 0 goals
PSPC 5.0 Goals

Delivery

System

Transformation

Actively

Engaged

Value

Purchasing

two parallel campaigns
Two Parallel Campaigns

Value Purchasing Campaign

System

Delivery Transformation

  • Team composition
  • Defining POF
  • Workflow for IMM
  • Using the Change Package
  • Health status & safety baselines
  • Tracking Performance Trends
  • Scale Up and Spread
  • Value Propositions
  • Leadership for Payment Arrangements
  • State reformation
  • Demonstrating impact & change
engaging teams in both campaigns

Engaging Teams in Both Campaigns

Place Holder for the ID & OR QIO slides

partnership with rcc s for success1
Partnership with RCC’s for Success
  • Monthly RCC calls, Topic Specific Calls!!
    • Topics meeting teams where they have needs
  • One on One calls
    • Setting individual teams up for success and contributing to the National Performance Story
  • Strategies to engage teams
    • Keeping the Main thing the Main thing!!
    • Saving lives!! Patients at the Center of PSPC
  • Going for the Gold
slide19
OSS

http://www.healthcarecommunities.org/workarea/downloadasset.aspx?id=4294976577

tools assisting qio s in supporting pspc teams
Tools Assisting QIO’s in Supporting PSPC Teams
  • Communication Tools
    • RCC/QIO Quarterly Calls
    • Listservs
    • Roll Up Reports
  • Quick Start Toolkit
    • http://www.healthcarecommunities.org/workarea/downloadasset.aspx?id=4294976525
  • PSPC 5.0 Change package
    • http://www.healthcarecommunities.org/Comm_DocsDetails.aspx?id=4294976502
  • PSPC 5.0 Guide
    • http://www.healthcarecommunities.org/workarea/downloadasset.aspx?id=4294976500
qio resources for success

QIO Resources for Success

Jennifer Thomas, PharmD

Manager Pharmacy Services

Kim Harris-Salmone, PhD, MPA

Vice President, Health Information Technology

Health Services Advisory Group

jennifer thomas pharmd manager pharmacy services

Integrating the Patient Safety Clinical Pharmacy Services Collaborative (PSPC) Resources: Delmarva Foundation, the Quality Improvement Organizations for the District of Columbia and Maryland

Jennifer Thomas, PharmD

Manager Pharmacy Services

objectives
Objectives
  • Describe the Quality Improvement Organizations (QIOs) use of the resources available from Patient Safety Clinical Pharmacy Services Collaborative (PSPC)
  • Identify two examples of Team use of the tools to identify and define change process and improvement
pspc resources and qio contract requirements
PSPC Resources and QIO Contract Requirements
  • Recruitment – binder content
  • Technical Assistance: HC website (join PSPC, register for OSS, listserv, helpdesk), National & Regional Calls (Region 3)
  • Assessment
  • Learning Action Networks (LAN)
  • Measures
    • ADE/pADE – define
    • Health markers
      • A1c
      • INR - in range
      • INR - monthly
  • Documentation
  • Reporting - OSS
ade pade medication related problems
ADE/pADE/Medication-Related Problems
  • PSPC defined (Dr. Chen – USC) ADE/pADE list
    • Medication-related problem
    • Safety (ADE/pADE)
    • Nonadherence and patient variables
    • Miscellaneous
    • NCC MERP classification
    • Severity rating
monthly team assessment
Monthly Team Assessment

Scoring of 1 through 3 should be entered in one of the 5 Change Package strategies highlighted in yellow

Y = yes, N= no & D = done should be entered into each of the change package concepts each month. Once the concept is implemented enter D and grey out the cell moving forward

slide35
Potential ADEs and Anticoagulation Health Marker Status: Upper Chesapeake Health Anticoagulation Clinic
slide39

Contact information:

Jennifer Thomas, PharmD

thomasjen@dfmc.org

410-872-9698

This material was prepared by Delmarva Foundation for Medical Care and Delmarva Foundation of the District of Columbia, the Quality Improvement Organizations for Maryland and the District of Columbia, under contract with the Centers for Medicare & Medicaid Services (C M S), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect C M S policy. 10SO W-MD/DC-ADE-112712-232

using pspc resources to engage teams and monitor teams successes

Using PSPC Resources to Engage Teams and Monitor Teams’ Successes

Kim Salamone, PhD, MPA

Vice President, Health Information Technology

Health Services Advisory Group

Ksalamone@hsag.com

pspc resources
PSPC Resources
  • Outcomes Sharing Site (OSS)
  • ADE Access Database
  • On-site technical assistance
    • Workflow
    • Interventions
    • Reports
  • Partnership with REC
    • EHR template modification
  • Change packages
    • Gives teams ideas for interventions
hsag s interventions
HSAG’s interventions
  • AZ Team 1 – long-time clinical pharmacy program
    • EHR use for tracking
    • Also use ADE
    • Medicare hospital admissions/readmissions
  • AZ Team 2 – new pharmacist-run diabetes clinic
    • ADE Database most valuable resource
    • On-site technical assistance
  • Both AZ and CA teams
    • On-site technical assistance
    • OSS for progress
    • ADE database/EHR
    • Sharing of best practices
monitor success
Monitor Success
  • Outcome Sharing Site (OSS)
    • Follow up with on-site visits
  • PDSA Status Updates
  • Team Development Level
  • Team Meeting Summaries/Next Steps
  • Tri-State Meetings at HSAG
    • Monitor
    • Problem solve
barriers to success
Barriers to Success
  • Technology
    • ADE database had to have certain OS
    • Groups’ IT departments restrictive
  • Turnover of team staff
  • Team time availability for the project
  • Team autonomy to implement PDSAs
slide45

Contact:

Kim Salamone, PhD, MPA

Vice President, Health Information Technology

Health Services Advisory Group, Inc.

Ksalamone@hsag.com

(o) 602.801.6960

(m) 602.513.0761

This material was prepared by Health Services Advisory Group, Inc., the Medicare Quality Improvement Organization for Arizona, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. Publication No. AZ-10SOW-7.3-112710-01

our collaborative culture
Our Collaborative Culture

PSPC Aim:

Inter-professional teams that improve the health outcomes and safety for high medication risk populations through patient-centered, cost effective medication management services align with quality national standards.

Results:

PSPC teams are transforming the primary healthcare delivery system by establishing effective interdisciplinary teams of care providers and integrating clinical pharmacy services into patient-centered, health home.

Future:

PSPC started its fifth year with a goal to ore than double the number of participating teams and communities to be part of the national movement to systematically transform the way health care is being delivered.

using qio s to create successful teams
Using QIO’s to Create Successful Teams
  • Partnering with PSPC Faculty to Provide Team Support
  • Embracing the PSPC Collaborative Culture
  • Technical Support at the local level
  • One on One Support for Team
  • Site Visits – Hands On Support!
  • Personal Relationships with Team
  • Joining with Teams in Celebrating Successes
modeling successful qio support
Modeling Successful QIO Support

New Mexico

Albuquerque MTM Collaborative and Walgreens Wondercats, both from NM, and QIO partner, Health Insight New Mexico, who collaborated on the journal article; Development and Dissemination of a Statewide System to Minimize Use of Potentially Inappropriate Medications. Walgreens Wondercats team member, Amy Bachyrycz, Pharm D, Albuquerque MTM Collaborative team member Melanie Dodd, Pharm D, and Health Insight New Mexico team partner, Galina Priloutskava, PhD, MBA, CHCA, authored the article discussing the Potentially Inappropriate Medications (PIMs) project in New Mexico in the most recent volume of Medical Care.

Texas:

  • Implementing local collaborative teams of clinics, hospitals, pharmacies and nursing homes to participate in national collaborative learning sessions

North Carolina:

  • A recent issue of the Washington Business Journal featured an article on Walgreen's pharmacists and their involvement with integrated medication management services related to hospital readmissions.  The article aligns nicely with the efforts being made by PSPC teams and emphasizes the impact these services have on the health care system.  The article also refers to PSPC team, Safe Med, from Winston-Salem, NC, led by Novant Medical Group, and their utilization of pharmacists to perform medication management services to patients.

Oregon:

In an press release from the Oregon Patient Safety Commission in March of this year, two PSPC teams were honored for their leadership in Patient Safety.

Quote from the Ceremony:

  • When health care Organizations are transparent about adverse events, they are helping to create an environment that prioritizes patient safety. “Adverse event” is a term used to describe unintended harm to a patient as a result of medical care. 2 of the PSPC teams in Oregon were recognized in an awards ceremony as leaders in the states Patient Safety Reporting Program.
  • “These organizations are among the best of the best when it comes to patient safety reporting in Oregon, said Beth Higgins, executive director of the Oregon Patient Safety Commission. “To be clear, this doesn’t mean these organizations have more adverse events than others in Oregon. It means they are the most diligent when it comes to reporting. Every health care organization experiences adverse events. These teams were acknowledged for were their responsiveness to adverse events by learning what happened and working to prevent the event from happening again.”

Read Article<Walgreen Pilot Cuts Hospital Readmission

pspc team optimization1

PSPC Team Optimization

Izabella Wentz, PharmD, FASCP

Clinical Pharmacy Specialist

Telligen, Illinois Quality Improvement Organization

Matt Lincoln, MBA

Associate Director, Pharmacy

Health Services Advisory Group of California, Inc. (HSAG-California)

team engagement strategies

TeamEngagement Strategies

Izabella Wentz, PharmD, FASCP

Clinical Pharmacy Specialist

Telligen, Illinois Quality Improvement Organization

pre work
Pre-work

Tools

  • Agenda
  • New team Toolkit
  • Register for PSPC
  • OSS Site Manual
  • Performance Story Overview
  • Team Progress Scale
  • Change Package
needs assessment
Needs Assessment

Tools

  • Green Team Needs Assessment
  • Change Log
technical assistance
Technical Assistance

Tools

Meeting #2

  • Agenda
  • MTI PowerPoint
  • Excel Patient Registry

Meeting #3

  • Agenda
  • Process Mapping PowerPoint
  • Post-it Notes
improvement
Improvement

Tools

  • Agenda
  • PDSA Short Form
  • PDSA Cycle Overview
successful team spread with qio support

Successful Team Spread With QIO Support

Matt Lincoln, MBA

Associate Director, Pharmacy

Health Services Advisory Group of California, Inc. (HSAG-California)

quality improvement organization qio support for team spread
Quality Improvement Organization (QIO) Support for Team Spread
  • Develop protocols:
    • Optimize IMMS workflow
    • Monitor intervention implementation
  • Build alliances to share resources:
    • Facilitate placement, pilot, and spread of pharmacy student rotations
    • Engagement of IT leadership and synergy with vendors
    • CEO participation in team meetings
successful team example
Successful Team Example
  • California team with single high-medication-risk Population of Focus (PoF)
  • HSAG-California facilitated gap analysis of medication management services provided to expanded group of high-risk patients with special needs (Medicare Special Needs Plan)
  • Team plans to initiate PDSA of expanded medication reconciliation for new patients
barriers
Barriers
  • Turnover in clinical and executive leadership
  • Turnover in clinical pharmacist positions supported by grant
  • Complex IT/EHR authorization requirements
next steps
Next Steps
  • Contact me directly to discuss support for team spread:

Matthew Lincoln, MBA

Associate Director, Pharmacy

mlincoln@hsag.com

818.265.4696

slide66

We convene providers, practitioners, and patients to build and share knowledge, spread best practices, and achieve rapid, wide-scale improvements in patient care; increases in population health; and decreases in healthcare costs for all Americans.

www.hsag.com

This material was prepared by Health Services Advisory Group of California, Inc., the Medicare Quality Improvement Organization for California, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. Publication No. CA-10SOW-7.3-112712-02