TCPI Project Pathway: Session 3 of 8 Staff Engagement: Teamwork and Joy # 6 and 19 (24) To QIA for possible use: Thank you for taking my call and listening to this opportunity we can offer to you, to help with quality improvement projects.

About the TCPI Milestones 22 Milestones for specialty practices 27 Milestones for primary care Scores on each milestone determine Phase completion For example, to complete Phase 1, as score of 3 is necessary on milestone 13 (setting an aim). Other phases require various scores for other milestones.

Milestone Classes Review Scoring and Strategies for Meeting Them (numbers in parentheses indicate milestone numbers for primary care) Each Milestone-Group Class will be held live 3 times: Quality Improvement Strategies and Action –milestones 14, 15, 16 (19, 20, and 21) (already held- recording available) Improvement Goals – milestones 1, 2, 3, 13 (1, 2, 3, 18) Staff Engagement: Teamwork and Joy – milestones 6 and 19 (6 and 24) Identifying Patient Risk and Using Best Practices – milestones 7, 11 (8, 9, 10, 16) Streamlining Clinical and Office Work – milestone 22 (27) Person and Family-Centered Care – milestones 4, 5, 12, 17 (4, 5, 7, 15, 17and 22 for primary care) Coordinated Care – milestones 8, 9, 10 (11, 12, 13, 14) Business Strategies – milestones 18, 20, 21 (23, 25, 26) Begins this week with attention to milestones 13, 1, 2, and 3. We’ll repeat this on…….. We will send you all the calendar for the remaining 6 classes and encourage you to attend one of the live sessions for milestones you are still working to achieve.

Today’s Objectives Review scoring for 2 staff-related milestones: 6 and 19 (24 for primary care) Outline strategies for meeting each of these milestones Review relevance of 2 milestones’ scores to phases Open discussion

Staff Engagement: Teamwork and Joy Milestone 6 -Practice sets clear expectations for each team member’s functions and responsibilities to optimize efficiency, outcomes, and accountability. Milestone 19 (24) - Practice has effective strategies in place to cultivate joy in work and can document results.

Milestone 6: Practice sets clear expectations for each team member’s functions and responsibilities to optimize efficiency, outcomes, and accountability (as score of 3 is needed to complete Phase 3) Milestone 13(18) is the only milestone associated with completing Phase 1. Most practices start out scoring a “zero” here, because this milestone is specific to participating in the TCPI. Let’s take a closer look at this milestone and how to develop this vision and aim statement.

Your Transformation Workplan – Practice Plan Tab

Strategies for meeting milestone 6 (a score of 3 is needed to complete Phase 3) Change Package – 1.2.2 Inventory the work to be done prior to a patient visit, during the visit, and after the visit and determine who in the organization can do each part of the work by matching their training and skills sets Use process maps or swim lane diagrams to clarify responsibilities once roles are assigned Identify staff interest and talents and align these with available opportunities Add fields to registry or EHR to capture care team member roles Share team roles with patients and families on paper and electronic systems Empower medical assistants with coaching skills so that they can expand their role in supporting self-management

Milestone 19 (24): Practice has effective strategies in place to cultivate joy in work and can document results. (a score of 3 is needed to complete Phase 4)

Strategies for meeting milestone 19 (24) (a score of 3 is needed to complete Phase 4) Change Package 3.2.3 Promote kindness to each other and to patients Celebrate successes Smile – it’s contagious and makes people happier Emphasize staff development and training Make sure performance standards and expectations are clear Consider using gratitude practices in meetings Implement reward and recognition systems for staff at all levels Get a masseuse to come give 15-minute chair massages every quarter Engage staff in redesign efforts Patient stories, family stories, share in community Practice joy in work committee Communicate frequently and openly to all staff

Strategies for meeting milestone 19 (24) - continued Institute for Healthcare Improvement (IHI) Joy in Work and Reducing Burnout series Include patient feedback in staff reviews Use incentive plans to reward participation at multiple points/ data- driven and peer evaluated Align compensation with team-based quality measures Encourage each person to have a personal development plan that is updated annually Get staff/provider input at all levels Hold fun social events together Use shout outs/ walls of success Conduct staff health and wellness initiatives Post quality data and gains Provide conflict resolution training Involve staff in developing training for other staff Provide nonviolence communicative training Staff retreats

This Photo by Unknown Author is licensed under CC BY-SA

Coming Up in the Next Class (week of August 19th) Identifying Patient Risk and Using Best Practices (#7 and 11 for specialty) Milestone 7: Practice has a reliable process in place for identifying risk level of each patient and providing care appropriate to the level of risk. This may include risk includes developing a health condition not already present, exacerbation of a condition or complications, need for a higher intensity of care, including hospitalization Milestone 11: Practice uses evidence -based protocols or care maps where appropriate to improve patient care and safety.

Coming Up in the Next Class (week of August 19th) Identifying Patient Risk and Using Best Practices – Primary Care Milestone 8: Practice uses a consistent approach to assign patients to a provider panel and confirms assignments with providers and patients. Practice reviews and updates panel assignments on a regular basis. Milestone 9: Practice has a reliable process in place for identifying risk level of each patient and providing care appropriate to the level of risk. This may include risk includes developing a health condition not already present, exacerbation of a condition or complications, need for a higher intensity of care, including hospitalization Milestone 10: The practice provides care management for patients at highest risk of hospitalizations and/or complications and has a standard approach to documentation. Milestone 16: Practice uses population reports or registries to identify care gaps and acts to reduce them.