Change Starts Here. The One about Demonstrating Change ICPC National Coordinating Center This material was prepared by CFMC (PM-4010-075 CO 2011), the.

Slides:



Advertisements
Similar presentations
PhD Research Seminar Series: Valid Research Designs
Advertisements

Change Starts Here. The One with the Trend Graphs: Introduction to the IC-4 Measure ICPC National Coordinating Center This material was prepared by CFMC.
Interpreting Run Charts and Shewhart Charts
Measurement for Improvement. Why we look at data graphed over time Change Made Change to process made in June.
Root Cause Analysis in Care Transitions: Chart Review Tools Tom Ventura, MS, MSPH Colorado Foundation for Medical Care
1 Using Root Cause Analysis to Reduce Hospital Readmissions Jennifer Wieckowski, MSG Health Services Advisory Group of California, Inc. (HSAG-California)
Designs to Estimate Impacts of MSP Projects with Confidence. Ellen Bobronnikov March 29, 2010.
Revenue Cycle Benchmarking Going Beyond… To Improve Revenue Cycle Outcomes Presented by: Frank Giannantonio President.
Change Starts Here. The One about Outcomes and Indicators ICPC National Coordinating Center This material was prepared by CFMC (PM CO 2011), the.
Holly S. Davis, M.Ed., MBA Health Care Excel Are Your Data Pulling You Overboard Or Anchoring You?
Wisconsin Pressure Ulcer Coalition Data Update Outcomes Congress Nathan Williams Jody Rothe, RN, WCC December 2, 2009.
Monitoring Improvement Using a Run Chart Priscilla Swanson, RN, CCM, CHC, CPHQ Nancy Siegel, MPH, PA-C June 10, 2013 QHOC meeting.
Program framework 1.Articulate program goals 2.Develop system level model for goal attainment 3.Assess current management efforts – identify gaps 4.Develop.
Shifting Your Quality Improvement into High Gear: Using Rapid Cycle Improvement to Impact Quality Outcomes Cindy Sun, MSN, RN, COS-C.
Community Planning Training 1-1. Community Plan Implementation Training 1- Community Planning Training 1-3.
Sharing and explaining the standardized infection ratio (SIR): Does your audience prefer words, colors, and/or δymβφĨs? Dana Burshell, MPH, CPH, CIC HAI.
Research Methods. Research Projects  Background Literature  Aims and Hypothesis  Methods: Study Design Data collection approach Sample Size and Power.
Inference for regression - Simple linear regression
Lessons from the Care Transitions Theme Jane Brock, MD, MSPH Alicia Goroski, MPH This material was prepared by CFMC (PM CO 2010), the Medicare.
Care Transitions (CT) Special Innovation Project (SIP) THIS MATERIAL WAS PREPARED BY THE ARKANSAS FOUNDATION FOR MEDICAL CARE INC. (AFMC), THE MEDICARE.
SIR 101: Interpretation and public reporting
The Standardized Infection Ratio Steven P Hudson, MBA, MA Statistician Health Care Excel, Inc.
Multiple Choice Questions for discussion
Health promotion and health education programs. Assumptions of Health Promotion Relationship between Health education& Promotion Definition of Program.
Targeting Resource Use Effectively (TRUE) Goal:Optimize hospice use –Increase appropriate referrals to hospice –Increase the length of stay of hospice.
The County Health Rankings & Roadmaps Take Action Cycle.
M ARYLAND H EALTH Q UALITY AND C OST C OUNCIL Quarterly Meeting December 19, 2014.
[Facility Name] [Presenter Name] [Date]. Objectives 2 After this session, you will be able to 1. describe Root Cause Analysis (RCA) and Plan-Do-Study-Act.
Skunk Works Evaluation Tools: How do we know if we are having an impact?
Care Transitions in Georgia: Partnering with your community to move readmissions Jennifer Hodge RN MSBA Aim Lead, Integrating Care for Populations Communities.
Evaluating the Vermont Mathematics Initiative (VMI) in a Value Added Context H. ‘Bud’ Meyers, Ph.D. College of Education and Social Services University.
Move to Improve Program Process and Results Gina Mazza RN, BSN Partner, Fazzi Associates Jim Culhane. MSW, MBA Director of Homecare and Personal Services.
INTERACT COLLABORATIVE ORIENTATION SESSION NYSHFA/IPRO PARTNERSHIP Sara Butterfield, RN, BSN, CPHQ, CCM Christine Stegel, RN, MS, CPHQ NYSHFA/IPRO INTERACT.
Masterful Facilitation Model. Facilitation Cycle Designing Intervention Facilitating &Evaluating Results Initial Contact & Clarify Objectives.
CMS National Conference on Care Transitions December 3,
Georgia Medical Care Foundation The Care Transitions Community Initiative Working Together Across Care Settings.
Making mental health service user involvement effective Eva Cyhlarova Mental Health Foundation.
Brianna Gass, MPH November 17, 2014 Local Needs, Local Data.
Change Starts Here. The One about Root Cause Analysis & Intervention Selection ICPC National Coordinating Center This material was prepared by CFMC (PM
September 18-19, 2006 – Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development Conducting and interpreting multivariate analyses.
SOCW 671 # 8 Single Subject/System Designs Intro to Sampling.
Data is your Friend Collecting, Charting, Analyzing, and Interpreting Data to Support Quality Improvement Michael Campitelli and Ruth.
WHA Improvement Forum For July    “Data Driven Improvement”   Presented by Stephanie Sobczak Courtesy Reminders: Please place your phones on MUTE.
Reduce Waiting & No-Shows  Increase Admissions & Continuation Reduce Waiting & No-Shows  Increase Admissions & Continuation Lessons Learned.
Evaluation Requirements for MSP and Characteristics of Designs to Estimate Impacts with Confidence Ellen Bobronnikov February 16, 2011.
Performance Improvement Project Validation Process Outcome Focused Scoring Methodology and Critical Analysis Presenter: Christi Melendez, RN, CPHQ Associate.
Onsite Quarterly Meeting SIPP PIPs June 13, 2012 Presenter: Christy Hormann, LMSW, CPHQ Project Leader-PIP Team.
Workflow and Protocol – Meaningfully Using the Electronic Health Record for Tobacco Screening and Cessation Intervention Carol Saavedra, BA Health Informatics.
Evaluation Results MRI’s Evaluation Activities: Surveys Teacher Beliefs and Practices (pre/post) Annual Participant Questionnaire Data Collection.
Jane Brock, MD, MSPH Colorado Foundation for Medical Care This material was prepared by CFMC, the Medicare Quality Improvement.
Prevention of BSI and VAP Measuring Change in Outcomes Part II Ted Speroff, PhD.
Cindy Tumbarello, RN, MSN, DHA September 22, 2011.
From Aggregate Indicators to Impacting Patients - Data Use to Inform Treatment and Improve Care Ian Wanyeki Track 1.0 Implementers Meeting Dar Es Salaam.
Run Charts ﹝趨勢圖、推移圖﹞ 彰化基督教醫院 陶阿倫 部長.
Process Control Charts
Evaluation Requirements for MSP and Characteristics of Designs to Estimate Impacts with Confidence Ellen Bobronnikov March 23, 2011.
Performance Improvement Project Validation Process Outcome Focused Scoring Methodology and Critical Analysis Presenter: Christi Melendez, RN, CPHQ Associate.
Performance Improvement Project on [insert topic]
Chapter 12 Single-Case Evaluation Designs
Performance Improvement Project Validation Process Outcome Focused Scoring Methodology and Critical Analysis Presenter: Christi Melendez, RN, CPHQ Associate.
Age-Related Macular Degeneration: Virtual Clinic Pilot
October 20, 2017 Providence St. Joseph, Burbank
Developing & Refining a Theory of Action
program framework Articulate program goals
Scorecards & Visual Display of Data
2018 OSEP Project Directors’ Conference
Grantee Guide to Project Performance Measurement
Presenter: Kate Bell, MA PIP Reviewer
Module 5 Part 3 Understanding System Stability: Types and Causes of Process Variation Adapted from: The Institute for Healthcare Improvement (IHI), the.
Name of Your Outcome Presenter’s Name, Organization and
Presentation transcript:

Change Starts Here. The One about Demonstrating Change ICPC National Coordinating Center This material was prepared by CFMC (PM CO 2011), the Medicare Quality Improvement Organization for Colorado 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.

Recap: measurement for IC-4 1.Time series outcomes – Effect on root cause/driver – Success of the intervention Rates; scores; rating scales Best-fit line or other signal indicating improvement What to do about outcomes not well portrayed as time-series 2.Intervention implementation – Reach/dosage of an intervention – Who was affected? Counts Rates among eligible population (offered, refused, completed)

Recap: suggested approach 1.Map out a detailed, community-level logic model of the intervention strategy. 2.Select and operationalize outcomes and processes from the logic model. 3.Develop and enforce the system for tracking implementation and outcome. 4.Effectively report time series data.

Recap: timing and duration When will improvement be detected? Considerations – How long should it take to observe an effect? – What should the effect look like? IC-4: ≥4 quarters of data within 18 months of community engagement – Ensure that the measurement period includes pre-intervention baseline data. Measure frequently – The more data points, the better. Monthly indicators lend themselves to run/control charts.

What’s this all about? Purpose – Confidently demonstrate that the interventions were effective. – Link interventions to observed changes in readmissions. – Validate or revise the logic model based on short- term outcomes.

Be thoughtful and careful Pitfalls – Waiting too long to begin the process – Checking progress infrequently – Going it alone Advice – Rapid cycle improvement Measure frequently, revise accordingly – Analytic support – NCC support

Tracking outcomes Time series – Run chart or control chart (≥12 data points) – Trend line (fewer data points) Cross-sectional; cohort – Group comparison Intervention vs. no intervention – Beneficiary-level Difference between pre- and post-intervention

Detecting improvement Does the intervention have an effect? Run chart: special cause – Co-occurrence with intervention deployment Best-fit trend line: statistical significance Between-group or pre-/post-intervention differences achieved and sustained

Time series: run charts Run chart – Data points overlaid against the median – Simple patterns suggest ‘special cause’ Runs (consecutive points above or below median) – Number of runs – Length of run Consecutive data points continually increasing/decreasing Very high or low point – Resources: Perla, Provost & Murray (2011) –

Run charts Perla, Provost & Murray (2011)

Time series: best-fit line Best-fit line among available data points – Cochran-Armitage test Statistical significance: slope of the line is different from zero – Requires analytic support – Resources: SAS documentation SAS paper: Liu (2007) –

Cross sectional and cohort data Not well portrayed as time series, per se… Group comparisons – Separate plot for each group on the same time-series graph Pre- and post-intervention change e.g., Patient Activation Measure – Consider ways to make it a group comparison Pre-intervention vs. post-intervention scores Sample of individuals who did not receive intervention Requires analytic support

What if we don’t see improvement? Refer to the logic model – External factors – Challenged assumptions What factors influenced the outcome? What adjustments could have been made? What other outcomes may have been measured?

Document what was learned Regardless of success or failure Context – What made the intervention successful or unsuccessful in your setting/community?

Additional resources Toolkit – measurement Run charts: Perla, Provost & Murray (2011) ICPCA NCC contact: Tom Ventura

Questions? The ICPC National Coordinating Center – Change Starts Here.