1. Venice Family Clinic QI Journey
Despina Kayichian, MD
Chief Medical Director

2. Objectives Identify some landmarks in our QI journey
Share some tools we used
Direction in 2016

3. PCMH Journey: Huddles 10/2014
Landmarks
New COO 1/2013
VFC QI 2 years
Initiativ
2013
QI Mgr 10/2013
QI Steering Cte 11/2013
UCLA Lean Academy 2014
New CMO 4/2014
PCMH Journey: Huddles 10/2014
QI Cte 5/2015

4. Some Tools… QI 101 QI Priorities Providers’ Dashboard
Huddles/Patient Visit Planning (Azara DRVS)
Learning Communities: CCI Innovation Catalyst Program; CCI SNAP (Safety Net Analytics Program)

5. QI 101… building the foundation for a data driven culture…

6. “I’ve got too much work to do to stop and listen to you”
“The Tools Are Available”
“The Tools Are Available”

7. QI 101…Lean Methodology Focus of process not people
Learn Observation tools: TOS, Process mapping, Spaghetti Diagrams
Identify waste
5 S
Standard Work
Root Cause Analysis
Iterative PDCAs…Disseminate…Sustain

8. Goals of Lean Eliminate waste Maintain continuous flow
Decrease variation
Organize facilities, and supplier and customer interaction
Satisfy customer/patient need perfectly
“Level-load” production to match the rate of customer demand
Patient involvement

9. Eight Wastes Defects Overproduction Waiting Not Utilizing Talent
Lab needs to redraw tests due to incorrect order
Registration paperwork having many redundant pages
Provider waiting for patient to be roomed, and is not free to do other tasks
Numerous ideas are “lost” only to be rediscovered later
MD/Nurse time needlessly spent on clerical tasks instead of value-added tasks
Transport
Inventory
Motion
Extra-Processing
Patients admitted are transferred to a unit with a similar level of care within hours of admission
Expired supplies because of excess ordering
Pharmacy tech spends time looking in multiple places for a particular med
MA documents immunizations in multiple systems.

10. PDCA- Continuous ImprovementDo
Check
Act
Plan
PDCA- Continuous Improvement
The method by which we should be practicing continuous improvement in our daily work
A tool to solve problems encountered while performing our daily work
Plan Do
Check
Act
Step 1 Clarify the Problem
Step 2 Current State
Step 3 Goals/Metrics
Step 4 Analysis/ Root Cause
Step 5 Plan & Implement Solutions
Step 6 Evaluate Results
Step 7 Standardize & Sustain

11. VFC QI Priorities

12. Providers’ Dashboard

13. Patient Visit Planning
Care Team/Huddles/Checklists
Patient Visit Planning (PVP)…challenges  solutions

14. Foundation for Success
Patient
Who
(QI Team)
Budget
(Protected Time) IT
(Azara DRVs)
Know
(Lean Academy)

15. Landmarks Budget New COO 1/2013 VFC QI Initiative 2013
QI Manager 10/2013
QI Steering Committee 11/2013
UCLA Lean Academy 2014
New CMO 4/2014
PCMH Journey: Huddles 10/2014
QI Committee 5/2015
Budget

16. QI Journey 2016
QI Workgroups tackling VFC QI Priorities; protected time for providers to participate.
QI 101 to providers/front line staff
Population management 2.0
Develop more QI champions/facilitators
Learning communities
My ultimate goal is to give back to the providers what was taken away from them in the post EHR era: to allow them to answer their patients’ concerns by looking into their eyes and not into the computer’s screen…
Our organization’s goal is to have a robust quality foundation when we embark on the Alternative Payment Method journey…