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Improving Asthma Care Holger Link, M.D. Carrie Phillipi, M.D., Ph.D. Art Jaffe, M.D.
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Outline Why You do Care Building teams and partnerships to improve patient outcomes The Doernbecher Experience
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Why You Do Care
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75,000
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Jonathan David Henry
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How can we partner with our patients and others to achieve better outcomes?
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What are we trying to accomplish? How will we know that a change is an improvement ? What change can we make that will result in improvement? ActPlan Study Do Asthma Nurse Educators Asthma Education Packets Discharge Education Checklist
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What is Chapter Quality Improvement? The involvement of AAP chapters in state and/or local activities aimed at improving the quality of care for children. These activities involve measurement and the collection of data over time to assess changes in practice performance.
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Key Players American Academy of Pediatrics American Academy of Pediatrics - Project Lead Cincinnati Children’s Hospital Medical Center Cincinnati Children’s Hospital Medical Center - QI expertise and coaching 4 Chapters 4 Chapters - Alabama - Maine - Oregon - Ohio 49 practices 49 practices 282 Clinicians 282 Clinicians
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Sandra Miller Sandra Miller Theresa Rice Theresa Rice Holger Link & Carrie Phillipi Holger Link & Carrie Phillipi Arthur Jaffe (OPS) Arthur Jaffe (OPS) The Oregon Chapter Team
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Peace Health Medical Group Riverbend Peace Health Medical Group Barger Peace Health Medical Group South Peace Health Medical Group Downtown Hillsboro Pediatrics Southern Oregon Pediatrics Oregon Medical Group Garden Way Childhood Health Associates of Salem Legacy Emanual Childrens Clinic Doernbecher Pediatrics Doernbecher Pediatrics Westside The Oregon Practices
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CQN Asthma Pilot Project MAINE OHIO OREGON ALABAMA 11 Practices 13 Practices 12 Practices 49 Practices 282 Clinicians
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Improvement Methods
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How are we doing at the National Level? Practice System Changes Registry Implementation Status
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How are we doing at the National Level? Practice System Changes Options for Practices without a Registry
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Commitment to Quality as a result of CQN Participation No Change in my commitment to QI work, 9% More committed to QI work, 91%
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Chapter Team Perspective: Value of Program Components
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Improvement Work Continuous tests of changeSustainability Imbed in everyday work Scale Up & Spread Taking local improvement And actively disseminating it across a chapter and/or practice Our First 6 months
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Our DCH Experience Art Jaffe Julie Johnson Lisa Johnson Everyone on the Gen Peds Clinic Team
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GOALS Describe structure and process Discuss our local focus Show baseline data Choosing PDSA’s and tracking results Successes and challenges The future: sustainability and generalizability
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Base-line: % Well-controlled (visits vs patients?)
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OOPS! No data reported back from AAP!!
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% Well-controlled Through July, 2010 DCH General Pediatrics ClinicOregon
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Base-line: % Optimal Care DCH General Pediatrics ClinicOregon
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Drilling Down On Optimal Care Validated InstrumentStep-wise Approach to Care
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Drilling Down On Optimal Care Flu shot given or recommended Use of Asthma Action Plan
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Targets of Opportunity 1.Validated Instrument - ACT and TRACK forms 2.Asthma Action Plan - PDSA iterations of plans - EPIC issues - The saga continues
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Optimal Care: Good News in June!!! DCH General Pediatrics ClinicOregon
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And then there was July DCH General Pediatrics ClinicOregon
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The Future Sustainability - What happens when the project ends? Generalizability - Asthma management throughout Oregon - Chronic care management in DCH Registry - Management of populations, not patients - Clinical care vs. research data base - Options for all of us
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