1. CQI FORUM Year II – Translate Learning Into Action! Measurement for Quality March 27, 2014

2. Objectives Review available data reports Identify methods for deciding where to focus further measurement and improvement Describe how to look at data over time

3. Your Ground Rules 1. What happens in the group stays in the group 2. Cell phone off or on vibrate 3. All ideas are valid 4. Treat one another with respect Listen without interruption Participate Act in a non-judgmental manner 5. Have open, potentially challenging discussions 6. Avoid side conversations 7. Raise hand when you want to speak 8. Consider alternative technologies & room arrangements for the meeting

4. MEASUREMENT FOR QUALITY Karen Parker Carolyn DeMark Rachel Trombly Cheryl Gonzalo

5. Management of Medications Karen Parker, RN

6. Situation Review of Oasis Outcome data on Home Health Compare Outcomes and process Measures Daily QI review of Charts Patient satisfaction reports

7. Problem Medication reconciliation was inconsistent Notification to MD in 1 day for significant issues not timely Patient satisfaction numbers for review of medications although above state and National levels was trending downward

8. Solution Survey Monkey to Clinical Staff to determine barriers to medication reconciliation Disease Management team meeting to discuss the process in detail and determine best practices by each discipline Development of Medication Management tools Development of specific Medication education for Clinical staff done for all current staff and added to the orientation program for new staff

9. Evaluation- Improvement Oral Medications ytd 2012- 2013 SHP data

10. Patient Satisfaction data- Fazzi

11. In review of Outcome reports and patient satisfaction we identified that the new medication process is working and our outcomes have improved.

12. CASE STUDY Carolyn DeMark, RN

13. REVIEW PRE- READING(S)- KEY POINTS Rachel Trombly Cheryl Gonzalo

17. A comprehensive quality assurance program is: Proactive. Educational. Realistic, scalable, and financially feasible. Simple and easy to implement. Secure and confidential Inclusive of all aspects of the author-to-text process. Reportable for tracking and trending purposes. Timely

18. Using HHCAHPS to Monitor and Improve Quality – an Example (C. G.) Run your HHCAPS report. Find the top 3-4 lowest scores or problem areas for your agency. (I picked 5 because they go together). Example: Talk about medications you are taking (% yes) 73.3 Ask to see medications (% yes) 54.0 Talk about purpose for medications (% yes) 66.7 Talk about when to take medications (% yes) 66.7 Talk about side effects of mediations (% yes) 47.4 Identified our quality problem area as medications in general. HHCAHPS report. Discussion: Improvement:

19. ADDITIONAL THOUGHTS Polly Campion

20. Let’s Look at Your Data To what reports do you have access? CASPER (Certification and Survey Provider Enhanced Reports) Fazzi Home Health Compare Others?

21. CASPER Reports

23. 66%

24. Let’s Look at Data Over Time

25. How Are We Doing?

26. Improvement in Ambulation? 66%

27. Measurement!!!

28. Why Measure? How else will you know that the change you made resulted in improvement? Measurement for Reporting Measurement for Improvement Used to judgeUsed for learning Source: IHI, Simplifying Measurement, 2012

29. If both types of measures are required, where do you start? Reporting: OBQI Improvement OBQI HHCAHPS Internal data

30. Ask of your data Where are the opportunities? Not meeting standard? Lowest performance? Most important aspects of care/service? Greatest impact on clients? Of interest to passionate leader?

31. Aim Statements

33. PDSA Worksheet

34. Small Group Work In twos or threes What resonated with you? Identify one action to test at your agency Report out

35. Next Steps Determine content for next meeting What do you want the focus of April’s meeting to be? Identify actions: What Who When

36. Evaluation What worked well? What could be improved?

37. Next Meeting – April 24, 2014 Agenda: To be determined (by group)