coach medical home strategies & tools to support patient-centered medical home transformation m...

Coach Medical HomeStrategies & tools to support patient-centered medical home transformation

MODULE 4: Measurement

Learning objectives for this module

After completing this module, you will know how to: Describe measurement for improvement and why it is

critical to PCMH transformation.

Help leaders, clinicians, managers, staff, and patients develop a measurement and reporting strategy to support PCMH transformation.

Coach Medical Home: Module 4

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Overview of contents

1. Why measurement for improvement is critical to PCMH transformation

2. Build an improvement-focused measurement strategy

3. Make measurement part of daily work through reporting

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Why measurement for improvement is critical to PCMH transformation

SECTION 1

Coach Medical Home: Module 4

Using measurement to drive PCMH transformation

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Different measures are meaningful for different audiences: Diabetes example

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Combined measures provide an overall view of

quality of care.

Specific measures show opportunities for improvement.

Focusing on improvement helps achieve practice goals

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Build an improvement-focused measurement strategy

SECTION 2

Coach Medical Home: Module 4

Why develop a measurement strategy?

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A measurement strategy’s components

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How leaders create a data-driven culture

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PCMH transformation

Quality improvement

Practice leaders should:

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Building a measurement strategy: Five ways to maximize value & efficiency

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The measurement strategy…

Leadership’s role in building the measurement and reporting strategy

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Leader appoints team or

point person

• Commit resources

• Provide training

• Develop reporting strategy

Engage clinicians & staff in deciding what to measure

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Strategic plan

Daily work

Other ideas

Data

Data

Data

Possible performance

measures

Aim for a balanced set of measures to reveal the big picture

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Start with nationally endorsed measures

Which national measures are tied to the practice’s goals?

•MU

•HEDIS

•NQF

•AMA-PCPI

•NCQA or PCMH

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An efficient approach that also allows the practice to compare to national benchmarks

Customize measures for the practice

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Finding value in measures that overlap

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Measurement for improvement

Measurement for required reporting

Internal External

Efficient data collection

Refine based on available data sources

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Use EHRs and registries for measurement as much as possible

It may take time for practices to get started, but it’s worth it:

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Balance cost vs. value

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Make measurement part of daily work through reporting

SECTION 3

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Engage clinicians and staff through training

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Builds trust and the capacity to use data to support PCMH transformation.Builds trust and the capacity to use data to support PCMH transformation.

Displaying data helps spread engagement

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Minimum standard for monthly reporting:Annotated run chart

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Percent of Patients with Documented Collaborative Goals

Goal = 60% to start.Encourage your teams to step it up once they get close to the goal.

Cycle 1: Dr. Smith/ 3 patients

Cycle 2: Test of Group Visit

Cycle 3: 8 patients self measuring blood glucose

© Institute for Healthcare Improvement

Why run charts work so well

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Run charts motivate teams to find ways to meet goals.

Questions to consider when reviewing run charts

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Percent of Patients with Structured Diagnostic Assessment in Record

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Nov-99 Dec-99 J an-00 Feb-00 Mar-00 Apr-00 May-00 J un-00 J ul-00 Aug-00 Sep-00 Oct-00 Nov-00 Dec-00 J an-01 Feb-01

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Percent of Patients with Follow-up Structured Assessment at 4-8 Weeks

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Nov-99 Dec-99 J an-00 Feb-00 Mar-00 Apr-00 May-00 J un-00 J ul-00 Aug-00 Sep-00 Oct-00 Nov-00 Dec-00 J an-01 Feb-01

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Average Change in MHI5 for Patients Treated After 12 weeks

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Nov-99 Dec-99 J an-00 Feb-00 Mar-00 Apr-00 May-00 J un-00 J ul-00 Aug-00 Sep-00 Oct-00 Nov-00 Dec-00 J an-01 Feb-01

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A family of measures refines understanding

© Institute for Healthcare Improvement

A dashboard provides a broader view

National PCMH Curriculum: Module #30

Example data wall for staff and patients

Measurement Wall at Community Health Partners, Inc., Livingston, Montana

Coaching tips summary31

Coach Medical Home: Module 4

As a coach, you can help a practice: