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

2

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


3

Why measurement for improvement is critical to PCMH transformation

SECTION 1


Using measurement to drive PCMH transformation


5

Different measures are meaningful for different audiences: Diabetes example


6

Combined measures provide an overall view of

quality of care.

Specific measures show opportunities for improvement.

Focusing on improvement helps achieve practice goals


7

Build an improvement-focused measurement strategy

SECTION 2


Why develop a measurement strategy?


9

A measurement strategy’s components


10

How leaders create a data-driven culture

11


PCMH transformation

Quality improvement

Practice leaders should:

11

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


12

The measurement strategy…

Leadership’s role in building the measurement and reporting strategy

13

13


Leader appoints team or

point person

• Commit resources

• Provide training

• Develop reporting strategy

Engage clinicians & staff in deciding what to measure

14

14


Strategic plan

Daily work

Other ideas

Data

Data

Data

Possible performance

measures

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

15

15


Start with nationally endorsed measures

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

•MU

•HEDIS

•NQF

•AMA-PCPI

•NCQA or PCMH


1616

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

Customize measures for the practice


17

Finding value in measures that overlap


18

Measurement for improvement

Measurement for required reporting

Internal External

Efficient data collection

Refine based on available data sources


19

Use EHRs and registries for measurement as much as possible

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

20


Balance cost vs. value


21

Make measurement part of daily work through reporting

SECTION 3


Engage clinicians and staff through training

23

23


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

24

24


Minimum standard for monthly reporting:Annotated run chart

0

10

20

30

40

50

60

70

80

90

100

Ma

r-9

9

Apr

-99

Ma

y-99

Jun-

99

Jul-9

9

Aug

-99

Sep

-99

Oct

-99

Nov

-99

Dec

-99

Jan-

00

Fe

b-0

0

Ma

r-0

0

Apr

-00

Ma

y-00

Jun-

00

Jul-0

0

Aug

-00

Sep

-00

Per

cen

t of

Pat

ien

ts in

Reg

istr

y

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

26

26


Run charts motivate teams to find ways to meet goals.

Questions to consider when reviewing run charts

27

27


Percent of Patients with Structured Diagnostic Assessment in Record

0

20

40

60

80

100

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

perc

en

t

Goal

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

0

20

40

60

80

100


perc

en

t

Goal

Average Change in MHI5 for Patients Treated After 12 weeks

0

5

10

15

20

25


Avg

. ch

ang

e in

MH

I5

Goal

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


As a coach, you can help a practice:

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

Documents

pcmhcoach medical home

reportingcoach medical

overlapcoach medical

valuecoach medical home

practicecoach medical

different measures

specific measures

combined measures