Twelve months of pre-enrollment data and post-enrollment, as accrued, were examined for clinic and control patients. Study enrollment is occuring on a rolling basis, therefore the control charts reflect data for each month of enrollment. the first 30 days of patient enrollment. This Therefore, “month zero” represents should remove seasonal variability from the charts as will be “month zero”s distributed evenly through peak winter/spring respiratory/flu seasons through milder summer and fall seasons. Use of Quality Tools (max points 250): Key driver diagrams were used to map out processes and interventions likely to reduce utilization (figure 1). Figure 1 Interventions (max points 150 includes points for innovation): This clinic was supported through a network-wide initiative of the Seton Healthcare Family, with alignment of goals at the highest level of the organization. Notably, cost reduction for the healthcare system remained a primary goal despite the likely loss of revenue for the sponsoring organization. Significant freedom was allowed in both the design and structure of the clinic for the experienced, frontline expert leaders of the clinic two parents of children with medical complexity. The project – leader is a parent that has led Central Texas focus groups for parents and the medical director is a parent-physician (pediatric subspecialist). Similarly, the core structural backbone of the clinic is a high-functioning, interprofessional team. Major themes in our improvement plan include building processes for effective Care Coordination, reducing variation by creating standardized approaches to common medical issues, and placing the needs and perspective of the patient and family at the center of the medical plan. Care coordination in this population involves an appreciation for the dynamic nature of complex diseases, the intense communication needs for effective therapeutic relationships and the existing fragmentation of care in our system. Innovations include: 24/7 availability with use of family-centered communication techniques (email, texting, cell phone, etc.) Team huddles to brief/debrief to keep the multidisciplinary team appraised of patient developments within the clinic Proactive tracking of procedures, tests, appointments on a shared clinic calendar to create a shared awareness of ongoing events Dynamically updated Care Plan documents for each patient Efficient and collaborative communication with specialists, therapists and nursing agencies (e.g. care tele-conferences) to streamline care Reducing variation: Team members and specialists reviewed current literature to develop standardized guidelines for management of common problems in this population: Seizures Behavioral issues Optimal Nutrition Feeding Intolerance Aspiration prevention
Twelve months of pre-enrollment data and post-enrollment, as accrued, were examined for clinic and control patients. Study enrollment is occuring on a rolling basis, therefore the control charts reflect data for each month of enrollment. Therefore, “month zero” represents the first 30 days of patient enrollment. This should remove seasonal variability from the charts as “month zero”s will be distributed evenly through peak winter/spring respiratory/flu seasons through milder summer and fall seasons. Use of Quality Tools (max points 250): Key driver diagrams were used to map out processes and interventions likely to reduce utilization (figure 1). Figure 1 Interventions (max points 150 includes points for innovation): This clinic was supported through a network-wide initiative of the Seton Healthcare Family, with alignment of goals at the highest level of the organization. Notably, cost reduction for the healthcare system remained a primary goal despite the likely loss of revenue for the sponsoring organization. Significant freedom was allowed in both the design and structure of the clinic for the experienced, frontline expert leaders of the clinic – two parents of children with medical complexity. The project leader is a parent that has led Central Texas focus groups for parents and the medical director is a parent-physician (pediatric subspecialist). Similarly, the core structural backbone of the clinic is a high-functioning, interprofessional team. Major themes in our improvement plan include building processes for effective Care Coordination, reducing variation by creating standardized approaches to common medical issues, and placing the needs and perspective of the patient and family at the center of the medical plan. Care coordination in this population involves an appreciation for the dynamic nature of complex diseases, the intense communication needs for effective therapeutic relationships and the existing fragmentation of care in our system. Innovations include: 24/7 availability with use of family-centered communication techniques (email, texting, cell phone, etc.) Team huddles to brief/debrief to keep the multidisciplinary team appraised of patient developments within the clinic Proactive tracking of procedures, tests, appointments on a shared clinic calendar to create a shared awareness of ongoing events Dynamically updated Care Plan documents for each patient Efficient and collaborative communication with specialists, therapists and nursing agencies (e.g. care tele-conferences) to streamline care Reducing variation: Team members and specialists reviewed current literature to develop standardized guidelines for management of common problems in this population: Seizures Behavioral issues Optimal Nutrition Feeding Intolerance Aspiration prevention