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Health IT Leadership Capstone ACPE Nov 8-9, 2011. K Gabrielle Gaspar, MD, MPH, CMQ Medical Director of Clinical Informatics Sutter Physician Services. Leadership Principles & Stragies. Adoption as Value Enabler Align Project with Organizational Goals Engaging Leadership - PowerPoint PPT Presentation
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Health IT Leadership Capstone
ACPENov 8-9, 2011
K Gabrielle Gaspar, MD, MPH, CMQMedical Director of Clinical Informatics
Sutter Physician Services
1
Leadership Principles & Stragies
• Adoption as Value Enabler• Align Project with Organizational Goals• Engaging Leadership• Leveraging Physician Champions• Role of Governance• Use Root Cause Analysis -> PDSA• Align training efforts with adoption goals• Provide prompt feedback
2
3
Improving the Quality of Clinical Data in an Electronic Medical Record
WhatMammography results as structured data in shared chart EMR –
One patient/One chart
WhySutter Health’s Destination 2012 goals Independent Practice Association dashboard goalsMeaningful Use
HowPDSA focusing on standardized workflows, improved clinical content forms
3
Current State
4
Model for Improvement
5
Capture 100% of Mammography Results in Flow Sheet
Results are accurate and available to clinicians in timely fashion
Improve work flow and available forms
Test of Change
Assessing Outcome
7
TOC 1 Mar 2, 8TOC 1b Mar 15TOC 2 April 19Rules violated – Point above Zone A
Point below Zone A
0.0
20.0
40.0
60.0
80.0
Month
% M
am
mo
s a
s A
ccu
rate
Str
uctu
red
Data
Summary
LCL (varies)
CL = 24.
UCL (varies)
May 15, 2011 18:00:00
Outcome Measure- Structured Data in FlowsheetP Chart
0.0
20.0
40.0
60.0
80.0
Month
% M
am
mo
s a
s A
ccu
rate
Str
uctu
red
Data
Summary
LCL (varies)
CL = 24.
UCL (varies)
May 15, 2011 18:00:00
Outcome Measure- Structured Data in FlowsheetP Chart
TOC2TOC1
Assessing the Process
8
10.0
30.0
50.0
70.0
90.0
Month
% E
nte
red
via
Pre
ven
tive
Car
e F
orm
Summary
LCL (varies)
CL = 25.
UCL (varies)
May 15, 2011 17:45:33
Process Measure- Use of Preventive Care FormP Chart
10.0
30.0
50.0
70.0
90.0
Month
% E
nte
red
via
Pre
ven
tive
Car
e F
orm
Summary
LCL (varies)
CL = 25.
UCL (varies)
May 15, 2011 17:45:33
Process Measure- Use of Preventive Care FormP Chart
TOC1TOC2
Checking for Unintended Consequences
9
01-Nov-2010
01-Dec-2010
01-Jan-2011
01-Feb-2011
01-Mar-2
011
01-Apr-2011
01-May-2011
1
3
5
7
9
Month
Ave
rag
e #
Day
s to
Sig
n R
epo
rt
Summary
LCL (varies)
CL = 4.
UCL (varies)
May 16, 2011 13:33:35
Balance Measure - Time to Sign ReportX-bar Chart
01-Nov-2010
01-Dec-2010
01-Jan-2011
01-Feb-2011
01-Mar-2
011
01-Apr-2011
01-May-2011
1
3
5
7
9
Month
Ave
rag
e #
Day
s to
Sig
n R
epo
rt
Summary
LCL (varies)
CL = 4.
UCL (varies)
May 16, 2011 13:33:35
Balance Measure - Time to Sign ReportX-bar Chart
Average Days: 3 (March, April)Rules violated:Point above Zone A4-5 points in lower Zone B
Holding Gain…
10
11
Lessons Learned
11
• Important to provide context
• Speak the language of your users
• Keep it simple
• Value of rapidly incorporating user feedback
• Be prepared to adapt workflows based on user preference
• Move upstream when possible
• Administrative and EMR data may not reconcile
1212
Leslie Bouillette, Sr Technical Analyst
Kevin Sapad, Clinical Quality Project Coordinator
Julie Cooper, EMR Manager
K Gabrielle Gaspar, Med Dir Clinical Informatics
THE
TEAM
Thank You
