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2013 PACT RECOGNITION BEST PRACTICES
The Appleton EAST Team Clinic VISN-12
Appleton, Wisconsin
ROLL OUT HISTORY: 6 MARCH 2012
Team was tasked with ensuring our Department of Veteran Affairs
National PACT Initiative agenda goals were implemented by 6 March
2012
The consensus amongst team members was that there was a need to
collaborate in development of a system of practical administrative
tools that would deliver same day care with various disciplines
No discipline was exempt from upholding the ethics deeply seeded
within each tenants of the VA’s I.C.A.R.E. Core Values
Our multi-disciplinary skilled clinical team brought 200 years of
Clinical experience
CREATION OF SYSTEM REDESIGN TOOLS
APPLETON CBOC EAST TEAM CLINIC, DEPARTMENT OF VETERANS AFFAIRS
PACT TEAMLET STASTNY: Panel Size 560 as of Feb 2012
COMPASS MEASURES REPORT PRESENTATION
Dr.(s) Mary Stastny, Mark Reginer, Ryan Prouty, Lisa Knoff, Leslie Weinbauer; PACT Coordinator Scott Herman; RN(s) Julie Schmitz, Suzette Franklin; LPN Rhonda Cummings; Dietician Deb Woefel; Social
Worker Greg Aleff; Admin MSA Tyler Stuebs, and Clinical MSA Thomas Beverly 4/16/2012
Abbreviations used: National - Nat’l; Encounter – enc; Month – mon; POA – Plan of Action; Time Sensitive - t/s; Reschedule – r/s, Close of business – COB, Appointment – appt; Phone - ph ; With – w/; Patients – pats.
Computerized Patient Record System
CLINICIAL INSTRUCTIONS
This is based on a document created and generously shared by:
Richard V. Sipe, Jr., Clinical Applications, Coordinator, Portland VA Medical Center
Modified for use at Zablocki VA Medical Center, Milwaukee, Wisconsin
Cprs query tool panel
management report for:
Recall orders
LACK OF PCP PANEL ACCESS (ACCESS/COORDINATION OF CARE)
SHARED APPOINTMENTS (ACCESS/COORDINATION OF CARE)
PATIENT FLOW PROCESS (SYSTEM REDESIGN)
TEAMLET UNITY (COMMUNICATION/SYSTEM REDESIGN)
PROBLEMS ENCOUNTERED
(ACCESS / CONTINUITY OF CARE / SYSTEM
SOLUTION 1 OF 2 :
L. WEEKLY ^P.A. REPORT REVIEW
REDESIGN)
PRE AND POST ^PAL MEETING
RESPONSIBILITIES FOR
RN’S
LPN’S
MSA’S
CPRS QUERY TOOL PANEL MANAGEMENT
SOLUTION 2 OF 2 :
REPORT
(ACCESS / CONTINUITY OF CARE / SYSTEM
REDESIGN)
RESULTS: COENEN TEAMLET
2957
COMPASS ACCESS METRIC: PCP Total Encounters
Pre Roll Out FY 2011:
1 986
Post Roll Out FY 2012:
Total Increase of 3864
* PCP accepted panel APR 2012 / FTE 1.0 M.D. *
Post Roll Out FY 2013:
5850
Ratio of PC Telephone Encounters to All PC Encounters National Goal: 20%
40.0% 34.82%
29.55% 33.82%
28.99% 28.71% 27.65%
Apr-12 May-12 Jun-12 Jul-12 Aug-12 Sep-12 YTD 2012
Coenen 28.99% 28.71% 34.82% 29.55% 33.82% 27.65% 30.54%
VISN 30.92% 32.72% 33.14% 33.08% 31.76% 26.76% 26.02%
30.54%
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
NATIONAL AVG.
Same Day Appointments w/ PCP Ratio Total National Goal: 66% 100.0% 90.91%
82.14% 90.0%
80.00% 75.96% 68.75% 66.67%
70.0%
60.0%
50.0%
80.0%
37.50% 40.0%
30.0%
20.0%
10.0%
0.0% Apr-12 May-12 Jun-12 Jul-12 Aug-12 Sep-12 YTD 2012
Coenen 82.14% 68.75% 37.50% 90.91% 66.67% 80.00% 75.96%
VISN 54.77% 51.65% 48.34% 52.02% 54.97% 67.79% 67.30%
RESULTS: STASTNY TEAMLET
COMPASS ACCESS METRIC: PCP Total Encounters
Pre Roll Out FY 2011:
2982
Post Roll Out FY 2012:
3906
Post Roll Out FY 2013:
4338
Total Increase of 1356
* PCP is FTE 0.5 M.D. *
Ratio of PC Telephone Encounters to All PC Encounters National Goal: 20%
20.0%
70.0%
59.79% 57.51% 57.97%
60.0% 51.67% 54.67% 51.65%
48.28% 50.0%
39.61%
40.0%
30.0%
10.0%
0.0% Mar-12 Apr-12 May-12 Jun-12 Jul-12 Aug-12 Sep-12 YTD 2012
Stastny 39.61% 59.79% 51.67% 54.67% 57.51% 57.97% 51.65% 48.28%
VISN 29.24% 30.92% 32.72% 33.15% 33.09% 31.77% 26.77% 26.49%
Same Day Appointments w/ PCP Ratio Total National Goal: 66% 120.0%
100.00% 100.00% 100.0% 87.50% 87.50%
81.01%
80.0% 60.00% 62.50% 66.67%
60.0%
40.0%
20.0%
0.0% Mar-12 Apr-12 May-12 Jun-12 Jul-12 Aug-12 Sep-12 YTD 2012
Stastny 100.00% 87.50% 60.00% 62.50% 87.50% 100.00% 66.67% 81.01%
VISN 53.89% 54.77% 51.65% 48.34% 52.02% 54.97% 67.79% 67.30%
2 day Contact Post Discharge Ratio-VHA D/C National Goal: 50%
50.0%
90.0% 80.00%
75.00% 80.0%
66.67%
63.16%
50.00%
70.0%
50.00% 60.0% 50.00%
40.0% 25.00%
30.0%
20.0%
10.0%
0.0% Mar-12 Apr-12 May-12 Jun-12 Jul-12 Aug-12 Sep-12 YTD 2012
Stastny 75.00% 66.67% 25.00% 50.00% 80.00% 50.00% 50.00% 63.16%
VISN 71.43% 62.42% 60.88% 65.01% 63.49% 61.61% 63.33% 60.90%
7day Contact Post Discharge Ratio-VHA D/C National Goal: 75%
80.0%
120.0% 100.00%
100.00% 100.00% 86.11% 100.0%
85.71% 75.00% 75.00%
50.00%
40.0%
20.0%
0.0%
60.0%
Mar-12 Apr-12 May-12 Jun-12 Jul-12 Aug-12 Sep-12 YTD 2012
Stastny 85.71% 100.00% 50.00% 75.00% 100.00% 75.00% 100.00% 86.11%
VISN 72.83% 75.41% 75.28% 75.58% 76.15% 76.08% 76.19% 74.52%
7
RESULTS: MIDDLETON TEAMLET
COMPASS ACCESS METRIC: PCP Total Encounters
Pre Roll Out FY 2011:
2871 Post Roll Out FY 2012:
3041
Total Increase of 39
Post Roll Out FY
2013:
3 268
* PCP is FTE 1.0 NP *
Ratio of PC Telephone Encounters to All PC Encounters National Goal: 20%
Mar-12 Apr-12 May-12 Jun-12 Jul-12 Aug-12 Sep-12 YTD 2012
Middleton 32.84% 28.57% 29.96% 31.16% 31.80% 41.97% 26.24% 30.48%
VISN 29.24% 30.92% 32.72% 33.15% 33.09% 31.77% 26.77% 26.49%
32.84% 28.57% 29.96% 31.16% 31.80%
26.24%
30.48%
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
40.0%
45.0% 41.97%
Same Day Appointments w/ PCP Ratio Total National Goal: 66%
120.0%
100.00% 89.29% 100.0% 88.89%
85.71%
66.67% 75.00% 80.0%
60.0% 50.00% 50.00%
40.0%
20.0%
0.0% Mar-12 Apr-12 May-12 Jun-12 Jul-12 Aug-12 Sep-12 YTD 2012
Middleton 88.89% 85.71% 66.67% 75.00% 50.00% 50.00% 100.00% 89.29%
VISN 53.89% 54.77% 51.65% 48.34% 52.02% 54.97% 67.79% 67.30%
2 day Contact Post Discharge Ratio-VHA D/C National Goal: 50%
40.0%
120.0%
100.00% 100.00% 100.0%
85.00%
75.00% 80.0%
60.0%
0.00% 20.0%
0.00% 0.00% 0.00%
0.0% Mar-12 Apr-12 May-12 Jun-12 Jul-12 Aug-12 Sep-12 YTD 2012
Middleton 0.00% 0.00% 0.00% 75.00% 100.00% 0.00% 100.00% 85.00%
CBOC 57.50% 82.14% 57.58% 63.64% 85.19% 54.84% 71.43% 62.80%
VISN 71.43% 62.42% 60.88% 65.01% 63.49% 61.61% 63.33% 60.90%
7day Contact Post Discharge Ratio-VHA D/C National Goal: 75%
120.0% 100.00% 100.00% 100.00%
100.0% 80.50%
75.00% 80.0%
60.0%
40.0%
20.0%
0.00% 0.00% 0.00% 0.0%
Mar-12 Apr-12 May-12 Jun-12 Jul-12 Aug-12 Sep-12 YTD 2012
Middleton 100.00% 0.00% 0.00% 75.00% 100.00% 0.00% 100.00% 80.50%
VISN 72.83% 75.41% 75.28% 75.58% 76.15% 76.08% 76.19% 74.52%
AST TEAM