#MEQAPI – Tweetchat March 16th 2017 3ET: Matching #Trumpcare (AHCA) to the IHI Triple Aim

Next tweetchat: Thursday March 16th, 2017 3:00-4:00 PM ET

Topic: Matching #Trumpcare (AHCA) to the IHI Triple Aim

This week the #MEQAPI topics are based on the Congressional Budget Office (CBO) report on the American Healthcare Act (AHCA) and the acts’ relationship to the Institute for Healthcare Improvement (IHI) Triple Aim.

Just a reminder, MEQAPI stands for Monitoring & Evaluation, Quality Assurance, and Process Improvement.

Since MEQAPI looks at the quality and safety of healthcare policies in addition to technology deployment and workflow optimization, it seems like a good time to look at the AHCA through that lens.

The six domains of care quality (STEEEP) mapped out by the Agency for Healthcare Research and Quality (AHRQ) are foundational to healthcare improvement. All care, and by inference quality measures, should be focused on being Safe, Timely, Effective, Efficient, Equitable, and Patient Centered.

We can look at the law, the analysis thus far, and the CBO evaluation, and ask how this may influence quality and safety, and to ask ourselves if it would be a positive influencer of care that is STEEEP.

The aim of this chat is thus to bump the Triple Aim up against the AHCA, and in the context of the CBO and other analyses of how the AHCA will work, discuss our views on a number of dimensions.

We are expecting @TheIHI to attend, and to participate in the discussion.

 

Topics

The following topics will be covered during the chat:

  1. What WAS IN the #AHCA you think will have a bearing on the IHI Triple Aim
  2. What was NOT in the #AHCA you think will have a bearing on the IHI Triple Aim?
  3. In relation to the Triple Aim and #AHCA, what do you expect to see personally/professionally?
  4. What do you think HC Quality orgs like @theihi @nqf and @AHRQNews should do about #AHCA?
  5. What do you think yourself, patients, and providers should do about #AHCA to drive care that is STEEEP?

 

The MEQAPI tweetchat aims to give voice to a broad range of stakeholders in healthcare improvement, and it embraces everyone from administrators to zoologists, and includes physicians, nurses, researchers, bed czars, cleaners, and yes, patients and care-givers.

 

#MEQAPI – Tweetchat March 9th 2017 3ET: Patient-Participative Questions To Improve Clinical Decision Making

Next tweetchat: Thursday March 9th, 2017 3:00-4:00 PM ET

Topic: Patient-Participative Questions To Improve Clinical Decision Making

MEQAPITweetChat.png

This week the #MEQAPI topics are based on a @physicianswkly article on preoperative questions by Dr.Schwarze MD. The article “Improving Surgical Decision Making” is available on the Physician’s Weekly website.

Co-hosting the chat is Chris Cole of @physicianswkly, and we hope to have Dr. Schwarze @GretchenSchwa10 to provide details, so please watch for their tweets during the chat. Dr. Schwarze is affiliated with the University of Wisconsin School of Medicine and Public Health (@uwsmph) and UW Health (@uwhealth)

Just a reminder, MEQAPI stands for Monitoring & Evaluation, Quality Assurance, and Process Improvement.

The MEQAPI tweetchat aims to give voice to a broad range of stakeholders in healthcare improvement, and it embraces everyone from administrators to zoologists, and includes physicians, nurses, researchers, bed czars, cleaners, and yes, patients and care-givers.

The six domains of care quality (STEEEP) mapped out by the Agency for Healthcare Research and Quality (AHRQ) are foundational to healthcare improvement. All care, and by inference quality measures, should be focused on being Safe, Timely, Effective, Efficient, Equitable, and Patient Centered.

In this chat, we will focus on safety and patient-centeredness, in the context of the Schwarze article.

To reduce the high number of medical errors resulting in missed opportunities, injury, and premature death, healthcare providers need to use basic quality improvement principles. Likewise, quality improvement techniques can help align patient expectations and most probable medical outcomes. A core principle of Lean Six Sigma is the inclusion of the Voice of the Customer (VoC).

In healthcare, VoC implies inclusion of the patient, their caregivers, and patient families in the development and execution of the careflow, and in making medical decisions. Various studies have shown that including patients in the overall quality processes increased patient satisfaction, and reduced cost and risk.

Participation by patients in the treatment decision-making process can reduce risk of errors, increase patient understanding of medicaloutcomes, and avoid patient dissatisfaction with results

Topics

The following topics will be covered during the chat:

  1. What risks/opportunities do you see in involving pts in clinical decisions by using standardized question prompt lists (QPL)
  2. Who should lead an initiative to involve patients in developing or using QPLs – Nursing/Physicians/QM/Case-Managers/Other
  3. Are there HIPAA risks in involving patients in developing or using QPLs
  4. How can we build patient involvement in QPLs into the careflow
  5. How would we tell if patient involvement in QPLs is working – what benefits would we be able to measure

and the numbers

meqapi mar 9 2017

#MEQAPI – Tweetchat March 2nd 2017 3ET – HSPI Conference #SHS2017

Next tweetchat: Thursday March 2nd, 2017 3:00-4:00 PM ET

Topic: Healthcare Systems Process Improvement Conference 2017 #SHS2017

This week we will be co-hosting with the Healthcare Systems Process Improvement Conference 2017 #SHS2017 chat along with Dr. Chuck Webster.

MEQAPI stands for Monitoring & Evaluation, Quality Assurance, and Process Improvement.

The MEQAPI tweetchat aims to give voice to a broad range of stakeholders in healthcare improvement, and it embraces everyone from administrators to zoologists, and includes physicians, nurses, researchers, bed czars, cleaners, and yes, patients and care-givers.

 

The six domains of care quality (STEEEP) mapped out by the Agency for Healthcare Research and Quality (AHRQ) are foundational to healthcare improvement. All care, and by inference quality measures, should be focused on being Safe, Timely, Effective, Efficient, Equitable, and Patient Centered.

MEQAPI therefore wants to look at healthcare policy implementation, technology deployment, and workflow optimization in terms of how to monitor them, and how to evaluate if they have (a) achieved what they sought to do, (b) don’t cause unexpected harm, (c) do not cost more than anticipated,  or (d) do not take much longer than planned. During and after implementation, MEQAPI seeks to rapidly identify risks, issues, and opportunities, and to use quality assurance and process improvement methods and tools to reduce risk and waste, increase efficiency, and improve outcomes for all stakeholders.

In comparison, the HSPI conference focuses on some topics that are very dear to MEQAPI:

  • Process Improvement
  • Leadership and Change Management
  • Operations Research
  • Quality and Safety
  • Human Factors

 

Topics

To mine the experiences of HSPI conference attendees, MEQAPI regulars, and other stakeholders and interested parties, the following topics will be presented during the tweetchat:

  1. Healthcare process improvement increasingly relies on software tools: your favorites?
  2. Is “process” different from “workflow”? If so, how? If not, why do people seem to insist on using both?
  3. Is Healthcare Management/Industrial Engineering” an obsolete phrase? If so, what should replace it?
  4. Health IT increasingly *IS* healthcare workflow. What HIT applications hold greatest promise to improve workflow?
  5. How can we bridge the chasm between process improvement & health IT creation & use?
  6. Bonus question: Quick! Make up a question & tweet it out right now!

… and the numbers

 

meqapi-stats-3-mar-2017

#MEQAPI – Tweetchat Feb 16th 2017 3ET

Next tweetchat: Thursday February 16th, 2017 3:00-4:00 PM ET

Topic: Patient Involvement in Healthcare Improvement

MEQAPI stands for Monitoring & Evaluation, Quality Assurance, and Process Improvement.

The MEQAPI tweetchat aims to give voice to a broad range of stakeholders in healthcare quality, and includes everyone from administrators to zoologists, and includes physicians, nurses, researchers, bed czars, cleaners, and yes, patients and care-givers.

We have selected a mini case study based on the BMJ paper by Lawton et al concerning a Patient Reporting and Action for a Safe Environment (PRASE) intervention.

Paper: “Can patient involvement improve patient safety? A cluster randomised control trial of the Patient Reporting and Action for a Safe Environment (PRASE) intervention

Url: http://qualitysafety.bmj.com/content/early/2017/02/03/bmjqs-2016-005570

The six domains of care quality (STEEEP) mapped out by the Agency for Healthcare Research and Quality (AHRQ) are foundational to healthcare improvement. All care, and by inference quality measures, should be focused on being Safe, Timely, Effective, Efficient, Equitable, and Patient Centered. A central focus of Lean Six Sigma is the need for all quality efforts to be aligned to the Voice of the Customer (VoC).

In healthcare, this means the patient’s voice, yet few quality measure in the National Quality Measures Clearinghouse (NQMC) are proxies for patient outcome, and fewer still are obtained from patient input. The lack of patient involvement in developing measures, collecting quality data, and understanding cost of noncompliance has led to missed opportunities and increased risk and waste. Lawton et al describe the use of the Patient Reporting and Action for a Safe Environment (PRASE) intervention at 33 hospital wards.

The intervention demonstrated a repeatable modality for patient involvement and participation in healthcare improvement.

Topics

  1. Have you seen opportunities for patient involvement in healthcare improvement, what were they
  2. What risks do you foresee in using patient input and participation in quality initiatives
  3. How would patient participation be kept within HIPAA boundaries
  4. What role does/should technology play in patient participation in healthcare improvement
  5. How can providers and patients work together to improve healthcare

 

thu-16-meqapi

#MEQAPI – Tweetchat Feb 9th 2017 3ET

Next tweetchat: Thursday February 9th, 2017 3:00-4:00 PM ET

Topic: Emergency Department Congestion – Patient flow and Healthcare Improvement

MEQAPI stands for Monitoring & Evaluation, Quality Assurance, and Process Improvement.

The MEQAPI tweetchat aims to give voice to a broad range of stakeholders in healthcare quality, and includes everyone from administrators to zoologists, and includes physicians, nurses, researchers, bed czars, cleaners, and yes, patients and care-givers.

The following topics will be posed this week related to patient flow and how it relates to healthcare improvement and quality:

We have selected a mini case study based on ED physician tweets about ED crowding.
Process and quality issues are often seen first in the ED, so a good place to start when looking at improving healthcare. ED crowding is very common, with over half of EDs reporting frequent boarding.

ED is also a very busy and hazardous place, you want to spend as little time in the ED in your life as possible. ED boarding creates additional patient safety risks.

For this discussion, we are defining Boarding as a length of stay (LOS) of over 2hrs for acuity 1-2, or over 6hrs for acuity 3-5. ACEP takes a more functional view of boarding

  1. In a 90 bed ED, 80 beds are boarded, and the ED census is 120. What questions would you ask, and of whom
  2. What risks do you foresee in ED crowding, what risks, issues, and missed opportunities have you experienced
  3. What opportunities do you see for reducing ED crowding, and who should grasp them
  4. What role does/should technology play in improving care workflow
  5. How can providers and patients drive reduction in ED crowding

… and the numbers

meqapi-feb-9

 

#MEQAPI – Tweetchat Feb 2nd 2017 3ET

Next tweetchat: Thursday February 2nd, 2017 3:00-4:00 PM ET

Topic: Administrative and Clinical Workflow and Healthcare Improvement

MEQAPI stands for Monitoring & Evaluation, Quality Assurance, and Process Improvement.

The MEQAPI tweetchat aims to give voice to a broad range of stakeholders in healthcare quality, and includes everyone from administrators to zoologists, and include physicians, nurses, researchers, bed czars, cleaners, and yes, patients and care-givers.

The following topics will be posed this week related to Workflow and how it relates to healthcare improvement and quality:

  1. What does care workflow mean to you, and where does care workflow start and end
  2. What care workflow risks and issues have you experienced, what harm or missed opportunity did you see
  3. How is poor care workflow contributing to the high rate of medical mistakes
  4. What role does/should technology play in improving care workflow
  5. How can providers and patients drive improvements in care workflow

Here’s some of those who attended the session:

 

meqapi-ppl

… and the Symplur analysis of the activity:

meqapi-perf

 

#MEQAPI – Tweetchat Jan 26 2017 3ET

#MEQAPI – Tweetchat Jan 26 2017 3ET

Next tweetchat: Thursday January 26th, 2017 3:00-4:00 PM ET

MEQAPI stands for Monitoring & Evaluation, Quality Assurance, and Process Improvement.

The MEQAPI tweetchat aims to give voice to a broad range of stakeholders in healthcare quality, and will include everyone from administrators to zoologists, and include physicians, nurses, researchers, bed czars, cleaners, and yes, patients and care-givers.

Three healthcare domains in which we might want to pay close attention are Care Policies, Care technologies, and care flow.

The following topics will be posed this week related to Health IT and how it relates to healthcare improvement and quality:

  1. What successes are there in Health IT – what is working well and how does that manifest
  2. What Health IT failed at least one element of Safety, Timely, Efficiency, Effectiveness, Equitability, Patient Centered – how
  3. What role should the government play in making Health IT improve healthcare cost, quality, and accessibility
  4. What role do the medical NGOs, journals, and professional bodies play in improving Health IT
  5. How can providers and patients drive improvements in Health IT