altamed el monte
QILC Focus
- start changing medical workflows
- test small
- update dental practice to allow for access
- medical/dental trainings/meetings
- use medical teams to develop change...give them power over their job/responsibility
- use your resources "at the top"
road to integration
April to Now
Referrals Success
Among 3 Pediatric providers, 2 PT (CHLA) and 1 FT
- Percent of slips resulted in pt interaction with dental (same-day visit, appt scheduled, CRA completion, CDHC performed education [pts who see outside DDS])
- March: 27%
- April: 37%
- May: 42%
- June: 39%
I think we're ready to spread clinic-wide!
- How do we know something is working...prove it!
- surveys, key data presentation
- Sustainability
- what does this mean to us?
- Is this helping our patients?
- Clinic without champions
- loosing Dr. Wilkinson & Robert
QILC Focus
- CDHC hardwired collaborative team
- reduce redundancies
- optimize each staff's time with the patient during pt cycle
- identify key players
- success still very reliant on CDHC
presented by Jacquelyn Rios
Passport referral graduated to Passport CRA + referral slip
advice....
- self-reflection as a group, as a CDHC
- what does success mean, in the next 30 days, quarter, end of grant period
- collaborate with everyone! (medical, dental, IT, leadership, MAs, front office--everyone)
February - April
No...not really ready yet.
90-Day
AIM statement
hardwire
an integration
process
that allows 0-5
year old patients
to be seen in both
medical and
dental as soon as
9 months of age
reworked to 4
months of age
- What's working? (PDSAs)
- Workflow Diagrams
- now vs. ideal
- long term hard wiring
- care pathway
- Making Changes--from the top
- CDHC IN MEDICAL WORKFLOW
- ONE REGISTRATION WORKFLOW
- SAME DAY VISIT WORKFLOW
- OHU WORKFLOW
- AFTER PEDS WORKFLOW
- DENTAL-IN-MEDICAL WORKFLOW
- 2 MONTH OLD WCC WORKFLOW
- 9 MONTH OLD WORKFLOW
- YELLOW PASSPORT WORKFLOW
- BLUE PASSPORT WORKFLOW
swim lanes
Next Steps
OUR MISSION
To eliminate disparities in health care access and outcomes by providing superior quality health and human services through an integrated world-class delivery system for Latino, multi-ethnic and underserved communities in Southern California.
- use data to drive change
- LEM Goal, 9% increase in only 2 months
- is "integration" working--ask the patients!
- case of Angel C. (Pedo patient)
- develop a clear understanding of how these visits affect your business
Referrals->Integration
- testing the reliability of PDSAs based on step by step audit
- review all tested workflows
- involve the people within the system in improvement/change
- develop your ideal/mapping
- Dental leadership helping drive integration
- LEM goal in the horizon
December - January
Understanding PDSAs & the Relationship with Medical Dept.
- PDSA #1: referral slips
- first attempt to develop a system
- start to track referral success
- Bringing medical team to QILC
- provided clarity on project
- aligned what CDHC was doing in the clinic w/ QILC topics
September -
November 2014
QILC Focus
- 6-step protocol provided more clarity on "why" and "what" we are trying to accomplish
- driver diagram & PDSA worksheet shed light on "how" we can get this done
- be the "integration" person, not the dental person
- Introspection & Analyze workflows:
- ambiguity in grant "why?" "what" and "how?"
- medical and dental teams were disconnected
- CDHC performed education and referral within medical visits
- little resistance, but little buy-in--OHI killed wait time perception
Become the expert
&
Engage your medical teams at all levels
THE ROLE OF THE CDHC
focus
- CDHC role
- the QILC
- the process
- turning challenges into opportunities
- confusing role?...be creative in accomplishing project goals
- lack of project knowledge?...you become the expert
- little direction/explanation of aims?...grant funds provide you time and resources to enhance systems