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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

QILC #3

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

QILC #2

  • 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

QILC #1

  • 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
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