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Best Practices in Accelerating Digital Transformation to Support Value-Based Care Models

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Linda Li

on 13 June 2016

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Transcript of Best Practices in Accelerating Digital Transformation to Support Value-Based Care Models

Providing Excellent Care
Discovery.
Clinical Practice Guidelines at Ontario Shores
Questions, comments or feedback?

Feel free to contact us at
OntarioShores.ca

700 Gordon Street,
Whitby, ON
L1N 5S9
Ontario Shores Centre for Mental Health Sciences (Ontario Shores) is a 326-bed teaching hospital specializing in comprehensive mental health and addiction services for those with complex serious and persistent mental illness. Ontario Shores is
composed of 16 inpatient units with 12-27 beds per unit with several outpatient services.
Ilan Fischler, MD, FRCPC Physician Lead
fischleri@ontarioshores.ca


Kelly Delaney, RPN, Clinical Educator
delaneyk@ontarioshores.ca


Wendy Odell, BBA, CHIM, CPHIMS-CA Manager, Clinical Information
odellw@ontarioshores.ca
Contacts
In October 2014 Ontario Shores became the first hospital in Canada and the first mental health hospital in the world to receive the prestigious HIMSS EMRAM Stage 7 award. This designation is awarded to healthcare organizations for having a completely paperless health information system which advances the use of patient
data to ultimately improve process and performance.
...minimizing the variability ...
Recovery.
Hope.

YEAR ONE
Learning Objectives:

1. Become familiar with the methodology to implement clinical practice guidelines (CPGs).

2. Develop an understanding of strategies embedded CPGs in documentation.

3. Appreciate how clinical dashboards can be used to achieve quality improvement objectives.
Interprofessional referrals
Nursing intervention
Compared to the hospital
Clinical Practice Guidelines (CPGs):

Best practice approach to assessment, diagnosis, and treatment of disorders
Created at a national and international level, by a panel of experts
Ontario Shores is committed to implementing CPGS annually over 5 years
Learning Objectives:

1. Become familiar with the methodology to implement clinical practice guidelines (CPGs).

2. Develop an understanding of strategies embedded CPGs in documentation.

3. Appreciate how clinical dashboards can be used to achieve quality improvement objectives.
Recommended guidelines
Optional ...
Diagnosis
YEAR TWO
Clinical Practice Guidelines for Schizophrenia
Quality Improvement using
Dashboards
In October 2015 Ontario Shores was named a 2015 HIMSS Enterprise Davies Award recipient. The Davies Awards program promotes electronic health record-enabled improvement in patient outcomes.
- Assessment and treatment of inpatients with
schizophrenia
- Metabolic monitoring inpatients and outpatients
- Realignment of therapeutic services
- CBT for psychosis
- Supportive employment
- Caregiver assessment
- Music/art therapy
Automated Physician Decision support
Implementing Clinical Practice Guidelines at Ontario Shores
Planning
Implementation
and... ADOPTION!
Training
Optimization
Pervasiveness of Use!
With these in place, we were able to begin building decision support in clinical documentation.
Adoption!
Schizophrenia

Clinical Practice Guidelines for Depression
- Diagnosis decision support
- Antidepressant side effect monitoring
- ECT consultation and monitoring documentation
- Standardized text for Medications
- Nursing intervention for depression education
- Caregiver assessment

Depression
Ontarioshores.ca
1.800.341.6323
No health without mental health
#MindVine
#MentalHealth
#5in5
Pervasiveness of use
Standardized documentation and prompts
*
click to document
Capturing accurate history
You just learned about:

1. Diagnosis driven care pathways
2. Inter-professional collaboration prompted by
documentation
3. Practice guidelines used in order
management
Reminders every day until completed
Standard Patient Health Teaching
You just learned...

1. Standardizing delivery of patient education
2. Standardizing documentation of medication
3. Methods to improve documentation leveraging
system and process flow
CPGs were created using a nine-step process:

1. Selection of a guideline
2. Development of algorithm to guide practice
3. Complete a gap analysis in relation to key recommendations
from the CPG
4. Create governance structure to support CPG implementation
5. Identify process and clinical outcome measures
6. Finalize project charter
7. Utilize informatics
8. Realignment of therapeutic services
9. Monitor adherence and promote quality improvement
But first... laying the foundation...

... many other templates/referrals were used for this care pathway. Please contact us for more information.

... many other templates/referrals were used for this care pathway. Please contact us for more information.
Documentation
Orders and documentation triggered evidence based assessments
Data collection. Dashboard design.
Reports discussed in committees and with user representative for analysis and recommendations
Dashboards
sent to Senior management team, Physicians and, charge nurses.
Quality initiatives and recommendations implementation
Feedback, feedback, feedback!
Program and Unit Dashboard
Physician Dashboard
Compliance Monitoring
Compliance Monitoring
Full transcript