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

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Linda Li

on 6 June 2017

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

Best Practices in Accelerating Digital Transformation to Support Value-based Care Models
Questions, comments or feedback?

Feel free to contact us at
OntarioShores.ca

700 Gordon Street,
Whitby, ON
L1N 5S9
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
...minimizing the variability ...

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
Ideally are "hardwired" into workflow processes to produce highly reliable usage
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
- 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
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
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
At Ontario Shores, 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