Post on 07-May-2015
transcript
Jamie Snow, MBA, CCLS Assistant Director of Child Life and Social Work
Mary E. Tietjens, BS, CCLS Manager of Child Life
Texas Children’s Hospital, Houston TX
Texas Children’s Hospital Child Life Conference
October 5, 2013
Identify key components of the Patient Protection and the Affordable Care Act of 2010 (ACA)
Review how the changing healthcare environment impacts health care consumers
Gain an understanding of common healthcare terminology and how to translate child life’s value into healthcare concepts
Examine why measuring and reporting the quality and outcomes of child life interventions adds value to your program
By the end of today’s workshop, participants will walk away with a high level overview of the changing healthcare market and an understanding of how to reframe the work of child life into healthcare concepts
Throughout today’s workshop, participants will begin the creation of a “Child Life Portfolio of Value” that can be utilized to demonstrate how child life services add value to their organization
Discuss current changes in the healthcare system, breaking down specific components and how they relate to the world of child life
Breakout Session: Link child life value to health care concepts
Report Out: Create your Child Life Value Portfolio
Discuss the importance of measuring quality and outcomes
Breakout Session: Identify ways to measure and report child life outcomes
Report Out: Enhance Child Life Value Portfolio with measurement and reporting strategies
Questions and answer session
Patient Protection and the Affordable Care Act of 2010 (ACA) - Fully implemented 2014
• Quality, Affordable Heath Care for All Americans
• Systematic insurance market reform – eliminate discriminatory practices
• Tax credits to support affordability • Penalties if not insured • More coverage for preventative services
• The Role of Public Programs • Expands eligibility for Medicaid • Enhanced federal support for Children’s Health Insurance
Program (CHIP)
• Improving Quality and Efficiency of Health Care • Investments to improve quality and delivery of care and inform
consumers about patient outcomes • Financial support linked to quality performance
Prevention of Chronic Disease and Improving Public Health • Create infrastructure for health promotion and disease prevention
• Healthcare Workforce • Encourage health workforce training and retention (Loan programs
for schools)
• Transparency and Program Integrity • Combat fraud in public and private programs
• Improving Access to Innovative Medical Therapies • More affordable medications for children and underserved
communities
• Community Living and Assistance Services and Supports • Long term insurance program for community living assistance
and support
• Revenue Provisions
• Excise tax on high cost employee sponsored health coverage
Value Based Purchasing
Bundle Payments Diagnosis Related Groups
Access to Care
Health care reform success is contingent on consumer savviness
Health care costs are moving toward consumers: creating more consumer driven care
Healthcare transparency Compare providers based on quality, safety and patient
satisfaction
Compare insurance plans: Insurance Marketplace
Consumer sites are become prevalent: HeathGrades
Access to information on smart devices is increasing
Pros Create more efficient processes in hopes to reduce cost New Model of Care – Good patient outcomes equal more
federal support More insured, could help the bottom line More preventative care
Cons Influx of new patients taxing the system as whole, creating
more paperwork, more need for access in a system that is already stretched for patient access
Complex and hard to fully understand Tracking quality metrics takes time and resources
Understand your individual health care institution’s change and evolution What quality metrics does my hospital report, or plan to
report, and how are they collecting and reporting that data?
What change is taking place to embrace health care reform?
Know your hospital’s priorities and goals
Track hospital/unit statistics
Who are your consumers
Embrace and market consumer driven healthcare Create an environment that embraces patient
engagement
Create value driven ideas and statements using marketing techniques Target audience
Tell the stories that targets key components Product, Pricing, Placement and Promotion
Provide examples
Create supply and demand
Convenience and Accessibility Strategies to enhance way finding
Community based hospitals, health centers
Medical Homes: High quality medical care for underserved communities
Child Life’s Role in Supporting Convenience and Accessibility Share expertise: wellness programs, orientation
On-site in-services
Identify Distinct Local Market Needs Child Life Teams: Meet unique needs of hospitalized
children
Marketing/Media
Child Life’s Role in Identifying Local Market Needs “What do our patients need?” vs. “What services do we
want to provide?”
Proactive Patient Outreach ACA: Health promotion/disease prevention:
Prevention and Public Health Investment Fund
“Sick care” vs. “Health care”
Supporting preventive care health initiatives
Child Life’s Role in Supporting Patient Outreach Health and wellness fairs
Programming around wellness: cooking classes
Healthily lifestyle choices: exercise incentives
Customer Service Focus Customer satisfaction linked to reimbursement
Child life traditionally linked to satisfaction
Child Life’s Role in Customer Service Competency driven
Highlight programs to your leadership
Performance tool objective
Patient Loyalty Consumer options focus on market differentiation
Insurance carrier
Hospital provider
Specialists
Don’t make assumptions
Child Life’s Role in Creating Patient Loyalty Develop relationships
Demonstrate strong competencies Clinical, work ethic and attitude
I.V.
“Put to sleep”, gas, anesthesia
Dye
Urine – “you’re in”
Stool
Medicine through a small, tiny tube; I.V. = into the vein
Medicine to help you go to sleep, different than sleep at night
Medicine to help us see your picture
Pee – use child’s familiar term
Pooh, Poop – use child’s familiar term
Accountable Care Organizations (ACO) Network of hospitals and physicians
Goal to limit unnecessary spending
Primary care physician driven
Savings incentives for keeping costs down
Fee for Service Payment model (past or current)
Quantity vs. quality
Bundled Payments Payment model (future)
Set expected cost of clinically-defined episodes of care
Marketplace/Exchange State/federal insurance website
Comparisons/financial assistance
Opened Oct. 1 for Jan. 1, 2014 coverage
Utilization Management/Review Assess interventions
Appropriateness, medical need, efficiency
Alignment with health benefit plan
Proactive vs. retroactive Terms are used interchangeably
Diagnosis Related Groups (DRGs) System to classify cases into groups
Intent to identify services needed
Set reimbursement and timeframes
Encourages examination of processes and discharge barriers
Potentially Preventable Readmissions (PPR) Analyze administrative data to identify readmissions
Factors that impact PPR Severity of illness, age, mental health diagnosis
Assess if related to a prior admission
Market Share
DRG s
Preventable Readmissions
Animal assisted therapy is a unique program within our market that enhances the emotional well-being of our patients and families.
Positive coping promotes the patient /families ability to achieve patient care goals and meet discharge criteria .
Enhanced understanding and compliance can be met through developmentally appropriate diagnosis teaching, aiding in the reduction of preventable readmissions.
Patient Satisfaction
Preventive Care
The Child Life Zone is offering additional play programming, enhancing the opportunity to normalize the healthcare environment and create customer satisfaction.
As a part of our department’s wellness initiative, child life is teaming up with nutrition support to offer cooking classes for patients and families coping with a diagnosis of type 1 diabetes
Break into your groups
Choose a member to scribe
Review the health care terms listed on your large Post It Note paper
Share and brainstorm your current programming components that bring value to your organization
Match programming components to a health care concept that demonstrates how child life brings value to that specific concept
The desired
outcome of this
exercise is to begin
reframing your
thought process and
link the value of
your child life
programming to
your hospital’s
overall health care
concepts.
Break Out Session
Choose someone to speak for your group
Share specific child life programming ideas that demonstrate value and identify the link to a health care concept.
Challenge yourself to utilize the heath care language when reporting out to the group!
The desired outcome
of this exercise is to
enhance your tool kit
of programming
ideas that
demonstrate the link
between child life’s
value and health care
concepts.
Use your Start Doing
and Keep Doing cards
to begin the creation
of your Child Life
Value Portfolio
Group Report Out
What determines quality Patient Satisfaction: Hospital Consumer Assessment of
Healthcare Providers and Systems (HCAHPS) Hospital Policies & Procedures Child Life Council EPB statements Accrediting Agencies Hospital Trends/Priorities (marketing priorities) Community Needs Assessment
Establish goals/objectives
How do you track and measure Use validated tool or develop tools and techniques to capture
quality
Determine your target audience
Include all stakeholders
Determine tools Scorecards/Dashboards
Meetings (presentations)
Marketing
Hospital Wide Implementation of Care Progression Rounds Better daily communication on patient care
Timely discharge (increase access)
Child life’s role in a hospital wide initiative Active and present members daily
Identify and report child life’s scope of services and barriers to discharge Coping/Diagnosis Education/Compliance
Project Scope: To build a child life specific Participant Classification System to support appropriate child life staffing for Texas Children’s Hospital (TCH).
Long Term Goal: Understand and track current staffing and plan towards a formal staffing model that would reflect child life priorities within a participant classification system. This classification system would eventually correlate with unit specific demand and child life quality measurements.
What Makes a Quality Intervention and How do you Measure the Outcomes of That Intervention Indentify tools and resources needed
Time for pre-assessment
PIES
Individualized intervention
Environment
Comfort Measures
Measure Outcomes “Active coping response” vs. “inactive coping
response”
Demonstrating behaviors “non-interfering”
“potentially interfering”
“interfering”
Measuring Quality
Reporting Outcomes
The child life department utilized a parent survey to assess the patient’s dietary habits pre and post implementation of the type 1 diabetes cooking class to measure changes in food choices and insulin levels.
Survey results were presented in a teaching aid summery which outlined specific learning objectives, evidence based practice references and methodology; demonstrating the link between developmentally appropriate teaching and behavior modification.
Break into your groups
Choose a member to scribe
Review the child life programming concepts listed on your large Post It Note paper
Share and/or brainstorm ideas for measuring and reporting the quality and outcomes of child life programming
Match child life programming components to a health care concept that demonstrate a measurable link between child life programming and quality health care outcomes.
The desired
outcome of this
exercise is to
generate ideas for
measuring and
reporting the
quality outcomes of
child life
programming
concepts.
Break Out Session
Choose someone to speak for your group
Share specific strategies that can be utilized to measure the quality of child life programming and the outcomes that can be linked to a health care concept.
Challenge yourself to utilize the heath care language when reporting out to the group!
The desired outcome of
this exercise is to enhance
your tool kit of quality and
outcome measurement
and reporting strategies
that demonstrate the link
between child life’s value
and health care concepts.
Use your Start Doing and
Keep Doing cards to add
reporting ideas to your
Child Life Value Portfolio
Group Report Out
Thank you for your thoughts and participation!
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