Pediatric and Adolescent Health Partners

February 12, 2011

Disclaimer

I have no relevant financial relationships with the manufacturers of any commercial products and/or provider of commercial services discussed in this CMS activity. I do not intend to discuss an unapproved/investigative use of a commercial product/device in their presentation.

Pediatric and Adolescent Health

Partners

Located in Midlothian, VA

We have 10 staff doctors and 1 pediatric rheumatologist with 3 locations serving 20,000 patients.

Team Members: Peter Blakey, MDTracie Williams, LPNStephanie Fitzgibbons, LPN

AimBy January 1, 2012 we plan to have

procedures and protocols in place to ensure: 100% return of NBS results by the 6 week well baby visit

100% of parental notification of the NBS results documented in the chart100% of providers utilizing ACT sheets where appropriate

Changes Implemented

Reliable Systems of CareEMR Template ChangesPDSA CyclesStaff ResponsibilitiesProtocol for Abnormal/ACT SheetsCHSCN Registry

Changes ImplementedFinance

Purchase Printed Information for Pre-NatalMeetings

Planning for Additional Staffing

Changes ImplementedCommunity-based Care

Established Communication with State Newborn Screen Services

Established Communication with Local Genetics Resources- MCV/VCU

Introduction of NBS at Pre-Natal Meetings

Changes Implemented

Active Well-informed Patients

NBS Procedure/Protocol Established from Initial Well Visit thru 6 week well baby visit.

Cycles of ImprovementMaking parents aware of the NBS and its importance.

~PLAN Begin introduction of NBS at pre-natal meetings with

printed materials provided to parents ~DO

NBS information provided to parents at pre-natal meetings

~STUDY Parents received information well by demonstrating

awareness of NBS at first well baby visit. We learned that there is a benefit to providing NBS

information prior to delivery~ACT

We have continue to provide this information at all subsequent pre-natal meetings.

Cycles of ImprovementDeveloped protocol to ensure timely return

of results and notification of parents.~Plan

Establish a protocol to involve doctors and nurses in the acquisition of NBS results in a timely manner.

~Do Initial visit (3-5 days)-nurse inquires about NBS

performed 2 week well baby visit-nurse ensures that NBS

results are available, provider discusses

Cycles of Improvement~Study

Discovered inconsistencies in physician and nurse documentation and performance

We have learned that we need better communication between nurses and doctors as it relates to NBS protocol.

~Act Planned additional meetings and inter-office email

between doctors and nurses.

Results

Results

Results

Results

Results

Results

Results

Results

What You Have Learned

We have learned that change was a challenge, the lack of communication was a surprise.

Inconsistent performance was a challenge.

Staffing shortage along with a busy daily schedule provided a challenge.

General Lessons LearnedContributions to our success

EMR Template ChangesSchedule communication with state NBS labBrochures provided at pre-natal meetingsPositive feedback from parents during NBS

discussions at well baby visitsAnticipated issues

Maintaining momentum going forward