Staff and Leadership Engagement 9.pdf · Staff and Leadership Engagement Prepared by: Shannon...

*All documents are property of Curis Consulting. Do not duplicate or distribute w ithout written permission.

Staff and Leadership EngagementPrepared by: Shannon Nielson, MHA, PCMH-CCE

Prepared for: CHAD

1.9.19

*All documents are property of Curis Consulting. Do not duplicate or distribute

w ithout written permission.

How are you measuring value today?



What we know…

PCMH

UDS

FTCA

Pt. Satisfaction

Surveys

HIE

ACO/APM

EMR

Meaningful Use

HEDIS



What they hear…

PCMH

UDS

FTCA

Pt. Satisfaction

Surveys

HIE

ACO/APM

EMR

Meaningful Use

HEDIS



Value Based Care Defined

The health outcomes of a population (population health) are driven by interventions (population health management) such as Patient Centered Medical Home concepts aimed to deliver upon improved outcomes, decreased cost, improved patient experience and provider experience (Quadruple Aim).

The measured impact on the Quadruple Aim determines your value.

Spreading value beyond your existing patients and to all eligible patients is the ultimate determination of sustainability within a value based care environment.



Compliant Quality

• HRSA

• FTCA

• HEDIS

• CMS

• PCMH



Meaningful Quality

Efficiency Effectiveness Quality

Quality Impact Value



Patient Staff Engagement

• Importance

• Confidence

• Readiness



Foundations for Engagement in Quality• Importance

• Purpose

• Data

• Confidence• Ownership

• Data

• Reward and Recognition

• Readiness• Responsibility

• Data



First Things First…Importance



Understanding the ‘WHY”

• There is a significant gap in the level of understanding around Health Center specific funding, compliance, regulations, documentation, data, reporting & more….

• There is also a disconnect when we talk about Value Based Care & PCMH requirements…

• Our teams will be far more likely to adhere to documentation protocols when they understand the ‘WHY’ behind them.



Closing the ‘WHY’ Gap

• How thorough is your team trained around health center regulations, UDS data, PCMH, Value Based Care, etc?

• How frequently is training updated or

repeated?

• How familiar are your staff and

leadership with outcome

expectations?

• Is your team informed about your

Value Based contracts and

understand their role in maximizing

reimbursements?



We have to do it for UDS…

Reason• We have to do it for UDS

Purpose• Improved documentation gives

us a better understanding of our opportunity to improve quality

• Where should we focus based on how patients utilize us

• We can identify a focused opportunity for growth/access

• Alignment with PCMH and HEDIS



We have to do it for PCMH

Reason• For PCMH we need to huddle

• We need to pick a CM population and you have to document goals

• We need to complete PDSAs to show CQI

Purpose• Improved communication and pre-

visit planning should create efficiencies, improve pt. experience and maximize your skill set

• There is a population that is more at risk and we can provide ongoing care management support to mitigate the risk and reduce risk

• Where is there an opportunity to improve and how do you think we can do it?



We have to do…. We need you to…

• By doing X we can improve Y

Yes, it’s that simple



Importance: Systems Level DataLeadership/Governance

MoneyMission

Mid-level ManagementMoney

Staff SatisfactionEfficiency

Front Line StaffPatient Satisfaction

QualityEfficiency

PatientsQualitySafetyCost



Data Usability

• Actionable• Lists

• Contact Information

• Population Based

• Team Relevant

• Realistic Measurable Outcomes• Process vs. Outcome

• Consistent



Data Visibility

• PLAN without data is a Wish

• DO without data is Simon Says

• STUDY without data is Water Cooler Gossip

• ACT without data is Groundhog’s Day



Data Visualization

• Consider visualization

• Transparency

• Limit data



How We Visualize our Data

• Identify areas that need attention or improvement

• Clarify which factors influence outcomes

• Help us understand what interventions are needed

• Know your audience



Systems Level Data Sharing



Visualization Changes Purpose



Confidence: Ownership

• Responsibility vs. Duties• Responsible

• Accountable

• Informed

• Consulted

• Innovation vs. Direction• Quality Teams

• Staff PI teams

• Failure is Fabulous



Confidence: Data

• Test informed data• Can you really improve A1Cs in 2 weeks

• Qualitative Data• Patient Feedback

• Staff feedback



Confidence: Reward and Recognition

• Reward Money• Presentation

• Announcements

• Creative incentives

• Competition Drives Engagement• Transparent Data

• Aligned Goals



Readiness: Responsibility

• Scope of Licensure• Team Based Care

• Role purpose

• Expected Outcomes

• Purposeful Process• Skill vs. Availability

• Communication and Access

• Expected Outcome



Readiness: Data

• Data Rules:• Platinum Rule: How will the data be used

• Golden Rule: How are the elements defined

• Silver Rule: When should you see the data change?

• Data Process:• Set your data strategy

• Define your staff engagement needs with your data strategy

• Validate and create your data

• Provide meaningful, actionable, baseline data

• Provide ongoing demonstrative, reactive data



Employee Satisfaction vs. Employee Engagement



Employee Engagement Surveys

• My roles and responsibilities are clearly defined

• My daily activities match my job description

• My skills/licensure/experience is used in my daily activities

• Most of the systems and processes here support us getting our work done effectively and efficiently

• I am given the opportunity to contribute my ideas and opinions on how we can improve

• I am given the opportunity to contribute my ideas and opinions on how we can improve

• Day to day decisions demonstrate that quality and improvement are top priorities

• Our organization promotes non-management employee participation in projects and committees

• What resources, tools or systems are needed to better help you do your job?

• What activities/committees/projects would you like to be involved in or see other staff members involved in?

• What would you like to most see improved upon in the organization that would result in enhanced engagement and satisfaction? (Examples include: EMR optimization, job clarification, communication, team building...)



Motivational interviewing for you

•O: Open ended questions

•A: Affirmations

•R: Reflective listening

• S: Summarize



UDS

• Annual Report for HRSA

• Table 6A, 6B and Table 7

• But did you know?....• Care Team Information

• Productivity

• Service Utilization

• Population Needs



FTCA

• Compliance• Safety

• Quality

• Billing

• Coordination



PCMH: It’s not a 4 letter word

Team Based Care

Knowing and Managing your

Patients

Patient Centered Access and Continuity

Care Management and Support

Performance Management and

Quality Improvement

Care Coordination

and Transitions



Putting Quality into Action

Access is the

opportunity

for care

Quality is the opportunity

for cost

Cost is impactedby

“appropriateness” of access

Appropriate access is driven by your population’s

care needs

Care needsdrive a

Provider’s adoption of

quality

Adoption of qualitydrives your

population health management

activities

PCMH activities drivethe ability to improve access beyond your

patients

Spreading your value beyond your patients is VALUE BASED

CARE

Care is the

opportunity

for quality



But I am not a Quality Person: E-I-E-I-O

• Engage (Patients)

• (Be) Informed

• (Define) Excellence

• Initiate

•Optimize



What Should you do now?

• Identify an opportunity• Process?• Outcome?• Responsibility?

• Ask for Information• Understand performance• Assist in setting goal • Ask for alignment

• Engage• Staff

• Patients



Organizational Alignment

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