Camillus Health Concern, Inc.

Transcription

1 Camillus Health Concern, Inc. Continuous Quality Improvement in a Homeless Healthcare Setting Rosendo Collazo, DO

2 WHO WE ARE Health Center for the Poor and Homeless 20 years Catholic Entity- BGS FQHC Federally Funded- HHS: HRSA/BPHC 4 sites* 51% Consumer Board of Directors

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7 4 Doctors 4 Nurse Practitioners 3 Nurses 6 Medical Assistants 1 Clinical Psychologist 2 Dentists 1 Dental Hygienist 1 Dental Assistant Who We Are Clinical Staff

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9 WHO WE SERVE Poor and Homeless of Miami Dade County 5200 individuals annually 28,000 visits annually 80 % Adults, 20 % Children 90 % Black and/or Hispanic 92 % Uninsured 90 % below the Federal Poverty Guideline

10 What We Do Primary Care Episodic/ Subacute Care Chronic Disease Management Preventive Screening Education and Testing Medical Outreach* Respite Beds Pharmaceuticals

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18 What We Do, too.. Dental Services Restorations Extractions Dental Hygiene Prosthodontics Podiatry Behavioral Health Services Psychiatric Services Medication Management Clinical Psychotherapy Group Therapy Case Management

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20 What We Do Specialty Services Emergency Services Surgical Referrals Jackson Memorial Hospital Bascom Palmer Eye Institute University of Miami School of Medicine Other Community Providers

21 HOW WE DO IT Integration of Services Multidisciplinary Approach Cordial and Respectful Environment Pragmatic Approach, Baby Steps.. Continuous Quality Improvement Program Plan Updated Every Year QI Committee Meets Quarterly

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24 Quality Improvement Program 34 Aspects of Care and/or Operations Indicators Performance Goals Data Source Frequency Responsibility

25 PEER REVIEW ASPECT OF CARE: Clinical Standard of Care INDICATOR: Provider effectiveness (Peer Review) PERFORMANCE GOAL: 80% of all records are compliant with Peer Review parameters checked DATA SOURCE: FREQUENCY: RESPONSIBILITY: Chart Review Quarterly (March, June, Sept, Dec) Medical Providers

26 JANUARY FEBRUARY MARCH APRIL MAY JUNE Fire Safety Patient Satisfaction survey Risk assessment for substance abuse Anti-Platelet Therapy in patients diagnosed with CAD Access to dental care for homeless clients Access to mental health care for homeless clients F.D. immunization compliance F.D. growth and development F.D. annual physical F.D. heath education for parents Incident reports Cholesterol screening in patients diagnosed with HTN Geriatric Functional assessment Geriatric Immunization compliance Provider effectiveness (peer review) Patient services documentation Completion of Employee Health documentation Documentation of controls Adolescent behavioral risk assessment Cardiovascular risk assessment Cervical cancer screening Breast cancer screening Patient Satisfaction survey Immunization of children less than 24 mo. of age Growth and development monitoring of 4-6 year olds Access to dental care for homeless clients Access to mental health care for homeless clients Required permits and licenses for the health center Incident reports Ophthalmic referral for diabetics Podiatry referral for diabetics HbA1C testing for diabetics HbA1C outcome for diabetics Provider effectiveness (peer review) Patient services documentation Completion of Employee Health documentation Documentation of controls Cardiovascular risk assessment HIV/AIDS screening for TB HIV/AIDS immunization compliance JULY AUGUST SEPTEMBER OCTOBER NOVEMBER DECEMBER Fire Safety Patient Satisfaction survey Anti-Platelet Therapy in patients diagnosed with CAD Access to dental care for homeless clients Access to mental health care for homeless clients F.D. immunization compliance F.D. growth and development F.D. annual physical F.D. heath education for parents Incident reports Cholesterol screening in patients diagnosed with HTN Geriatric Functional assessment Geriatric Immunization compliance Provider effectiveness (peer review) Patient services documentation Completion of Employee Health documentation Documentation of controls Cardiovascular risk assessment Cervical cancer screening Breast cancer screening Patient Satisfaction survey Immunization of children less than 24 mo. of age Growth and development monitoring of 4-6 year olds Baby bottle tooth decay counseling Access to dental care for homeless clients Access to mental health care for homeless clients Current professional licensure Incident reports CPR certification Ophthalmic referral for diabetics Podiatry referral for diabetics HbA1C testing for diabetics HbA1C outcome for diabetics Provider effectiveness (peer review) Patient services documentation Completion of Employee Health documentation Documentation of controls Cardiovascular risk assessment HIV/AIDS screening for TB HIV/AIDS immunization compliance

27 Diabetes Continuum of Care 3 rd Most Common Diagnosis Very High Cost of treatment Never an Only Child Multidisciplinary Approach to Treatment Medication Education Podiatry Ophthalmology Laboratory

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29 Eye Examinations Leading Cause of Acquired Blindness Yearly, Regular Eye Examinations Bascom Palmer Eye Institute

30 Diabetes Continuum of Care ASPECT OF CARE: Diabetes Health Care INDICATOR: Ophthalmic referral for diabetics PERFORMANCE GOAL: 80% of established diabetic clients will have an annual ophthalmic referral DATA SOURCE: Chart Review FREQUENCY: Biannual (May, Nov) RESPONSIBILITY: Dir. of Health Services, C.S. Adm.

31 Foot Examinations DM, a Leading Cause of Amputations Neuropathy Vascular disease Regular Foot Examinations Required Podiatry Service 3 days per week Barry University Faculty and Residents

32 Diabetes Continuum of Care ASPECT OF CARE: Diabetes Health Care INDICATOR: Podiatry referral for diabetics PERFORMANCE GOAL: 80% of established diabetic clients will have an annual podiatry referral. DATA SOURCE: Chart Review FREQUENCY: Biannual (May, Nov) RESPONSIBILITY: Dir. of Health Services, C.S. Adm

33 Laboratory Testing Consistent Blood Sugar Control Hemoglobin A1c- Every 3-6 months Reduction of Co- Risk Factors Lipid testing, annually

34 Diabetes Continuum of Care ASPECT OF CARE: Health Maintenance INDICATOR: HbA1C testing for diabetics PERFORMANCE GOAL: 80% of established diabetic clients will have had an HbA1C test within the last six months. DATA SOURCE: Chart Review FREQUENCY: Biannual (May, Nov) RESPONSIBILITY: Dir. of Health Services, C.S. Adm.

35 Diabetes Continuum of Care ASPECT OF CARE: Health Maintenance INDICATOR: HbA1C outcome for diabetics PERFORMANCE GOAL: 70% of established diabetic clients will achieve a 20% reduction in HbA1C levels within 12 months of baseline reading or maintain HbA1C level of 7.5 or less DATA SOURCE: Chart Review FREQUENCY: Biannually (May, Nov) RESPONSIBILITY: Dir. of Health Services, C.S. Adm

36 Diabetes Continuum of Care ASPECT OF CARE: INDICATOR: Diabetes Health Care Lipid Screening in Diabetics PERFORMANCE GOAL: 70% of established diabetic clients will have a lipid panel screening in the previous 12 months DATA SOURCE: FREQUENCY: Chart Review Biannually (May, Nov) RESPONSIBILITY: Dir. of Health Services, C.S. Adm

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