Alignment Strategies at the JPS Health Network

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1 Improving the Patient Experience Alignment Strategies at the JPS Health Network JPS HEALTH NETWORK 537 bed hospital, Level 1 Trauma Center Tarrant County s Safety Net Hospital 15 primary care clinics 20 school based clinics 8 specialty clinic sites 338 active medical staff 100 primary care providers 6000 employees 1

2 Healthcare in a Safety Net System Ever increasing population of underinsured/uninsured patients Aging population with increasing chronic conditions More to know, more to do, more to manage, more to watch, more people involved than ever before!! ORGANIZATIONAL ALIGNMENT Patient Quality, Satisfaction & Safety starts with Culture Physician alignment is the key to changing culture Improvement in patient, provider and employee satisfaction is a journey Engage Providers as stakeholders Envision a culture of excellence 2

3 Where did our journey begin? Establishing vision Reviewing current state»physician compensation was fee for service» Quality assumed but not measured»high ED utilization» Barriers to access»patient satisfaction in the less than 5% Developing a Strategic Plan: 7 steps 1. The Organization would need to develop a Strategic Initiative Plan 2. Adopt an EMR platform 3. Develop Departmental Metrics that aligned with the JPS Strategic Initiatives 4. Transparency with the Data 5. Engage Physicians Directly with action planning to achieve metrics 6. Establish a PCMH as a care delivery model 7. Develop a compensation plan that incentivizes outcomes 3

4 1. JPS Pillars A good starting place Hurdle 1 Developing Strategic Initiatives Service Quality Stewardship People Engagement Population Health Academics Hurdle 2 Aligning Initiatives with Medical Staff 2. Adopt an EMR platform 4

5 3. Developing Clear Measures Metric alignment with JPS Strategic Initiatives Relevant and Achievable Communicate results regularly 4. TRANSPARENCY 5

6 6. Provider Feedback System Physicians are data driven driven Providing high quality care to patients Accomplishing organizational objectives 6

7 Accountability: #1 reason why execution is not accomplished Chairman Share the vision, set the tone and pace Meet quarterly with regional directors Meet monthly with all medical directors for larger strategy Regional Directors Meet monthly with operational and medical leaders Discussion and action planning Translate the vision Site Directors Create transparency for patients and staff Further refine action planning for unique sites Display data on the Strategic Initiative Board 6. PCMH Care Delivery Model 7

8 PCMH Care Delivery team: Diabetes Action Plan Population Care Manager to Classify patient zone Schedule visit with Health Care Coach 1.HGBA1C greater than 12 Enroll in Diabetic Group Classes. Health Care Coaching as trained. Ensure that patient has glucometer and supplies. Assess readiness for change, develop care plan. 2. Those patients recommended by pcm that need coaching Affordability an issue? Visit with Social Worker. Consider appointment with Pharm D. Follow up Q 3 month visit or at PCP discretion Ensure that patient has BS log and will check BS regularly Short interval visits with Health Coach as indicated, report glucose results to pcp for med. adjustments. App. With pcp every 3 months or with PCP till patient in yellow zone or sooner appointment if patient with excessive high or low glucose readings. 7. COMPENSATION PLAN Competitive compensation plan, 50% MGMA mean Compensation is salary based, signing into a culture 10% of compensation is at risk, based on achieving 3/5 metrics in each Strategic Pillar. Pillars are weighted based on Organizational priorities Bonus based on excelling with 5/5 metrics Medical Directors with 50% of the at risk salary based on Clinic performance. 8

9 5/27/2015 RESULTS Service: Average days to 3rd next available new patient appointment Target is 30 days Average 3rd Next New Patient Appointment Apr 15 Mar 15 Jan 15 Feb 15 Dec 14 Oct 14 Nov 14 Sep 14 Jul 14 Aug 14 Jun 14 Apr 14 May 14 Mar 14 Jan 14 Feb 14 Dec 13 Nov

10 Service Pillar: Patient Satisfaction Feb Mar April May June July Aug Sep Oct Nov Dec 13Jan Feb Mar April May Sept Oct Nov Dec 14Jan Series1 Updated: 4/1/2015 Quality Pillar: Pneumococcal Vaccine 90 Pneumococcal Vaccinations (Higher is better) Pneumococcal Vaccinations (Higher is better)

11 Quality Pillar: Colorectal Screening Colorectal Cancer Screening (Higher is better Target 60) Colorectal Cancer Screening (Higher is better) Quality: Cervical Cancer Screening Cervical Cancer Screening (Higher is better Target is 70) Cervical Cancer Screening (Higher is better) 11

12 Population Health: Diabetes B/P Blood Pressure Control (<140/90) (Higher is better Target is 68) Blood Pressure Control (<140/90) (Higher is better) Population Health: Diabetes eye exam 70 Retinal Eye Exam (Higher is bettertarget is 52%) Retinal Eye Exam (Higher is better)

13 Population Health: Diabetes foot exam 80 Foot Exam (Higher is better Target is 58) Foot Exam (Higher is better) Population Health: Diabetes HGBA1C A1C Poor Control (Lower is better Target is 43) **A1C Poor Control (>9.0%) (Lower is better)

14 Lessons Learned Nothing ventured, nothing gained Start with data that is readily available Metrics need to be RELEVANT and ACHIEVABLE Transparency as the goal for all data Communicate ahead of time proposed changes to those effected downstream. Allow plenty of time for discussion with stakeholders. Medical Director s need to be leaders & coaches Contact Info Dr. Robert Richard, Chairman Community Medicine» rrichard@jpshealth.org Dianna Prachyl, VP Community Health» dprachyl@jpshealth.org 14

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