Innovative Audience Outreach:

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2 Innovative Audience Outreach: Education through e-learning and Animation Biddy Smith, RN, BSN Network Task Lead for Special Projects Mitzi Vince Communications Specialist

3 Quality Insights QIN-QIO 3 Covers fives states: Delaware Louisiana New Jersey Pennsylvania West Virginia Special Innovation Projects (SIPs) Quality Improvement in Long-Term Acute Care Hospitals Reducing Opioid Misuse and Diversion Increasing Annual Wellness Visit Utilization Palliative Care and Hospice Referrals for Heart Failure Patients

4 Today s Objectives 4 Understand the goals and challenges of the Palliative Care and Hospice Referrals for Heart Failure Patients Special Innovation Project Understand the logistics of developing creative solutions to promote learning Outline our plan for promoting e-learning and animation products

5 Objective: Understanding Goals and Challenges 5

6 Palliative Care SIP: Project Goals 6 Increase palliative care and hospice referrals and see fewer late referrals for hospice care resulting in a reduction in unnecessary hospital utilization and improved quality of care Specific Tasks: Develop palliative care teams that serve patients with heart failure in advanced disease stages as well as their families Educate clinicians to foster high-quality conversations with patients and families about advance care planning Improve provider competence in provision of basic palliative care for patients with advanced serious illness

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8 8 Palliative care is end-of-life care. a) True b) False

9 9 Which of the following is the best definition of palliative care? a) Relief of symptoms, pain, and stress from a terminal illness b) Relief of symptoms, pain, and stress from any serious illness c) Relief of symptoms, pain, and stress for patients who have chosen not to pursue further medical treatment for their disease d) Comfort care at the end of life

10 10 Managing symptoms including pain is an important part of palliative care. a) True b) False

11 11 Based on studies in 2001, where do most people die? a) Hospital inpatient/ outpatient/ ED b) Nursing home c) Patient s Home d) Dead on arrival, hospice, other, unknown location

12 Ideally, Palliative Care decisions are based on the following: a) Patient s current medical status/course of illness b) A professional opinion about alternatives open to the patient c) Notifying the patient s family, friends, employer and others about the patient s illness d) A and B e) All of the above f) None of the above 12

13 13 This is an intervention that should start early in the disease process. a) Communication b) Education c) Goal Clarification d) All of the above

14 Palliative Care might be right for you if you: 14 a) Have one or more serious illnesses b) Have symptoms that impact your quality of life c) Need help planning for your future health care d) Need help coping with the stress of an illness e) Have had frequent ER visits or hospital admissions as a result of the same symptoms f) All of the above

15 How did you do? 15

16 Barriers, Barriers 16

17 Challenges for Patients, Families and Caregivers 17 Greater deficit of understanding Myth: Palliative Care is Hospice Care. Quality in your days

18 Challenges for Providers 18 Expectation Getting into offices would be a challenge Reality Check WE don t understand Palliative Care Stakeholder Feedback Not enough qualified clinicians are comfortable having advance care planning discussions with patients

19 How We Started 19 Learning and Action Networks (LANs) with participants from multiple care settings Partnerships with community organizations and stakeholders Technical assistance to communities Health event presentations or exhibitors Educational materials

20 A New Approach 20 Providers Electronic learning experiences e-learns Patients, Families and Caregivers Animated videos Powtoons

21 Goals and Challenges: A Summary 21 Goals: Increase palliative care and hospice referrals See fewer late referrals for hospice care Reduce unnecessary hospital utilization and improve quality of care Challenges: Audience understanding of Palliative Care Provider comfort in advance care planning discussions

22 Objective: Understanding Logistics 22

23 My Quality Insights 23 On-demand learning and resources Cross-setting and cross-task Engages leaders and frontline staff in a virtual setting Developed in partnership with Pittsburgh Regional Health Initiative (PRHI) and the Tomorrow s Healthcare platform

24 The Logistics of e-learns 24 Format Three-part series; one hour/module Physician-only module Content development Stakeholder input Research and data from national organizations End-of-Life Nursing Education Consortium (ELNEC) Supporting videos and other media Case studies and success stories Continuing education credits One contact hour/module Staff review Provided through Pittsburgh Regional Health Initiative (PRHI)

25 The Logistics of e-learns 25 PowerPoint and script development Audio recording and editing Post test Course evaluation Resources to attach PRHI production Final staff review Timeline

26 e-learn Module Demonstration: 26

27 Login 27

28 Login 28

29 Choose MyQI University 29

30 Choose Course 30

31 Start Course 31

32 Proceed through Course 32

33 When Completed 33 Take post-test Take evaluation Print certificate (if 80% achieved on post-test)

34 e-learn Logistics: A Summary 34 Develop format and content Decide on continuing education PowerPoint and audio Attached resources Evaluations Assembly of all components Final review and launch

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36 The Logistics of Powtoons 36 Subscription-based Create and export to: YouTube Slideshare Vimeo Wistia MP4 PDF

37 The Logistics of Powtoon 37 Develop concept Write script/storyboard Record and edit audio Produce video in Powtoon Choose template Select graphics Add text Set animation Add audio Rehearse/Adjust timing Export to desired platform

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39 Powtoon: Round #2 39 Positive feedback led to broader creation New topic: Medicare s Annual Wellness Visit More to come

40 Powtoon Logistics: A Summary 40 Develop concept and script Record and edit audio Produce within Powtoon Export to desired platform

41 Objective: Outlining a Plan for Promotion 41

42 e-learn Promotion 42 e-newsletters Flyers Peer-to-Peer Learning and Action Networks (LANs) Advisory Committees

43 Powtoon Promotion 43 YouTube Website Other social media e-newsletters Webinars Content distributors

44 Promotion: A Summary 44 e-learns Flyers e-newsletters Peer-to-Peer Powtoons Website Social Media e-newsletters Webinars Content distributors

45 How did we do? 45

46 Successes and Impact 46 e-learns Positive feedback from completers Rural hospital using for staff education Home health agencies using for staff education Powtoons Louisiana physician showing in office Hospitals have asked to broadcast videos Gaining popularity on our YouTube channel

47 Barriers 47 e-learns Powtoons Completion Rate Cartoon Stigma

48 Plan-Do-Study-Act (PDSA) 48 e-learns Use as group activities Alleviate barriers of sign-in process Powtoons Keep videos at five minutes or less

49 What We Learned 49 Use technology to our benefit Respect time

50 A Summary 50 Goal to improve palliative care and hospice referrals and reduce unnecessary hospital utilization Recognized challenge of Palliative Care understanding Developed new approach to educating through e-learning and animated video Promoted through website, social media, e-publications and peer-to-peer interaction

51 Questions? 51

52 Contact Us 52 Biddy Smith, RN, BSN Network Task Lead for Special Projects Phone: (800) ext Mitzi Vince Communications Specialist Phone: (800) ext Website:

53 Thank You 53 This material was prepared by Quality Insights, the Medicare Quality Innovation Network-Quality Improvement Organization for Delaware, Louisiana, New Jersey, Pennsylvania and West Virginia under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. Publication number QI- SIP