際際滷

際際滷Share a Scribd company logo

Developing a Comprehensive QA Program (Connect 2016) - David A. Miles, Ph.D. (2)

Download as PPTX, PDF
David Miles
David Miles

This document outlines the development of a comprehensive quality assurance program for an EMS organization. It discusses establishing documentation guidelines, identifying why documentation is important, developing a standardized QA process using forms and reports, implementing the process by training auditors, and tracking compliance over time. Key steps included involving multiple stakeholders, dividing the work among referrals auditors, and addressing challenges like resistance to change. The overall goal was to improve clinical outcomes, documentation, and compliance through a systematic, process-oriented QA program.

1 of 44
Download to read offline
Developing a Comprehensive QA Program David A. Miles, Ph.D.
Welcome! Thank you for choosing to attend this session! Together in this hour we will accomplish the following items: Give you some examples and tools that you can use to develop a QA program in your organization Review how our organization began developing a comprehensive QA program Look at pitfalls and items to avoid so you can learn from some of our mistakes Answer any questions and exchange great ideas HAVE SOME FUN!!!
If learning isnt fun, youre doing it wrong! Gary J. Confessore, Ed.D. Professor Emeritus The George Washington University
Format for the Session Case Study Interactive Q&A at the end
Tell me a little bit about you? What type of EMS organization do you represent? What role do you fill in that organizations? What would be most helpful for you in todays presentation?
Our QA Journey Previously hit or miss Not systematic Not process oriented Chiefly complaint or issue driven with some periodic random QA
First things First
Documentation Guidelines Served as Standard Work for Crews to utilize for their documentation. also standard work for those doing the QA as a guide Format: Began with the very first tab in FieldBridge and went step-by-step with what to place in what box Simple for the new employee to use and follow Choices based on our agency
Started with the Why Stress to our EMS providers WHY our documentation was so important Ultimate Goal for Program Improved Clinical Outcomes Documentation Guidelines
Documentation Guidelines Step-by-step through the tabs Covered the Narrative Portion separately Examples at the end of the document Specific Reporting Requirements Vents, medication drips, equipment, etc. Many involved in the process of creating the guidelines Field providers, Supervisors / Field Training Officers, Managers Billing Department Heavily influenced by Info from Page, Wolfberg, & Worth The Missing Protocol: A Legally Defensible Report (1999 - Denise Graham )
What did we want to accomplish? Improved Clinical Outcomes / Patient Care Improved Clinical Documentation Legal and Billing Compliance with State QA Guidelines West Virginia Maryland Virginia ONE PROCESS (not three)
Process that we developed What was the process? what do you mean you cant read all of that from the back row?
Lets take a closer look
QA Process
QA Process
QA Process
Developing a Comprehensive QA Program (Connect 2016) - David A. Miles, Ph.D. (2)
Implementation (behind the scenes) QA auditors identified Field Training Officers & Field Supervisors Process to capture and distribute information Report Writer 2.0 Could have entitled the session How to build a QA process while not knowing ANYTHING about the QA/QI module in ImageTrend QA Spreadsheet on our internal SharePoint Site Created a site within our corporate SharePoint for the FTOs/Supervisors specific to QA HIPPA Compliant no access to site from crews, etc. All with access have signed ImageTrend Confidentiality Agreement Tools for Auditors Fillable PDF form for auditing run sheets
Standardize as much as possible Reports ran every week on Monday Monday through Sunday of previous week Know where to go to find their weekly assignment SharePoint site via Spreadsheet No more than 5 QA audits per week per person Standardize Forms (QA Audit Form) Naming convention for saving work Training for all auditors One-day initial training On-going coaching by Referral Auditors Implementation
QA Audit Review Form Everything in- between goes step-by-step through the PDF PCR
QA Audit Review Form (First Page)
QA Audit Review Form (First Page)
QA Audit Review Form (Last Page)
QA Audit Review Form (Last Page)
Reports that we run
Reports that we run
Reports that we run
Reports that we run
Disseminating the Weekly QA (OLD) Original configuration with only 2 FTOs doing QA
Disseminating the Weekly QA (OLD) Once we added multiple FTOs and Supervisors doing QA
Prepare to be OVERWHELMED!
Disseminating the Weekly QA (NEW)
Disseminating the Weekly QA (NEW)
BIG Lesson: Divide out the work
Addition of Referral Auditors
Addition of Referral Auditors
Addition of Referral Auditors
Tracking Compliance THREE MAIN FUNCTIONS for Referral Auditors: Follows up with Field Staff on QA notes that they were copied on Randomly reviews the QA audits to ensure quality and provide feedback (i.e.: especially those with no QA notes to providers ever) Tracks delinquent QA audits
Results?
Results? By tracking the problem we saw a DRAMATIC improvement in number of QA notes sent for inadequate Narratives
Now where are we in the process Status Post: ICD-10 (Looking to revamp our Documentation Guidelines) Shuffle the deck with our Referral Auditors (experts, leaders, role-models) Adding new FTOs New training and processes starting with Referral Auditors New 1 day training for all Start looking to improve again
Lessons Learned WOW it sure would be nice to know how to REALLY utilize the automatic reporting and features in the QA/QI Module Planning is great but Implementation can be rough - EXPECT resistance from ALL parties involved Im NOT using the CHART format, sir! Time Consuming behind the scenes The more buy-in from QA officers beforehand the better Keep plugging away at it it does get better. HINT!!!!
Q & A
Remember always give credit where credit is due!

More Related Content

Developing a Comprehensive QA Program (Connect 2016) - David A. Miles, Ph.D. (2)

  • 1. Developing a Comprehensive QA Program David A. Miles, Ph.D.
  • 2. Welcome! Thank you for choosing to attend this session! Together in this hour we will accomplish the following items: Give you some examples and tools that you can use to develop a QA program in your organization Review how our organization began developing a comprehensive QA program Look at pitfalls and items to avoid so you can learn from some of our mistakes Answer any questions and exchange great ideas HAVE SOME FUN!!!
  • 3. If learning isnt fun, youre doing it wrong! Gary J. Confessore, Ed.D. Professor Emeritus The George Washington University
  • 4. Format for the Session Case Study Interactive Q&A at the end
  • 5. Tell me a little bit about you? What type of EMS organization do you represent? What role do you fill in that organizations? What would be most helpful for you in todays presentation?
  • 6. Our QA Journey Previously hit or miss Not systematic Not process oriented Chiefly complaint or issue driven with some periodic random QA
  • 8. Documentation Guidelines Served as Standard Work for Crews to utilize for their documentation. also standard work for those doing the QA as a guide Format: Began with the very first tab in FieldBridge and went step-by-step with what to place in what box Simple for the new employee to use and follow Choices based on our agency
  • 9. Started with the Why Stress to our EMS providers WHY our documentation was so important Ultimate Goal for Program Improved Clinical Outcomes Documentation Guidelines
  • 10. Documentation Guidelines Step-by-step through the tabs Covered the Narrative Portion separately Examples at the end of the document Specific Reporting Requirements Vents, medication drips, equipment, etc. Many involved in the process of creating the guidelines Field providers, Supervisors / Field Training Officers, Managers Billing Department Heavily influenced by Info from Page, Wolfberg, & Worth The Missing Protocol: A Legally Defensible Report (1999 - Denise Graham )
  • 11. What did we want to accomplish? Improved Clinical Outcomes / Patient Care Improved Clinical Documentation Legal and Billing Compliance with State QA Guidelines West Virginia Maryland Virginia ONE PROCESS (not three)
  • 12. Process that we developed What was the process? what do you mean you cant read all of that from the back row?
  • 13. Lets take a closer look
  • 18. Implementation (behind the scenes) QA auditors identified Field Training Officers & Field Supervisors Process to capture and distribute information Report Writer 2.0 Could have entitled the session How to build a QA process while not knowing ANYTHING about the QA/QI module in ImageTrend QA Spreadsheet on our internal SharePoint Site Created a site within our corporate SharePoint for the FTOs/Supervisors specific to QA HIPPA Compliant no access to site from crews, etc. All with access have signed ImageTrend Confidentiality Agreement Tools for Auditors Fillable PDF form for auditing run sheets
  • 19. Standardize as much as possible Reports ran every week on Monday Monday through Sunday of previous week Know where to go to find their weekly assignment SharePoint site via Spreadsheet No more than 5 QA audits per week per person Standardize Forms (QA Audit Form) Naming convention for saving work Training for all auditors One-day initial training On-going coaching by Referral Auditors Implementation
  • 20. QA Audit Review Form Everything in- between goes step-by-step through the PDF PCR
  • 21. QA Audit Review Form (First Page)
  • 22. QA Audit Review Form (First Page)
  • 23. QA Audit Review Form (Last Page)
  • 24. QA Audit Review Form (Last Page)
  • 29. Disseminating the Weekly QA (OLD) Original configuration with only 2 FTOs doing QA
  • 30. Disseminating the Weekly QA (OLD) Once we added multiple FTOs and Supervisors doing QA
  • 31. Prepare to be OVERWHELMED!
  • 34. BIG Lesson: Divide out the work
  • 38. Tracking Compliance THREE MAIN FUNCTIONS for Referral Auditors: Follows up with Field Staff on QA notes that they were copied on Randomly reviews the QA audits to ensure quality and provide feedback (i.e.: especially those with no QA notes to providers ever) Tracks delinquent QA audits
  • 40. Results? By tracking the problem we saw a DRAMATIC improvement in number of QA notes sent for inadequate Narratives
  • 41. Now where are we in the process Status Post: ICD-10 (Looking to revamp our Documentation Guidelines) Shuffle the deck with our Referral Auditors (experts, leaders, role-models) Adding new FTOs New training and processes starting with Referral Auditors New 1 day training for all Start looking to improve again
  • 42. Lessons Learned WOW it sure would be nice to know how to REALLY utilize the automatic reporting and features in the QA/QI Module Planning is great but Implementation can be rough - EXPECT resistance from ALL parties involved Im NOT using the CHART format, sir! Time Consuming behind the scenes The more buy-in from QA officers beforehand the better Keep plugging away at it it does get better. HINT!!!!
  • 43. Q & A
  • 44. Remember always give credit where credit is due!