How to Complete an IAFP YHP QI Project 1. The first step is to view one of the online presentations for the topic you are interested in and complete the post test and evaluation. Currently, two of the Your Healthcare Plus activities have been approved by the American Board of Family Medicine as an external provider of Part IV Maintenance of Certification for Family Physicians credit. The Managing Adult Depression in Primary Care and Managing Childhood Asthma in Primary Care have been approved as quality improvement projects that would fulfill Part IV of the ABFM MoC. ABFM MoC approval for the other programs is pending. 2. Download the pre & post assessment surveys and Quality Improvement worksheets from the www.yhplus.com website. These documents will be used to guide you through the process and will also serve as documentation. 3. The pre & post assessment surveys are optional, but recommended. These surveys are designed to help your practice evaluate how you currently care for the patients with the chronic illness you have selected for your quality improvement project. This tool is designed to help you decide where to direct improvement efforts in your practice. The post assessment survey can be used to see if your practice has improved, or can be used during the QI project to see if you are on track. Since, these surveys are optional, you do not need to submit them to receive CME or ABFM MoC credit. STAGE A 4. Meet as a team and discuss what goals you are trying to accomplish. Document your goals on the QI worksheet. 5. Choose performance measures based on your goals. You can use the measures recommended on the QI worksheet for your clinical topic, or choose your own. The measures need to be able to be tracked over time in your practice. You will be collecting data on these measures for the duration of your project and hopefully into the future once you get a system in place to routinely monitor your practice. 6. Collect base line data for your practice based on your measures. Baseline data can be collected in a couple different ways: a. REPORTS FROM MCKESSON or AUTOMATED HEALTH SOLUTIONS (Illinois Only): Providers who are signed up to be a medical home for the Illinois Health Connect program (provide care to Illinois Medicaid patients) automatically receive patient summary reports from Your Healthcare Plus (the disease management program run by McKesson Health Solutions) and Illinois Health Connect (the primary care case management program run by Automated Health Solutions) on a quarterly basis. The reports outline performance data on patient population within each of the following chronic diseases (currently: asthma, depression, COPD, heart failure, diabetes, substance abuse, coronary artery disease). This report outlines all Medicaid eligible patients with those chronic diseases against guideline measures. The reports also summarize each guideline measure for each provider’s eligible patient population versus the statewide average. These detailed reports will serve as the pre and post intervention audit for providers participating in the quality improvement portion of this program. Participants will be urged to look at the data provided to them on these reports when completing their quality improvement module. Providers can use the guideline measures on these reports as their quality improvement measures b. OTHER STATE AGENCY OR INSURANCE COMPANY REPORTS (outside Illinois or those in Illinois choosing not to use information described in a. above) – Other state agencies or insurance companies may provide individualized reports on a providers patient population that can be used for baseline data and to track improvement. c. CHART PULL – If the provider does not receive reports on any of their patient population they can still complete the QI project but completing a chart pull. This can be done with either paper records or with an EMR. The best way to start this is to assign a member of your team to conduct the chart pull. 7. Baseline information on all measures chosen must be submitted to the IAFP in order to receive CME credit for that portion of the QI project and in order for the QI project as a whole to be complete. At the end of the project the provider must also include a review and comparison of original baseline data as compared to current data on that patient population in order to receive CME credit for that portion of the QI project and in order for the QI project as a whole to be complete. Submit stage A to the IAFP office for approval & review. Your performance measures and baseline data will be reviewed by a physician. IAFP staff will notify you within 4 weeks regarding your data and any recommendations made by the physician reviewer. Completion of Stage A is worth 5 CME credits. Stage B 8. Start the QI process using the PDSA (Plan-Do-Study-Act) Cycle to improve patient care. The QI worksheet will guide you through the steps on how to complete this stage. a. Plan Phase: document what changes can be made that will result in an improvement? Meet with your office staff and colleagues to generate a list of ideas for improvement and document those ideas. b. Do Phase: Select one idea that can be tested this week. Remember to test the change on a small scale. Document the change in detail including what you will be doing differently, who will be doing what and when the test will begin and end. Use data collection sheets to gather data. This process should be repeated until your team has achieved its desired results. c. Study Phase: At the conclusion of your testing phase, review your performance measurement data and feedback from patients and staff to determine the impact d. Action Phase: Based on a review of your data, decide whether to refine and re-test the team’s improvement idea or if the test was successful and should be incorporated more fully into the practice. e. Repeat these phases in cycles. You will need to complete at least two cycles in order to receive CME credit, however it is recommended that you complete any many cycles as needed in order to obtain the desired result. 9. Need assistance? You can contact the IAFP at firstname.lastname@example.org with any questions you have. Your question will be forwarded to the appropriate YHPlus physician reviewer to answer. OR, you may post and view questions on the www.yhplus.com forum. Here you can get help from colleagues and be able to help others, too. Completion of Stage B is worth 5 CME credits. You may submit this stage separately or together with Stage C. Stage C 10. Once you have completed all the cycles it is now time to evaluate your progress. Collect the same data you used as your base line. 11. Meet with your team and review and compare your base line and post-intervention data. Write a summary of your findings on the QI worksheet. 12. Write a brief narrative about the barriers you had to overcome and solutions for your success. These "lessons learned" may be used to help guide other practices in the future. 13. Create a run chart summary of your post-intervention data and/or a summary of the monthly data you collected throughout the course of your project. All data should be aggregate, de-identified patient data. You can create a line chart in Excel or create the chart by hand and paste it into a separate Word document and fax or e-mail it as an attachment. 14. Document all of this information on your QI worksheet and submit, along with your chart, to the IAFP office for review and approval. Please also submit the names of all physicians and providers requesting credit (both CME & MoC). Please be sure to also include which credit you are seeking and your membership numbers. All information will be reviewed by a physician. Please allow 4-6 weeks for approval. 15. Once approved, you will receive a certificate of completion and be awarded 20 AMA Category 1 credits. If you are seeking to have this fulfill the ABFM Moc you will receive another certification of completion for that. The IAFP will also notify the ABFM on which Dipomates completed the project. Once the ABFM is notified that a physician has completed an external Part IV activity, the ABFM updates the physician’s portfolio. The activity will appear with a link beside it that says “pending payment”. Dipomates will need to pay the ABFM for the activity as they would any other activity. (There is no fee required by the IAFP to participate in this project). 16. Celebrate!! You just completed your first YHP QI project!
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