OrgID OrgName FSR Sustainability Plan QI Plan 1st Condition TLN Administrators of Tulane Educational Fund 9/9/2008 9/17/2008 9/9/2008 Depression Major Depressive CCH Catholic Charities Archdiocese of New Orleans 9/8/2008 9/8/2008 9/10/2008 Disorder Bronchiolitis/ CHP Children's Hospital Medical Practice Corp 9/9/2008 9/9/2008 9/9/2008 Palivizumab CGR Common Ground Health Clinic 9/8/2008 9/8/2008 9/15/2008 Depression & Depressive CVH Covenant House New Orleans 9/19/2008 9/19/2008 9/9/2008 Symptoms DOC Daughters of Charity Services of New Orleans 8/29/2008 8/29/2008 9/12/2008 Diabetes EXL EXCELth 9/9/2008 9/9/2008 9/10/2008 Hypertension JCH Jefferson Community Health Care Centers, Inc. 9/12/2008 9/12/2008 Hypertension Use of a addictive JPH Jefferson Parish Human Services Authority 8/26/2008 8/26/2008 - revised 9/11/2008 9/12/2008 substance LEG Leading Edge Services Int'l, Inc. D/B/A Family Health Center 9/15/2008 9/15/2008 9/15/2008 Hypertension L9W Lower 9th Ward Health Clinic 9/8/2008 LHS LSU Health Sciences Center (SBHC) 9/8/2008 Request ext till 9/17 Tobacco Use Patients being treated with LHN LSU Healthcare Network (LSUHN) 8/29/2008 9/2/2008 9/8/8 rev 9/19/8 stimulants MCL Medical Center of Louisiana at New Orleans 9/18/2008 9/18/2008 9/10/2008 Hypertension MTR Metropolitan Human Service District 8/26/2008 8/28/2008 9/16/2008 NOAH New Orleans Adolescent Hospital 9/16/2008 9/11/2008 9/9/2008 - not acceptable ADHD NOHD New Orleans Health Department 9/9/2008 9/9/2008 NOM New Orleans Musicians Assistance Foundation req. ext 9/12/08 9/8/2008 4/8/08 NOA NO/AIDS Task Force 8/29/2008 8/28/2008 9/8/2008 HIV/AIDS ODH Odyssey House Louisiana 8/28/2008 9/10/2008 Diabetes PLQ Plaquemines Medical req. ext 9/12/08 MCF Sisters of Mercy Ministries D/B/A Mercy Family 9/8/2008 9/8/2008 8/2/08 - version3 STB St. Bernard Health Center, Inc. 9/11/2008 9/11/2008 ext.9/15/2008 Hyperlipidemia STC St. Charles Community Health Center 9/19/2008 9/19/2008 9/11/2008 STH St. Thomas Community Health Center 8/27/2008 8/27/2008 9/15/2008 Hypertension *Blue Highlight denotes C-IBHA participant *Orange highlight denotes CIBHA participant for next round **Tulane and Musicians have each been divided into two sections for C-IBHA only Based on ALL CIBHA participants, there are 65 sites PCASG Deliverables Workflow/ EBG 2nd Condition 3rd Condition Algorithm EBG 1 EBG 2 EBG 3 Review September 2006, CDC Standards of care for recommendations for HIV diabetes for diabetics. testing of adolescents and Diabetes Care 31: S12-54, HIV Diabetes PHQ-9 adults. 2008. Staff completed a file audit on clients that were seen Cognitive Behavioral Therapy between June 1, 2008 and for Depression combined August 31, 2008. The three with Psychiatry (Medication Generalized Anxiety preferred diagnoses appear Management) as indicated. Disorder Adjustment Disorder above. (prevalence) Use PHQ-9 Amer Acad Pediatrics Clinical Practice Guidelines for Diagnosis and Management of Bronchiolitis Spot check of 40 random client charts, more than half of the clients reported depression or depressive symptoms. PHQ-9 The guidelines and measures that were selected were determined by the UHF Foundation for a national demonstration project from a subset of AQA starter measures. They correspond to mortality/morbidity statistics for national health disparities as well as Lousiana statistics. The UDS reports confirm that they are USPSTF Guidelines for priorities for our local patients ADA Guidelines for Diabetes NIH Guidelines for Cancer Screening – Breast, Cardiovascular Disease Cancer Screening as well. Care Hypertension and Lipids Cervical, Colon Algorithm for Treatment of Diabetes Hyperlipidemia Prevalence HTN Seventh Report of the Joint National Committee on Prevention, Detection, EMR record search; most Evaluation, and Treatment of Diabetes STDs prevalent High Blood Pressure The Matrix Model Intensive Outpatient Alcohol and Drug Treatment is a comprehensive, evidenced- based, sixteen week individualized program designed to give people with a substance abuse issue the knowledge, structure, and support to allow them to achieve abstinence from drugs and alcohol and initiate a long-term program of Major depression Bipolar Disorder recovery. Determined based on clinic most frequently treated newly diagnosed and established patients seen within the last 6 Laboratory tests of CD4 T- months with fewer no-show lymphocyte load and Plasma Diabetes Primary HIV Infection visits. RNA viral load. Each of the conditions has been identified by the State of Louisiana, Office of Public Health as significant for Clinical Quality Improvement in the care of adolescent patients in School Based Overweight/Obesity - High Health Centers. Several are Blood Pressure/ included in their Quality LA-OPH best practices forms Hypertension and Improvement review as LA-Office of Public Health LA-OPH Best practices for Hypertension and Chlamydia STI Screening Diabetes “Sentinel Conditions.” Best Practices guidelines guidelines Diabetes Screening Patients being treated with stimulants will have their blood pressure and heart Each visit with a patient with rate (while seated) measured Major Depression must at each visit beginning when include an assessment of Neuroleptic drug side the stimulant is prescribed Movement rating scale suicidality in the progress effects Major Depression for a baseline measure. (AIMS) note. Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of Diabetes Heart Failure High Blood Pressure July 2007, American Academy of Child and Adolescent Psychiatry published practice A query ran in the parameters for the treatment ARAMIS/OMH-IIS tracking of children and adolescents Depression Mood Disorder program with ADHD Comprehensive strategy for measuring the full range of performance indicators as provided by HRSA through the HIVQUAL project is being The agency collected data for implemented with enhanced the past two weeks; electronic health records and Benign Hypertension Syphilis Unspecified prevalence. patient management system. Guidelines set forth by the American Diabetes Association with further support coming from the Guidelines set forth by the Cardiovascular Disease Joslin Diabetes Center American Heart Association Evaluated the top 20 conditions, selected the 3 conditions that they felt adversely affected their community as a whole, had evidence-based guidelines i. LDL Screen performed which would have an Third Report of the National ii. LDL-C Results < 130 immediate impact on Heart, Lung, and Blood iii. Blood Pressure > 130/90 patients‟ lives, and were Institute‟s Expert Panel on iv. Obesity (BMI > 29) amenable to chronic disease Detection, Evaluation and v. Regular exercise management with available Treatment of High vi. Coronary artery disease Diabetes Coronary Artery Disease resources. Cholesterol in Adults on lipid lowering drugs Providers met in sub groups to look at various nationally recognized EBG for each condition. They then met as a group and presented * American Diabetes recommendations of which Association 2008 guidelines National Asthma Prevention EBG to adopt. Then they * IDF Diabetic Guidelines JNC Seventh Report for the and Educations Program Diabetes Asthma chose the guidelines. 2005 Joint National Committee 2005 Guidelines EBG Planned Staff Annual Action Required Measurement 1 Measurement 2 Measurement 3 Training Attestation Sec MOU Adult x Peds PHQ-9 * 75% of clients will demonstrate stability supported by a reduction in score on the depression screen and on the formal assessment and self reports. * 75% of clients will report satisfaction at post-test on their satisfaction survey. x 1) Goal to identify 100% of the at risk patients for increased hospitalization due to RSV 2) Goal to correctly administer Palivizumab prophylaxis to at least 90% of the identified at risk infants 3) Goal to monitor and adjust if needed for our assumption that 80% of the infants born at gestational age 32 to 35 weeks have at least 2 high-risk criteria 4) Goal to reduce the number of these at risk children admitted to the hospital for Bronchiolitis or RSV x Program evaluation will look at the number of clients from each level of depression severity and evaluate them based on the average improvement of each level and the number of clients whose treatment followed our „optimal treatment guidelines.‟ x * Percentage of patients with diabetes with one or more A1C test(s) conducted during the measurement year. * Percentage of patients with diabetes with most recent A1C level greater than 9.0% (poor control). * Percentage of women * Percentage of patients with who had a mammogram diabetes who had their blood during the measurement pressure documented in the past year or year prior to the year less than 140/90 mm Hg. measurement year. * Percentage of patients with * The percentage of adults diabetes with at least one Low who had an appropriate Density Lipoprotein cholesterol screening for colorectal (LDL-C) test (or ALL component cancer. tests). * Percentage of women * Percentage of patients with who had one or more Pap diabetes with most recent LDL-C tests during the less than 100 mg/dL or less than measurement year or the 130 mg/dL. two prior years. x * % adults with diagnosed hyptertension whose most recent BP was <140/90 * % pts with diabetes who had their blood pressure controlled (<140/90 at last visit) during the measurement year * % pts with diabetes who had their blood pressure controlled (<130/80 at last visit) during the measurement year. x Documentation of treatment provided according to the selected guidelines x * Decrease in an individual‟s alcohol and/or substance use * Increase in participation in recovery-oriented behaviors and life satisfaction, which are believed to support abstinence x * CD4 count * Plasma HIV RNA viral load x % of Students Receiving Comprehensive Exam or Risk-Assessment that report % of Students Receiving sexual activity have Comprehensive Exam % of Students Receiving documentation of have documentation of Comprehensive Exam or Risk- Chlamydia/gonorrhea BMI and BMI % at Assessment that have screening within last 12 comprehensive physical documentation of tobacco use months. Progression toward exam visit. Progression status. Progression toward goal goal will be monitored toward goal will be will be monitored bi- annually via annually via random chart monitored bi- annually via random chart review of sub-set of review of sub-set of patients random chart review of sub- patients (minimum 10 charts) or (minimum 10 charts) or set of patients (minimum electronic database review of electronic database review of 10 charts) or electronic patients receiving patients receiving database review of annual/comprehensive physical annual/comprehensive patients receiving examination or risk behavior physical examination or risk annual/comprehensive screening. behavior screening. physical examination. x x Will randomly select and audit medical records on a monthly basis for MCLNO, and quarterly for HCSD according to ICD 9 Hypertensive Diagnosis Codes beginning with 401 i. Diabetic and chronic renal hypertensive control - BP < 130/80 mmHg ii. Heart failure hypertensive control - BP < 130/85 mmHg iii. Essential hypertension control – BP < 130/80 iv. Compelling indications (See table 2 below) v. Appropriate use of aspirin in patients with CVD risk > 10% x Main x StAnna x x x x x x * Number of Patients with * Number of patients with * Average HbA1c for all patients appropriate BP control severity assessment with a Diabetic Diagnosis * Number of patients with at * Number of patients with * Number of Patients with 2 HbA1c least 2 BP readings in the appropriate treatment with in last 12 months last year anti- inflammatory * Number of patients with * Number of patients with * Number of patients with documented self management documented self documented self goals management goals management goals 2 17 (9 organizations) 5 organizations originally were participating but have decided "p CCH, LEG, MTR, NOAH, ODH Denoted in orange highlight C-IBHA Deliverables Internal Revised External Eval Technical Sep 16 Oct 15 Rec'd TA Rec'd Revised TA Questionnaire Internal Questionnaire Score Assistance Conf Call Conf Call Questionnaire Date Questionnaire Revision Date Review Review Review (max 36) Provided x 8/6/2008 x 8/12/2008 x 31 x x 8/6/2008 x 29 x 7/18/2008 x 16 x 9/25/2008 x 9/22/2008 x 34 x 9/18/2008 x 8/15/2008 x 9/9/2008 x 19 x 9/24/2008 x 8/12/2008 x 9/19/2008 x 31 x x 7/16/2008 x 20 x x x 9/22/2008 x 7/22/2008 x 20 x x 8/1/2008 x 29 x 7/10/2008 x 9/22/2008 x 34 x 7/8/2008 x 9/19/2008 x x 31 34 7/15/2008 x 32 9/23/2008 x 21 x 0 2 11 1 26.50 26.73 1 5 (9 organizations) iginally were participating but have decided "participant in the next round"
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