North Cluster meeting minutes 1/5/09

Ongoing Focus:

Nurses:
1. encourage my group health use
2. 100% fluoride for WCC 6mo-3yrs
3. note same day HEDIS outliers for providers

Providers:
1. 100% AVS
2. act on same day HEDIS outliers

New to do:
Becky: look into paps, mobile mammo (see below)
Mark: look into PCR's/PAR's bringing up and offering MyGroupHealth brochures on check in
Nurses: note vitals refusals, lay out BP cards if BP's higher than target
Providers: special attention to BP's
____________________________________________
Present: Anna, Becky, Diane, Jason, Lakisha, Liz, Mark, Shiji, Ted (Yay! This is the closest we've come to a perfectly attended meeting since October)
Absent: RN

Leaders: Jason and Liz

A. Pushes for AVS's and fluoride have been good. Keep up the good work.

B. Attention to MyGroupHealth signups has been waning because of business. Will try to re-focus. Mark will also check with front desk folks to see if they are offering MyGroupHealth brochures to people when they check in. If not, will start.

C. Liquid nitrogen - being left open. Will pay attention to closing valve tightly. No splash nozzle was ordered a long time ago.

D. would like mobile mammogram schedules posted in rooms again. Also will request more dates

E. reminder for appropriate vitals at every visit, including weights. If pt refuses - please note that for provider. 1 trick is to offer to weigh pts with them standing backwards so that they don't have to see it themselves.

F. unclear why our numbers are so poor with our paps. Unclear if the overide modifiers in Epic actually turn off the HEDIS measurement. Becky will look into this.

G. HTN seems like a good big measure to target.
1. Reminders that nurses and providers repeat BP's if they are elevated (everyone is doing this already).
2. BP cards. Have a big stash of BP wallet cards in all the rooms so that we can hand these out routinely. Recommend that nurses put one of those on the table if they notice an elevated BP. This will serve as a reminder to the doc that this needs addressing and lead to more education and self surveillance for pts.
3. will ask Shannon to come talk with us at our next meeting about her role in the eBP study and how we can adapt that for our own cluster purposes and who would do her role in this.