CLUSTER OBJECTIVES
• Quality improvement
• Team building
April 13, 2009 Great meeting: in attendance Lakisha, Liz, Alisha, Anna, Becky, Ted, Jason, Diane
• KUDO’s
We did a great job with PEEPS, thanks for all who could help with inspirations/time/creativity
-we are managing the largest panels per FTE, thanks for everyone for going above and beyond!
• BUSINESS
Time off
Caulda will be in 4/17 and 4/24, then start 0.8 time 4/27/09 M-F
4/17/09 Diane at CME, Levine to cover Jason and Diane’s box in am
4/27-28 Jason out for CME
Outreach
Plan for this week: Sounds like providers not really aware of the ‘game plan’ despite heroic efforts by MA/Rn to inform us (thank you)! We will shoot for an MA presentation next week on what the overall plan has been and what is working/not working, and of course how we can all improve our outreach.
HOW IS YOUR DAY
Epic schedule: Becky will help if any trouble spots, just let her know
Xray request from AndreaMarcek:
It is difficult to prescreen appointments at end of the day.
Becky will talk with Radiology and see if hours can get shifted from 830-530 and check in with Administration to see if they can ease up on any penalties Andrea is getting if she has overtime.
• QUALITY IMPROVEMENT PROJECTS
Medication lists: how do we want to reconcile
We did not have enough time to explore completely:
For next meeting:
Consider how we can all contribute to improving our medication lists reconciliation. Bring ideas/suggestions to meeting and we can share and maybe make a North cluster guideline.
HAVE A GREAT WEEK!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Saturday, April 18, 2009
CORE MEETING MINUTES 4/7/09
Tuesday, April 7th, 2009
7:30- 8:30 AM
Doctor’s Lounge
Agenda
7:30 Injection Room Meeting Minutes:
New Policy on Staff and PPD shots- Yearly PPD test are no longer the practice at GH. (Unless of course you work in respiratory therapy area’s. etc….) new Hires will still be required to get a series of 2 PPD tests.
Anyone that has a positive or suspicious result will be required to get a Chest X-ray and follow up with their PCP
NDC numbers will now need to be entered on all patients receiving medicare. GHC is starting small with immunizations and the 81 drugs listed on the Injection Room Matrix. Training will occur at each clinic by the CIS Consultants, (Kitty). Official implementation date has not been defined
Flu campaign is all most over. Extra Vaccine can be returned to the Pharmacy. The plan for administering the vaccine did not work well this year. A lot of the patients we sent over by providers to get the shot, as they should of.)
The problem was that the patients that got the injection went back and told their friends and then we started getting those patients. This happened so often that by the time the flu campaign started a lot of the injections had been given, so much so, that the nurse that came to clinic specifically to do injections was slow and often sat reading her book.
8:10 Nadia Duffy Attended core meeting to discuss power outage and medications
• Review and updated Procedure manual. Nadia also introduced the new type of bag to use for medications. Revised who to contact if there is an outage. Sheila will create an algorithm for this. Nadia will get 4 new keys made so that the “contact” staff will be able to enter the building
7:30- 8:30 AM
Doctor’s Lounge
Agenda
7:30 Injection Room Meeting Minutes:
New Policy on Staff and PPD shots- Yearly PPD test are no longer the practice at GH. (Unless of course you work in respiratory therapy area’s. etc….) new Hires will still be required to get a series of 2 PPD tests.
Anyone that has a positive or suspicious result will be required to get a Chest X-ray and follow up with their PCP
NDC numbers will now need to be entered on all patients receiving medicare. GHC is starting small with immunizations and the 81 drugs listed on the Injection Room Matrix. Training will occur at each clinic by the CIS Consultants, (Kitty). Official implementation date has not been defined
Flu campaign is all most over. Extra Vaccine can be returned to the Pharmacy. The plan for administering the vaccine did not work well this year. A lot of the patients we sent over by providers to get the shot, as they should of.)
The problem was that the patients that got the injection went back and told their friends and then we started getting those patients. This happened so often that by the time the flu campaign started a lot of the injections had been given, so much so, that the nurse that came to clinic specifically to do injections was slow and often sat reading her book.
8:10 Nadia Duffy Attended core meeting to discuss power outage and medications
• Review and updated Procedure manual. Nadia also introduced the new type of bag to use for medications. Revised who to contact if there is an outage. Sheila will create an algorithm for this. Nadia will get 4 new keys made so that the “contact” staff will be able to enter the building
West Cluster Meeting April 1, 2009
West Cluster Meeting April 1, 2009
Present: Becky, Mark, Doug, Kelly, Sean, Esma, Timieko, Jason and Star
Discussion about vitals station; should we build a room around the current nursing station or get extra equipment? Since it may just be 1.5 – 2 yrs before we get a new building maybe we can just get by without construction. We will try with maybe just another scale and a thermometer and see how this goes. Becky will order scale and thermometer.
Tackle box- providers could consult and give nursing staff a list of what would be useful in a kit to take to rooms for joint injections rather than providers going to the West injection supply room for supplies. We can buy the tackle box(es 1-2) and submit the receipt for reimbursement.
Discussion about 5th provider seating; Becky checked with building contractors and no sinks can be removed from current provider offices without a lot of added expense. If someone who is not working with patients can just have a safe place to put their personal belongings; they can use:
1. Room 127 or this can be converted into Dr. Knopp’s office
2. Can put a computer into Christina, RN’s previous space
3. Can put another station into one of the current provider offices
Meeting closed at 1:40PM
Star Morales, CMA
Present: Becky, Mark, Doug, Kelly, Sean, Esma, Timieko, Jason and Star
Discussion about vitals station; should we build a room around the current nursing station or get extra equipment? Since it may just be 1.5 – 2 yrs before we get a new building maybe we can just get by without construction. We will try with maybe just another scale and a thermometer and see how this goes. Becky will order scale and thermometer.
Tackle box- providers could consult and give nursing staff a list of what would be useful in a kit to take to rooms for joint injections rather than providers going to the West injection supply room for supplies. We can buy the tackle box(es 1-2) and submit the receipt for reimbursement.
Discussion about 5th provider seating; Becky checked with building contractors and no sinks can be removed from current provider offices without a lot of added expense. If someone who is not working with patients can just have a safe place to put their personal belongings; they can use:
1. Room 127 or this can be converted into Dr. Knopp’s office
2. Can put a computer into Christina, RN’s previous space
3. Can put another station into one of the current provider offices
Meeting closed at 1:40PM
Star Morales, CMA
Simplified Outreach Targets for Flow Nurses
Here's a draft of a simple, one pager to help flow nurses go after patients with outstanding need for quality improvement.
Children's Immunizations
Children 2 years of age need the following shots:
• Diphtheria, tetanus, pertussis (DTaP) (4 doses)
• Inactivated polio virus (IPV) (3 doses)
• Measles, mumps, rubella (MMR) (1 dose)
• H. influenzae type B (Hib) (3 doses)
• Hepatitis B (HepB) (3 doses)
• Chickenpox (varicella) (1 dose) or documentation that they had chickenpox.
Diabetes
DM: HbA1c Test*
Get a hemoglobin A1C at least once a year
DM: HbA1c >9.0%*
Get the hemoglobin A1C <9
DM: LDL Screen*
Get an LDL once a year.
DM: LDL <100*
Get the LDL cholesterol <100
DM: Nephropathy Monitoring
Get a microalbuminuria test once a year.
Heart Care
CAD: Persistence of Beta Blocker Treatment
IF patient has had a heart attack, THEN the patient should be on a beta blocker (atenolol, metoprolol, or carvedilol).
CAD: Cholesterol Management – LDL Screen*
Get an LDL once a year.
CAD: Cholesterol Management – LDL<100*
Get the LDL cholesterol <100
Controlling High Blood Pressure*
Get the most recent blood pressure in clinic <140/90
Screening
Breast Cancer
Get a mammogram every two years for women 40-69.
Cervical Cancer
Get a pap smear every two years for women 21-65.
Colorectal Cancer
Get fecal occult blood test every year for patients OR get a colonoscopy every ten years for people 50-80.
Children's Immunizations
Children 2 years of age need the following shots:
• Diphtheria, tetanus, pertussis (DTaP) (4 doses)
• Inactivated polio virus (IPV) (3 doses)
• Measles, mumps, rubella (MMR) (1 dose)
• H. influenzae type B (Hib) (3 doses)
• Hepatitis B (HepB) (3 doses)
• Chickenpox (varicella) (1 dose) or documentation that they had chickenpox.
Diabetes
DM: HbA1c Test*
Get a hemoglobin A1C at least once a year
DM: HbA1c >9.0%*
Get the hemoglobin A1C <9
DM: LDL Screen*
Get an LDL once a year.
DM: LDL <100*
Get the LDL cholesterol <100
DM: Nephropathy Monitoring
Get a microalbuminuria test once a year.
Heart Care
CAD: Persistence of Beta Blocker Treatment
IF patient has had a heart attack, THEN the patient should be on a beta blocker (atenolol, metoprolol, or carvedilol).
CAD: Cholesterol Management – LDL Screen*
Get an LDL once a year.
CAD: Cholesterol Management – LDL<100*
Get the LDL cholesterol <100
Controlling High Blood Pressure*
Get the most recent blood pressure in clinic <140/90
Screening
Breast Cancer
Get a mammogram every two years for women 40-69.
Cervical Cancer
Get a pap smear every two years for women 21-65.
Colorectal Cancer
Get fecal occult blood test every year for patients OR get a colonoscopy every ten years for people 50-80.
Cluster Meeting 3/30/09 Minutes
Cluster Meeting 3/30/09 Minutes:
In attendance: Lakisha, Liz, Alisha, Anna, Diane, Jason, Ted, Becky
GRATITUDES
Great meeting and great team!
We can do Kudos each week and show and tell/or an unknown factoid each week for Monday morning ice breakers, nice way to start our week!.
BUSINESS
-upcoming time off:
4/17/09 Dozois out for CME
4/27-28 JW out for CME
4/8-13 Peds out
- rooms : East cluster to get back to us on room 127 &128 use on Monday & Tues AM and Wednsday PM's
-computers working on this!
- Peds room configuration:
Water pitcher: if ok with Lynn, will put in MA’s office against window.
File cabinet on other side of room divide to left of Lynn’s desk
Coat rack requested for peds room with 4 hooks
- invite Nill to participate when he can at meeting to include peds perspective
HOW ARE MA/RN'S DOING
Providers doing better with messages, helping a lot, keep up the great work
HOW ARE MD/PA'S DOING
Things have been going great, flow seems to be working well!
HEDIS MEASURES
Fluoride update, we are doing better! Will get quarterly reports
AVS update – we are doing well, keep it up 100% for Ted whoo hoo!
-outreach time for staff : we are getting consistent outreach time and Ma/RN using it to prescreen upcoming visit for hedis
- providers doing good with telemedicine and phone visits
-+ FOBT follow up- had to table for next meeting, will be addressed next visit.
other agenda items
-potluck/party- not addressed but I would love to have folks over with family to my house when it gets sunny so we can hang and let the kids and partners play!
In attendance: Lakisha, Liz, Alisha, Anna, Diane, Jason, Ted, Becky
GRATITUDES
Great meeting and great team!
We can do Kudos each week and show and tell/or an unknown factoid each week for Monday morning ice breakers, nice way to start our week!.
BUSINESS
-upcoming time off:
4/17/09 Dozois out for CME
4/27-28 JW out for CME
4/8-13 Peds out
- rooms : East cluster to get back to us on room 127 &128 use on Monday & Tues AM and Wednsday PM's
-computers working on this!
- Peds room configuration:
Water pitcher: if ok with Lynn, will put in MA’s office against window.
File cabinet on other side of room divide to left of Lynn’s desk
Coat rack requested for peds room with 4 hooks
- invite Nill to participate when he can at meeting to include peds perspective
HOW ARE MA/RN'S DOING
Providers doing better with messages, helping a lot, keep up the great work
HOW ARE MD/PA'S DOING
Things have been going great, flow seems to be working well!
HEDIS MEASURES
Fluoride update, we are doing better! Will get quarterly reports
AVS update – we are doing well, keep it up 100% for Ted whoo hoo!
-outreach time for staff : we are getting consistent outreach time and Ma/RN using it to prescreen upcoming visit for hedis
- providers doing good with telemedicine and phone visits
-+ FOBT follow up- had to table for next meeting, will be addressed next visit.
other agenda items
-potluck/party- not addressed but I would love to have folks over with family to my house when it gets sunny so we can hang and let the kids and partners play!
CORE MEETING MINUTES 3/17/09
CORE MEETING MINUTES 3/17/09
7:30 Patient/staff calls are still coming back to the core.
Marc says that all clinics area dealing with this and that as soon as a solution comes up, he will up dates us. Marc suggested that the core starts keeping track of the blind transfers
PTM from downtown was trying to get a hold of a Per diem staff person. The call was misunderstood and the PTM was transferred to 3 other clinics so that she could “talk to the injection room nurse about traveler shots”
Core has noticed more mistakes being made when it comes to patient appointments. Pt has a appointment card which clearly states day and time- pt shows up at clinic tries to check in, appt time or date are wrong, they are then sent back to core so that the core staff can handle it.
This practice will now be handled by the PCR’s and the flow staff for that PCP. Patients will not be sent back to the core
8:10 MAs still need to be trained in core. She will take a look and see what days are good for training.
7:30 Patient/staff calls are still coming back to the core.
Marc says that all clinics area dealing with this and that as soon as a solution comes up, he will up dates us. Marc suggested that the core starts keeping track of the blind transfers
PTM from downtown was trying to get a hold of a Per diem staff person. The call was misunderstood and the PTM was transferred to 3 other clinics so that she could “talk to the injection room nurse about traveler shots”
Core has noticed more mistakes being made when it comes to patient appointments. Pt has a appointment card which clearly states day and time- pt shows up at clinic tries to check in, appt time or date are wrong, they are then sent back to core so that the core staff can handle it.
This practice will now be handled by the PCR’s and the flow staff for that PCP. Patients will not be sent back to the core
8:10 MAs still need to be trained in core. She will take a look and see what days are good for training.
West Cluster Meeting Notes 3/25/2009
West Cluster Meeting Notes 3/25/2009
Booking appointments too close together;
Will discuss with call center to question people (spouses or adult children who need to accompany pts) to make sure there is enough time in between appts if each person is booked in the same day; we had one booked 20 minutes apart in different areas of the clinic and our patient had dementia and needed the family member there…
Flow staff can ask pts to please try and coordinate appts…
Huddles- What do we do? It is different for each provider (some prefer and some don’t)
Saves time
Get room ready
Getting follow up records before visit if possible
Long range planning
Working with ONE team (flow staff and PCP) is better for patient.
Huddles go more smoothly to anticipate patient needs
Outside records tracking;
Whoever schedules the ER follow up visit should request outside records. Who does this?
OB vs. Non-OB provider. Deal breaker or not? Dr. Levine is interviewing female providers for a .7 or a .8 FTE position. Need someone friendly and patient oriented who is also personable and team oriented.
Jason Mateo, MA
JM/sm
Booking appointments too close together;
Will discuss with call center to question people (spouses or adult children who need to accompany pts) to make sure there is enough time in between appts if each person is booked in the same day; we had one booked 20 minutes apart in different areas of the clinic and our patient had dementia and needed the family member there…
Flow staff can ask pts to please try and coordinate appts…
Huddles- What do we do? It is different for each provider (some prefer and some don’t)
Saves time
Get room ready
Getting follow up records before visit if possible
Long range planning
Working with ONE team (flow staff and PCP) is better for patient.
Huddles go more smoothly to anticipate patient needs
Outside records tracking;
Whoever schedules the ER follow up visit should request outside records. Who does this?
OB vs. Non-OB provider. Deal breaker or not? Dr. Levine is interviewing female providers for a .7 or a .8 FTE position. Need someone friendly and patient oriented who is also personable and team oriented.
Jason Mateo, MA
JM/sm
Decisions From East Cluster 3/31/2009
We agreed on the following priorities for future work:
Develop procedures for looking ahead on the schedule and trying to meet patient needs before the visit
Develop our skills in doing regular email outreach to patients (including establishment of communication etiquette, checking to see if patients use email)
Further expand upon our outreach efforts related to quality of care. Items to work on include: 1) creating standard operating procedures as to how outreach should be done; 2) creating a list of high value frequently used smart phrases that are kept updated; 3) simplifying the list of quality outreach targets; 4) creating a simple list explaining the different medications involved in outreach; 4) ensuring that everyone has good preference lists to ease ordering
As a further note, issues that were brought up but not delved into related to lack of standard practice among docs in the use of the PHQ9 and what expectations are for physicals.
Develop procedures for looking ahead on the schedule and trying to meet patient needs before the visit
Develop our skills in doing regular email outreach to patients (including establishment of communication etiquette, checking to see if patients use email)
Further expand upon our outreach efforts related to quality of care. Items to work on include: 1) creating standard operating procedures as to how outreach should be done; 2) creating a list of high value frequently used smart phrases that are kept updated; 3) simplifying the list of quality outreach targets; 4) creating a simple list explaining the different medications involved in outreach; 4) ensuring that everyone has good preference lists to ease ordering
As a further note, issues that were brought up but not delved into related to lack of standard practice among docs in the use of the PHQ9 and what expectations are for physicals.
3/23/09 North Cluster Minutes
Discussion CLUSTER MEETING GOALS/OBJECTIVES
The cluster meetings are pivotal in the success of our Medical Home Model.
The goals set forth for the clusters are very specific and straight forward.
1) create the highest level of teamwork possible
2) create the best cluster/clinic in regards to:
HEDIS scores,
wound closure rates
application rates for pediatric dental varnish, usage rates for the AVS, chronic condition coding
-Discussion on item #1:
1) focus on off loading our nurses, a priority of the MD retreat. Nurses feel providers are doing better on the number of result notes being sent to the inboxes, and providers doing better at batching those notes. this is helpful and appreciated. Keep it up!
2) Using the dot system consistently helps smooth cross coverage of providers, thus helping the team function together.
3) Use the yellow patient discharge sheets helps the team flow patients better. Patients know where they need to go, nurses can help direct and core/lab are better informed of providers intentions.
A suggestion was made that those sheets be kept inside the red folders to help remind patients to keep them out (and not fold up and put in purse/pocket)
4) consider a 1/2 day retreat for the North cluster once we have both Emily and Caulda on board, maybe sometime in the fall, to help team build and shape our focus
Discussion on item #2
1) try to get weekly numbers on fluoride usage
2) try to get weekly numbers on AVS usage
2) pick several Hedis measures to start focusing on. Items suggested at today's meeting included:
-PAP
-Colon cancer screening
-6 month pediatric vaccinations
-Mammograms
-HTN
3) Chronic condition coding
we will need to look into how to approach improving in this arena
4) wound closure rates
see how I can get numbers on our patients with open wounds, how do we track/follow?
SCHEDULE CHANGES
Emily Chao(pediatrician starting in August) and Caulda (starting April 27th) will be working M-Th , both will have Fridays off Ted (starting May 4th) will be Tuesday through Friday with Mondays off.
The only change this will require is in support staff coverage for Ted on Tuesday afternoons if Lakisha can not change her schedule. We have enough MA's in the afternoon so either way that should not be a problem.
OFFICE CHANGES
Office change has been completed with phones transferred over. Diane is at Shiji's desk, Nill is working up front with Lynn, and Anna at the MA's office.
We need to confirm that this will work with Emily when she arrives, realizing this is a temporary solution till we are in our new building.
there will be an additional computer/desk set up next to Emily's desk if we have student overflow.
We are working with East cluster on our high volume days which are Tuesday mornings (5 providers in) and Monday AM and Wednesday PM with 4 providers.
TIME OFF UPDATES
in order to better coordinate our cluster staffing and ensure there is adequate coverage and no 'surprises' we will try and get updates at least two weeks in advance for small 1-2 day abscences and more lead for longer 'vacations'.
encourage everyone put days out on big calandar behind Anna's desk
Wednesday 3/25 Diane is out all day for AP2 program (associates program mandatory for new GHP hires) no other abscences noted for April.
Jason out first two weeks in May
OTHER AGENDA ITEMS
no other agenda items brought up at meeting.
The cluster meetings are pivotal in the success of our Medical Home Model.
The goals set forth for the clusters are very specific and straight forward.
1) create the highest level of teamwork possible
2) create the best cluster/clinic in regards to:
HEDIS scores,
wound closure rates
application rates for pediatric dental varnish, usage rates for the AVS, chronic condition coding
-Discussion on item #1:
1) focus on off loading our nurses, a priority of the MD retreat. Nurses feel providers are doing better on the number of result notes being sent to the inboxes, and providers doing better at batching those notes. this is helpful and appreciated. Keep it up!
2) Using the dot system consistently helps smooth cross coverage of providers, thus helping the team function together.
3) Use the yellow patient discharge sheets helps the team flow patients better. Patients know where they need to go, nurses can help direct and core/lab are better informed of providers intentions.
A suggestion was made that those sheets be kept inside the red folders to help remind patients to keep them out (and not fold up and put in purse/pocket)
4) consider a 1/2 day retreat for the North cluster once we have both Emily and Caulda on board, maybe sometime in the fall, to help team build and shape our focus
Discussion on item #2
1) try to get weekly numbers on fluoride usage
2) try to get weekly numbers on AVS usage
2) pick several Hedis measures to start focusing on. Items suggested at today's meeting included:
-PAP
-Colon cancer screening
-6 month pediatric vaccinations
-Mammograms
-HTN
3) Chronic condition coding
we will need to look into how to approach improving in this arena
4) wound closure rates
see how I can get numbers on our patients with open wounds, how do we track/follow?
SCHEDULE CHANGES
Emily Chao(pediatrician starting in August) and Caulda (starting April 27th) will be working M-Th , both will have Fridays off Ted (starting May 4th) will be Tuesday through Friday with Mondays off.
The only change this will require is in support staff coverage for Ted on Tuesday afternoons if Lakisha can not change her schedule. We have enough MA's in the afternoon so either way that should not be a problem.
OFFICE CHANGES
Office change has been completed with phones transferred over. Diane is at Shiji's desk, Nill is working up front with Lynn, and Anna at the MA's office.
We need to confirm that this will work with Emily when she arrives, realizing this is a temporary solution till we are in our new building.
there will be an additional computer/desk set up next to Emily's desk if we have student overflow.
We are working with East cluster on our high volume days which are Tuesday mornings (5 providers in) and Monday AM and Wednesday PM with 4 providers.
TIME OFF UPDATES
in order to better coordinate our cluster staffing and ensure there is adequate coverage and no 'surprises' we will try and get updates at least two weeks in advance for small 1-2 day abscences and more lead for longer 'vacations'.
encourage everyone put days out on big calandar behind Anna's desk
Wednesday 3/25 Diane is out all day for AP2 program (associates program mandatory for new GHP hires) no other abscences noted for April.
Jason out first two weeks in May
OTHER AGENDA ITEMS
no other agenda items brought up at meeting.
3/17 Provider meeting minutes
3/17 Provider meeting minutes
Present: Ashley, David, Diane, Doug, Jason, Kelly, Ted, Wellesley
Absent: Caulda, Marty, Sarah
1. reviewed events/updates
2. cluster meeting debrief:
a. all felt that it was worthwhile to continue weekly meetings. Worth the access hit for maintaining a culture of teamwork and improvement. Also felt that the amount of time was appropriate, though most clusters were really only having 30min meetings with late start times and needing to room those 8:40/1:40 patients.
b. North and West have felt behind because so much time has been devoted to personnel changes and moves. Plus, over paneling in North has prevented any outreach that involves adding appointments.
c. East cluster has been doing well, especially in the recent month with a renewed focus on team and making life better for nursing staff.
d. Many felt that the focus of these meetings should be teamwork and efficiency, and to specifically downplay or eliminate HEDIS from the mix since those will happen if the first part happens. HEDIS can seem like an insurmountable barrier to some, but can serve as a rallying point for nurses.
e. Many also agreed that it is still valuable to have a solution to a problem that does not stick and then to revisit it again. As long as we are promoting a sense of problem solving in the process, and not just complaining. All improvements should be seen as trials, and if a solution is not permanent, it is not necessarily a failure.
f. Need to keep things goal oriented (Wellesley suggested a goal of good nurses’ lives, for example) and measureable (could be something as simple as asking nurses how they are doing)
g. All agreed that sharing info would be great.
i. Forum may not be the best time to do it because some providers can never make it. Also, forum is so valuable, the sharing would be limited to very brief FYI’s only, and not include the discussion that we all felt was necessary.
ii. Blog is nice as a reference, but is not looked at much (sorry W)
iii. Regular meetings, especially of cluster leaders, would be best.
Decision: add noon meeting every 4th Tuesday for cluster leaders and anyone else who wants to attend. Diane will coordinate and remind providers of initial meeting next week.
Jason
PS. I created a dot phrase for all of our email addresses for pasting into an Epic staff message (a pool would not work). To compose a message to all BRN providers, do the following (this looks unnecessarily complicated, but I wanted to teach folks who don’t know a few very useful keyboard shortcuts that are faster than right mouse clicks):
1. Create a new message
2. in the “notes” section (body of the text), type “.1smproviders” (1 for our department as always, sm for staff message)
3. hit “control” and “A” to highlight the text
4. then hit “control” and “X” to cut the text
5. click mouse cursor in the “To” section
6. hit “control” and “V” to paste the text
(note that unfortunately, it will often look like that field is still blank, but the addresses are there. If you want to confirm, arrow to the left.)
Present: Ashley, David, Diane, Doug, Jason, Kelly, Ted, Wellesley
Absent: Caulda, Marty, Sarah
1. reviewed events/updates
2. cluster meeting debrief:
a. all felt that it was worthwhile to continue weekly meetings. Worth the access hit for maintaining a culture of teamwork and improvement. Also felt that the amount of time was appropriate, though most clusters were really only having 30min meetings with late start times and needing to room those 8:40/1:40 patients.
b. North and West have felt behind because so much time has been devoted to personnel changes and moves. Plus, over paneling in North has prevented any outreach that involves adding appointments.
c. East cluster has been doing well, especially in the recent month with a renewed focus on team and making life better for nursing staff.
d. Many felt that the focus of these meetings should be teamwork and efficiency, and to specifically downplay or eliminate HEDIS from the mix since those will happen if the first part happens. HEDIS can seem like an insurmountable barrier to some, but can serve as a rallying point for nurses.
e. Many also agreed that it is still valuable to have a solution to a problem that does not stick and then to revisit it again. As long as we are promoting a sense of problem solving in the process, and not just complaining. All improvements should be seen as trials, and if a solution is not permanent, it is not necessarily a failure.
f. Need to keep things goal oriented (Wellesley suggested a goal of good nurses’ lives, for example) and measureable (could be something as simple as asking nurses how they are doing)
g. All agreed that sharing info would be great.
i. Forum may not be the best time to do it because some providers can never make it. Also, forum is so valuable, the sharing would be limited to very brief FYI’s only, and not include the discussion that we all felt was necessary.
ii. Blog is nice as a reference, but is not looked at much (sorry W)
iii. Regular meetings, especially of cluster leaders, would be best.
Decision: add noon meeting every 4th Tuesday for cluster leaders and anyone else who wants to attend. Diane will coordinate and remind providers of initial meeting next week.
Jason
PS. I created a dot phrase for all of our email addresses for pasting into an Epic staff message (a pool would not work). To compose a message to all BRN providers, do the following (this looks unnecessarily complicated, but I wanted to teach folks who don’t know a few very useful keyboard shortcuts that are faster than right mouse clicks):
1. Create a new message
2. in the “notes” section (body of the text), type “.1smproviders” (1 for our department as always, sm for staff message)
3. hit “control” and “A” to highlight the text
4. then hit “control” and “X” to cut the text
5. click mouse cursor in the “To” section
6. hit “control” and “V” to paste the text
(note that unfortunately, it will often look like that field is still blank, but the addresses are there. If you want to confirm, arrow to the left.)
Subscribe to:
Posts (Atom)