BBCAI Resources/Activities Master List

Resources
Business Case Tool Template	Community Profile Guidance	Chart Audit Tool
		COE Framework

Focus	PDSA Cycle
Foundational	PDSA 1: Confirm your population of focus. Using your EHR, confirm the number of patients who are 19 or older. This is the overall POF; specific vaccines may define applicable subsets of this POF. Run a report from your EHR that allows you to identify the gap between the number of patients who have had a flu vaccine and the number of patients that are eligible for this vaccine.
Business Case Tool	PDSA 2: Have your Finance team complete as much as possible of the Finance Assumptions page. If your payer mix differs from the payers that are included on the sheet, feel free to modify the headings. The goal is to understand reimbursement by those payers covering a significant portion of your population. We do not need to include every payer represented by your population. This tab feeds much of the rest of the document.
Controllable Opportunity Cost	PDSA 3: Complete an audit of 20 charts for patients who are listed on the gap report to determine whether there is some documentation in the chart that they did have the vaccines, but this fact was not documented in the vaccine section of the chart and therefore not picked up for billing or reporting purposes. This audit effort highlights the opportunity for improvement in your charge capture and documentation process.
Workflow documentation	PDSA 4: Complete two workflow maps. Complete one workflow map for seasonal flu vaccines. The second workflow map is for lifetime immunizations such as Shingrix. This is very important for codifying your system for immunizations and improving it. As part of workflow documentation try to confirm the time it takes to do each task as well as who does that task. Be sure to include any linkage to population health work or care management that is part of your outreach or engagement with patients.
Business Case Tool	PDSA 5: Complete the Workflow Assumptions tab using the information from your workflow mapping. This might require a meeting with your clinical champion, pharmacy, and finance staff. Also complete the Cost and Volume Assumptions tab with volumes from the first PDSA and the cost of the vaccines, supplies used, as well as acquisition and disposal costs. This may be dependent on PDSA 4.
Understanding Leakage.	PDSA 6: From session 2-5 review your schedule of patients who are in the population of focus and find out how many are getting their vaccines elsewhere (e.g., CVS, Walgreens, local pharmacy). This is what we call the leakage (patients going elsewhere) number and can help estimate your true vaccine rate of your patients. Enter these numbers on Leakage tab in the tool so that the tool can calculate the opportunity cost for these vaccines done elsewhere.

	OTHER ACTION ACTIVITIES
Understanding the Environment	Deliverable 1: Develop a Community Profile using the Baldrige Community of Excellence Framework as a guide. The Profile is suggested to be specific to immunizations in your community. This includes mapping Pharmacies, Urgent Care Centers, Health Department Services, and community organizations that are influencers for your patients. Consider this as creating a storyline for immunizations in your community that can be used to help engage stakeholders.
Stakeholder Partner Mapping	Deliverable 2: Develop a stakeholder map of prospective partners you can bring into a process to improve adult immunizations. These can include non-traditional partners such as grocery stores, gyms, restaurants, etc.
Strategic Plan	Deliverable 3: Refine a strategic framework for your organization working with your community partners. In one of our sessions, you will be able to develop a strategic framework with your partners.
Codesigned Workflow	Deliverable 4: Develop a new workflow working with community partners in a codesign approach. In one of our sessions, you will be able to start a workflow with your partners.
Business Case	Deliverable 5: Quantify your business case for immunizations and the insights gained from this quantification.