HEPC Lessons Learned Partner 1
- Andrea Price Old Account (Deactivated)
- Erin Mulholland (Unlicensed)
Source:
Instructions
We would like to provide you some guidance for how to effectively use the following template
How should use this document?
- This document should be used for you to register any milestones, good or bad, throughout our project that may be used to help future participants
- We do not have any expectation about what the milestones should be, so you should document them as much as you can.
- We are hoping that by reviewing this document anyone will be able to see how your process for implementing our project went
The cells that are grayed-out serves as an example of what you could document
Here is a brief description of the data points listed:
| Data Point | Description |
|---|---|
Date | Should be the date of the event/milestone you are describing-- use the first of the month if the specific date isn't known |
| Challenge or Best Practice | Select Challenge if this you identified a roadblock regardless of whether you were able to resolve it. If it is an observation, innovation or opportunity, select Best Practice. |
| Category | Suggested categories include Data (extracting, entry, validation, etc.), Implementation (integrating into the EHR or HIT system), Roll out (training, challenges at the site with administration, payment, staffing, etc.), Workflow (difficulty in integrating into practice, innovation in care pathway, etc.), Experience (patient or care team feedback--positive or negative, innovations to improve experience, patient-centered changes, care team-centered changes, etc.). You can propose or add additional categories if needed but be judicious. |
| Description | Describe the issue in as much detail as you can. It could describe a challenge you encountered, an innovation you developed, a finding that surprised you (A-ha! Moment), or a practical modification or solution that made you more efficient or effective. |
| What went well | Use this space to provide a brief description of what do you think worked out well. Even if you are reporting a challenge, try to provide the positive aspects of the situation or you may leave this blank. Perhaps things went as expected or maybe another department provided the support needed for staff to buy into the project |
| What is blocking you or did not go well | The opposite of the above-- even if it's an innovation there may be barriers to implementing it. Specifically mention any blockers and include those which are external and may not be able to be overcome in the foreseeable future. If there was nothing negative, you can leave this blank |
How did you address or would you correct this for next time? | This field will differ slightly based on the issue type. What did you do to address the challenge? How did you implement your solution or innovation? What will you do differently next time? If you will test the solution and consider new changes in the future, you can say that. |
| Follow Up | Is the milestone fully accomplished or there are next steps? If so, briefly describe them |
| Solution Team | Who is or are the point person(s) to provide more detail or participated in the development of the innovation/solution |
Lessons Learned: Challenges and Best Practices - AllianceChicago - NACHC
AllianceChicago
| Date | Challenge or Best Practice | Category | Description (Use your own words) | What went well and why? | What is blocking you or did not go well and why? | How did you address or would you correct this for next time? | Is there any follow up needed? | Solution Team |
|---|---|---|---|---|---|---|---|---|
| YYYY-MM-DD | Select One:
| Select One:
| Issue | + | - | ? | Next Steps | Who can speak about this issue? |
2020-04-20 | Challenge | Data | Missing patients on our data pull | We were able to get the majority of patients on first data pull | Many patients who received vaccines were missing on our initial pull | Team did some reviews of patient charts and discovered that encounter code 992XX was missing from the data pull. Next time we should have a medical provider review the list of encounters. We standardized the data pull so it can be reused. | Create standard queries for encounters and common conditions so they become standardized. Look for unusual encounter codes to make sure coding is appropriate. Obtain feedback from chief medical officer about list of requirements and where data points are located within the EHR | HIT data manager |
| 2021-05-14 | Best Practice | Implementation | Hep C team tasked with following up with patients to complete treatment cascade | One CHC has HepC coordinators and case managers tasked with tracking patients screened positive for HepC, and following up with them when services are due to continue through the treatment cascade. | A challenge in this system at the moment is that this is entirely based on provider referral, and the case management team may be unaware of patients with HepC if the diagnosing provider does not refer the patient to them. | We are working toward a report identifying all positively screened and diagnosed patients to ensure that all patients in the HepC treatment cascade can get this support. | Alliance building report | Case management team; HIT |
| 2021-06-02 | Challenge | Implementation | Lack of treatment resources | One CHC is located in an area with very limited specialty care, making it very difficult to connect patients to treatment outside of the primary care clinic. | CHC is working to continue building internal capacity to treat patients diagnosed with HepC. | No | CHC HepC team | |
| 2021-07-29 | Best Practice | Workflow | EMR forms providing CDS | EMR forms used to identify patients needing screening, needing treatment, etc. | Continuing to work to standardize use of these forms across clinicians. | Ongoing training | No | CHC HepC team |
| 2021-08-18 | Challenge | Data | Data discrepancy between cascade data in Alliance cascade report and data CHC has been using via an external population health tool. | CHC has had a tool to use to follow up with patients prior to development of a tool by AC. | Data discrepancy suggests that data CHC has used historically has been incomplete. | Will continue to validate reports and work with CHC to adjust workflows to utilize the more complete dataset. | Ongoing validation | HIT team |
| 2021-08-18 | Challenge | Implementation | Staffing/capacity | CHC staffing shortages impacting team's capacity to implement proposed QI. | Will continue to monitor capacity with Malama to determine ability to start QI implementation. | Implementation deferred | CHC Team | |
| 2022-01-31 | Best Practice | Data | Diagnosis accuracy | Patient records were improved and HepC cascade performance improved by correcting EHR documentation | CHC identified several patients where incorrect diagnoses were used - historical diagnoses charted as current HepC infections | CHC team continuing to provide feedback to providers who use incorrect diagnoses | CHC team | CHC team |
| 2022-01-31 | Challenge | Workflow | Lack of treatment resources | CHC has not yet been able to onboard more providers to offer HepC treatment in-house | CHC continuing to recruit from existing providers to identify someone willing to learn to treat HepC | CHC team | CHC team | |
| 2022-03-04 | Challenge | Data | Data accuracy | Several deceased patients showing on report. CHC identified that pts have not been marked as inactive/deceased in EMR | CHC updating documentation to capture deceased patients | CHC team | CHC team | |
| 2022-04-08 | Best Practice | Workflow | Outreach to engage patients | Outreach to patients who have not followed up on HepC diagnosis was effective; 3 new patients engaged | Patients often fail to follow-up on HepC dx; significant barriers to accessing HepC tx, as only on prescriber in CHC | CHC continuing to use outreach to mitigate barriers to care | CHC team | CHC team |
| 2022-09-30 | Challenge | Workflow | Insurance | Insurance denied covering HepC treatment since pt failed a drug test | CHC continuing management of patient, will re-attempt in future | CHC team | CHC team |
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