Update on OCC Projects and Initiatives

 
Brief Update on OCC projects
 
CREEK Quarterly Call
Leo Greenstone, M.D.
 
BLUF
 
OCC is focusing on 6 major areas:
Access: RCI, CO-ED
Timeliness: RCI, Scheduling Grid integration
Care Coordination: CO-ED, tools/notes
Quality of care: Patient Safety guidebook& process, HPP
Cost: CO-ED, UM education and SEOC Governance
Cerner: Data an process synchronization, process enhancements,
efficient Revenue capture
 
A
c
c
e
s
s
 
RCI goals:
1. Improve Veterans experience. 
V-signals measure
2. Inform Veteran of internal options for care (F2F, VVC, CRH, CC).CTB 2.0 measure
3. Expedite CC scheduling. Capture preferences, Veteran self-scheduling, RCT
scheduling. (
CTB 2.0 measure
)
CO-ED goals
1. Decrease # of Veterans going to community EDs. Tele UC/ED, call 1
st
 initiative
using C3s, CC/ICM enhancements. 
ED dashboard measure
2. Improve care coordination. Reaching out to common community ED/hospitals,
CC/ICM enhancements, develop a baseline and strong practice ED guidebook.
Increased f/u in VA PC/SC, decreased ED readmissions. 
ED dashboard measure
 
I
m
p
r
o
v
e
 
C
o
n
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r
e
f
e
r
r
a
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t
i
m
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l
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s
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RCI (see access slide)
VISN based flex teams as a recommendation
Scheduling grid integration project will:
-Connect to providers EHRs (Cerner, Epic, Athena, Meditech, Allscripts)
-Ability to schedule in their grids
-Receive the med docs at the time the note/encounter are completed
-Enhanced Directory/provider profile info/search capabilities
-Enhanced Veterans self-scheduling using VAOS with automated search
and sending HSRM referral to the provider
 
C
a
r
e
 
C
o
o
r
d
i
n
a
t
i
o
n
 
CC/ICM pilot assessing who best should support complex Veterans
with coordination their episode of care? (CC RN vs. lead coordinator)
What are the best tools to use to document the care plans and their
completion? (HSRM, CMT etc…)
How do we measure if care coordination is actually taking place?
(Note title use, CTB, HSRM task completion ???)
What is the impact of coordinating or not? V-signals, etc..
(See CO-ED on access slide)
 
P
a
t
i
e
n
t
 
s
a
f
e
t
y
 
a
n
d
 
q
u
a
l
i
t
y
 
Patient safety guide book
Tracking reports on use of JPSR, PQIs
HPP designation on va.gov and scripting for staff
Always seeking better ways of capturing quality data on community
providers
 
C
o
s
t
 
ED and follow on admissions lead the way so pilot mandating call for all
admissions to look for early transfer opportunities.
Does the CO-ED initiative decrease ED/admission costs?
Does the RCI drive more care into the VA?
Assess impact of using SEOCs
Assess frequency of “over use” of SEOCs beyond the consult order request.
Does the homemaker home health aide program decrease use of CNH? Is it
used consistent with current evidence?
Pursue value-based options in VCCP (joint replacements, Cardiac surgery
etc..)
 
C
e
r
n
e
r
 
Data pushed to CDW
Reports displaying same metrics (file entry date {FED} to first
scheduled, unscheduled #s, FED to appt, PID to appt)
Rich step by step referral cycle time data in Cerner
Enhanced processes and eliminating systems
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OCC, under the leadership of Dr. Leo Greenstone, M.D., is focusing on 6 major areas including improving access for veterans, enhancing care coordination, ensuring quality of care through patient safety guidelines, optimizing costs, and governance. Projects include improving consult/referral timeliness, integrating scheduling grids, and enhancing patient safety measures. The aim is to enhance the overall experience and outcomes for veterans under VA care.


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  1. Brief Update on OCC projects CREEK Quarterly Call Leo Greenstone, M.D.

  2. BLUF OCC is focusing on 6 major areas: Access: RCI, CO-ED Timeliness: RCI, Scheduling Grid integration Care Coordination: CO-ED, tools/notes Quality of care: Patient Safety guidebook& process, HPP Cost: CO-ED, UM education and SEOC Governance Cerner: Data an process synchronization, process enhancements, efficient Revenue capture

  3. Access Access RCI goals: 1. Improve Veterans experience. V-signals measure 2. Inform Veteran of internal options for care (F2F, VVC, CRH, CC).CTB 2.0 measure 3. Expedite CC scheduling. Capture preferences, Veteran self-scheduling, RCT scheduling. (CTB 2.0 measure) CO-ED goals 1. Decrease # of Veterans going to community EDs. Tele UC/ED, call 1stinitiative using C3s, CC/ICM enhancements. ED dashboard measure 2. Improve care coordination. Reaching out to common community ED/hospitals, CC/ICM enhancements, develop a baseline and strong practice ED guidebook. Increased f/u in VA PC/SC, decreased ED readmissions. ED dashboard measure

  4. Improve Consult/referral timeliness Improve Consult/referral timeliness RCI (see access slide) VISN based flex teams as a recommendation Scheduling grid integration project will: -Connect to providers EHRs (Cerner, Epic, Athena, Meditech, Allscripts) -Ability to schedule in their grids -Receive the med docs at the time the note/encounter are completed -Enhanced Directory/provider profile info/search capabilities -Enhanced Veterans self-scheduling using VAOS with automated search and sending HSRM referral to the provider

  5. Care Coordination Care Coordination CC/ICM pilot assessing who best should support complex Veterans with coordination their episode of care? (CC RN vs. lead coordinator) What are the best tools to use to document the care plans and their completion? (HSRM, CMT etc ) How do we measure if care coordination is actually taking place? (Note title use, CTB, HSRM task completion ???) What is the impact of coordinating or not? V-signals, etc.. (See CO-ED on access slide)

  6. Patient safety and quality Patient safety and quality Patient safety guide book Tracking reports on use of JPSR, PQIs HPP designation on va.gov and scripting for staff Always seeking better ways of capturing quality data on community providers

  7. Cost Cost ED and follow on admissions lead the way so pilot mandating call for all admissions to look for early transfer opportunities. Does the CO-ED initiative decrease ED/admission costs? Does the RCI drive more care into the VA? Assess impact of using SEOCs Assess frequency of over use of SEOCs beyond the consult order request. Does the homemaker home health aide program decrease use of CNH? Is it used consistent with current evidence? Pursue value-based options in VCCP (joint replacements, Cardiac surgery etc..)

  8. Cerner Cerner Data pushed to CDW Reports displaying same metrics (file entry date {FED} to first scheduled, unscheduled #s, FED to appt, PID to appt) Rich step by step referral cycle time data in Cerner Enhanced processes and eliminating systems

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