Workflow Redesign by Brenna Waxman https://padlet.com/brenna19/m4e5yjaf7dc2 AgeWell House Calls Referral Process en-us 2019-12-01 13:30:56 UTC 2023-03-25 05:26:16 UTC hello@padlet.com https://padlet.net/icons/png/1f418.png Hospital Readmission Reimbursement Rates areed81 https://padlet.com/brenna19/m4e5yjaf7dc2/wish/418140292 Website Two]]> 2019-12-01 14:25:50 UTC https://padlet.com/brenna19/m4e5yjaf7dc2/wish/418140292 High cost of hospital readmission areed81 https://padlet.com/brenna19/m4e5yjaf7dc2/wish/418141402 Video Two]]> 2019-12-01 14:34:22 UTC https://padlet.com/brenna19/m4e5yjaf7dc2/wish/418141402 Allscripts Solutions areed81 https://padlet.com/brenna19/m4e5yjaf7dc2/wish/418141762 Website Three]]> 2019-12-01 14:36:59 UTC https://padlet.com/brenna19/m4e5yjaf7dc2/wish/418141762 Article Five brenna19 https://padlet.com/brenna19/m4e5yjaf7dc2/wish/419312087 Comparing Ageing in Place to Home Health Care: Impact of Nurse Care Coordination on Utilization and Costs]]> 2019-12-03 20:13:15 UTC https://padlet.com/brenna19/m4e5yjaf7dc2/wish/419312087 Article Four brenna19 https://padlet.com/brenna19/m4e5yjaf7dc2/wish/419349326 Electronic Referral Systems in Health Care: A Scoping Review]]> 2019-12-03 21:32:54 UTC https://padlet.com/brenna19/m4e5yjaf7dc2/wish/419349326 Article Three brenna19 https://padlet.com/brenna19/m4e5yjaf7dc2/wish/419354806 Prevention of Delayed Referrals Through the Champlain BASE eConsult Service]]> 2019-12-03 21:47:05 UTC https://padlet.com/brenna19/m4e5yjaf7dc2/wish/419354806 Article Two brenna19 https://padlet.com/brenna19/m4e5yjaf7dc2/wish/419360935 Shared Care: Using an Electronic Consult Form to Facilitate Primary Care Provider-Specialty Care Coordination  ]]> 2019-12-03 22:04:08 UTC https://padlet.com/brenna19/m4e5yjaf7dc2/wish/419360935 Article One brenna19 https://padlet.com/brenna19/m4e5yjaf7dc2/wish/419446387 Closing the Referral Loop: an Analysis of Primary Care Referrals to Specialist in a Large Health System]]> 2019-12-04 03:28:45 UTC https://padlet.com/brenna19/m4e5yjaf7dc2/wish/419446387 Scope Considerations brenna19 https://padlet.com/brenna19/m4e5yjaf7dc2/wish/419458640 The scope of this workflow redesign includes three departments and two system programs. The departments include  Inpatient Care Mangers (IPCM), AgeWell Housecalls (AWHC), and Baptist Primary Care Ambulatory Care Coordination (BPC ACC). The system programs include Allscripts  Care Manager and Allscripts Care Director. 

Care Manager is currently utilized by the IPCMs and BPC ACCs for documentation and communication regarding patients in other areas of the organization. Care Director is currently utilized by AWHC for documentation purposes. Care Manager can easily place a referral to AWHC through tasking functionality within the programs. The two programs can easily communicate because they are both a product of Allscripts with the purpose of interoperability.

The involved departments and system programs will not have a dramatic change. The mode of communication regarding referrals will improve with the electronic referral process versus the current manual faxing method ]]> 2019-12-04 04:39:45 UTC https://padlet.com/brenna19/m4e5yjaf7dc2/wish/419458640 Justification for Project brenna19 https://padlet.com/brenna19/m4e5yjaf7dc2/wish/419462275 Increasing patients utilization of primary care will reduce unnecessary hospitalization and readmissions.  By stream-lining an electronic referral process, referrals are able to be easily tracked and there is less of a chance of a referral getting lost in the paper shuffle.  

Centers for Medicare and Medicaid Services (CMS) implements reimbursement penalties for 30-day readmissions for chronic illnesses. Patients are more likely to have a readmission if they are unable to transport to their Primary Care Physician for follow-up appointments. The aim of improving the referral process is to increase access to the AWHC program for patients who qualify. Currently, AWHC has an 8% readmission rate which is 7% less than the golden Medicare standard of 15%. 

Internal customers include all involved departments. The IPCM and BPC ACC will benefit by creating less workload and a stream-lined electronic referral process in a system that they are already using. The financial department will also benefit as an internal customers by cost savings in Medicare reimbursement penalties.  AWHC will benefit by ensuring all referrals received will be addressed and increase in patient population. 

External Customers include the patients. Patients will benefit with increased access to primary care services that do not require them to physically go to the doctor's office. AWHC patients are all very frail and physical unable to go the a doctor's office for follow-up appointments. 

Improvement in the volume of referrals sent to AWHC will give more patients access to primary care services at home. 

Adding the notification of accepting or denying referrals to the referring clinician to the work process will facilitate better communication between care team members. ]]> 2019-12-04 05:02:22 UTC https://padlet.com/brenna19/m4e5yjaf7dc2/wish/419462275 Project Specifics brenna19 https://padlet.com/brenna19/m4e5yjaf7dc2/wish/419467104 Team Lead - Brenna Waxman and Amanda Francisco
Project Manager - Brenna Waxman
Project analyst - Amanda Francisco

The cost of this project including time spent by staff and implementation of software improvements will be divided by the three departments that are utilizing the referral process. 

The cost will be approved in advanced by the directors of the corresponding departments who will be utilizing the updated referral process.

]]> 2019-12-04 05:37:35 UTC https://padlet.com/brenna19/m4e5yjaf7dc2/wish/419467104 Current State Workflow Map brenna19 https://padlet.com/brenna19/m4e5yjaf7dc2/wish/419468329 2019-12-04 05:45:49 UTC https://padlet.com/brenna19/m4e5yjaf7dc2/wish/419468329 Electronic Referrals With Alliance Medical brenna19 https://padlet.com/brenna19/m4e5yjaf7dc2/wish/419470501 Video One]]> 2019-12-04 06:00:57 UTC https://padlet.com/brenna19/m4e5yjaf7dc2/wish/419470501 Improve the Referral Process, , Improve Safety brenna19 https://padlet.com/brenna19/m4e5yjaf7dc2/wish/419474288 Website One]]> 2019-12-04 06:23:32 UTC https://padlet.com/brenna19/m4e5yjaf7dc2/wish/419474288 Required Resources, Departments and People brenna19 https://padlet.com/brenna19/m4e5yjaf7dc2/wish/420044056 The resources needed for this project will be an upgraded software programs and computers in which the program runs. 

The departments involved in the workflow redesign will include AWHC, BMC ACC, and IPCM. Additional, the Informatics department will be involved in customizing the programs to support the electronic referral process. 

The people required to make this workflow redesign successful will be the directors of the involved departments for approval of the steps included in the new workflow design. The intake care coordinator and ACC with AWHC will be included. The registered nurses and social workers that work in the IPCM and BPC ACC positions will also be involved in the process. ]]> 2019-12-05 03:04:59 UTC https://padlet.com/brenna19/m4e5yjaf7dc2/wish/420044056 New Workflow and Process Test brenna19 https://padlet.com/brenna19/m4e5yjaf7dc2/wish/420048578 The new referral process for AWHC will be tested prior to the Go-Live date for the new workflows. A Monday thru Friday work week before the Go-Live date will be utilized as a "test week". The AWHC intake coordinator and ACC as well as two nurses from the BMC ACC and two nurses from the IPCM will be involved in the test week. A meeting will be conducted prior to the test week with all individuals involved. An informatics team member will be available throughout the test week should any issues or concerns arise throughout the test week. A meeting will be conducted at the end of the test week to work out any kinks before the Go-Live date. ]]> 2019-12-05 03:28:22 UTC https://padlet.com/brenna19/m4e5yjaf7dc2/wish/420048578 Training on the New Workflows brenna19 https://padlet.com/brenna19/m4e5yjaf7dc2/wish/420051087 All programs involved in this new workflow are already in use by the corresponding departments. Allscripts Care Manager is currently utilized by the IPCMs and BPC ACC. Allscripts Care Director is currently utilized by AWHCs for documentation purposes. Training would only have to include the new referral tasking functionality within the programs.  

Prior to the Go-Live date,  training sessions will be implemented for each department involved in the workflow redesign. Care Manager and Care Director will be in training mode where the IPCMs and BPC ACC are able to practice sending referral tasks within the programs. AWHC intake and ACC will also be able to practice receiving referral tasks and sending are communication task regarding the acceptance or denial of patient. This training will take place over two different training sessions lasting up to two hours for each session. The training sessions will give opportunities to address any questions or concerns by all individuals involved.  

Hot sheets will also be created to be distributed to the team members whose workflow will change based on the new referral process. The hot sheets will include step-by-step instructions to creating and sending a referral and communication task in the programs. ]]> 2019-12-05 03:40:49 UTC https://padlet.com/brenna19/m4e5yjaf7dc2/wish/420051087 "Go-Live" Management brenna19 https://padlet.com/brenna19/m4e5yjaf7dc2/wish/420054390 During the "Go-live", informatics team members will be available to each involved department via email or direct phone call to assist with any issues. If needed, an informatics team member will go to the site where assistance is needed. Since the IPCMs and BPC ACCs are spread out over three counties, it is impossible to have an informatics team member at all sites at the same time during the "Go-live". ]]> 2019-12-05 04:01:35 UTC https://padlet.com/brenna19/m4e5yjaf7dc2/wish/420054390 Analysis and Revisions brenna19 https://padlet.com/brenna19/m4e5yjaf7dc2/wish/420056018 A monthly report will be generated to track the number of referral tasks sent to AWHC by the IPCMs and BPC ACCs as well as the number of accepted referrals and denial referrals. Additionally, a monthly report will be generated to track the number of communication tasks being sent back to the original referrer. This monthly report will be compared to the monthly report for the number of referrals into AWHC to ensure that communication tasks are being sent back. 

If inconsistencies are identified, then retraining will be necessary.  If the number of referrals begin to decline over time to AWHC, then retraining might be necessary.  ]]> 2019-12-05 04:14:03 UTC https://padlet.com/brenna19/m4e5yjaf7dc2/wish/420056018 References brenna19 https://padlet.com/brenna19/m4e5yjaf7dc2/wish/420060498 Azamar-Alonso, A., Costa, A. P., Huebner, L. A., & Tarride, J. E. (2019). Electronic referral systems in health care: a scoping review. ClinicoEconomics and Outcomes Research : CEOR, 11, 325–333. doi:10.2147/CEOR.S195597

Liddy, C., Drosinis, P., Fogel, A., & Keely, E. (2017). Prevention of delayed referrals through the Champlain BASE eConsult service. Canadian Family Physician Medecin de Famille Canadien, 63(8), e381–e386.

Patel, M. P., Schettini, P., O'Leary, C. P., Bosworth, H. B., Anderson, J. B., & Shah, K. P. (2018). Closing the referral loop: an analysis of primary care referrals to specialists in a large health system. Journal of General Internal Medicine, 33(5), 715–721. doi:10.1007/s11606-018-4392-z

Popejoy, L. L., Galambos, C., Stetzer, F., Popescu, M., Hicks, L., Khalilia, M. A., Marek, K. D. (2015). Comparing Aging in Place to Home Health Care: Impact of Nurse Care Coordination On Utilization and Costs. Nursing economic$, 33(6), 306–313.

Rea, C. J., Wenren, L. M., Tran, K. D., Zwemer, E., Mallon, D., Bernson-Leung, M., Toomey, S. L. (2018). Shared care: using an electronic consult form to facilitate primary care provider-specialty care coordination. Academic Pediatrics, 18(7), 797–804. https://doi-org.ju.idm.oclc.org/10.1016/j.acap.2018.03.010
]]> 2019-12-05 04:48:20 UTC https://padlet.com/brenna19/m4e5yjaf7dc2/wish/420060498 Future State Workflow Map brenna19 https://padlet.com/brenna19/m4e5yjaf7dc2/wish/420251679 2019-12-05 15:01:29 UTC https://padlet.com/brenna19/m4e5yjaf7dc2/wish/420251679 Question Two brenna19 https://padlet.com/brenna19/m4e5yjaf7dc2/wish/420254592 Is there a workflow process in your area of nursing that has changed from a paper process to an electronic  process? If so, was it beneficial? Please explain. ]]> 2019-12-05 15:05:10 UTC https://padlet.com/brenna19/m4e5yjaf7dc2/wish/420254592 Question One brenna19 https://padlet.com/brenna19/m4e5yjaf7dc2/wish/420263810 Does the cost of implementing new program software and training staff benefit an organization in regards to stream-lining a new electronic process? Please explain.]]> 2019-12-05 15:16:31 UTC https://padlet.com/brenna19/m4e5yjaf7dc2/wish/420263810