Scrubbing the Panels Using the FMEA Process to
Scrubbing the Panels: Using the FMEA Process to Improve Continuity of Care Chris Benavente, MD Santina Wheat, MD, MPH Mary R. Talen, Ph. D. Northwestern Family Medicine Residency Program STFM 2016
Disclosures • The presenters have nothing to disclose
Objectives • Identify the systematic steps toward diagnosing empanelment and continuity in a PCMH using the FMEA process. • Describe strategies to engage key stakeholders in the FMEA process • Identify leadership and organizational challenges in implementing an FMEA process for continuity of care.
Background • Continuity of care between patients and providers and maintaining these relationships over time is essential for quality care initiatives and coordinated care. • Scheduling follow-up visits with a PCP in a multiprovider and residency practice, however, is riddled with loop holes of discontinuity of care. • The goal of this project is dissect the ways that continuity of care between providers and patients is derailed in our scheduling process.
FMEA Method • A team-based systematic and proactive approach for identifying: – ways that a process can fail, – why it might fail, – the effects of that failure, and – how it can be made safer/better • A nine step process using the IHI FMEA (Failures, Modes, and Events Analysis) (http: //app. ihi. org/Workspace/tools/)
Step 1: Select a Process • Continuity of Care: – What is the process for scheduling followup appointments with the same provider or healthcare team
Step 2 • • • Providers Call Center Staff: MA, RN, PBA IT/EMR Facilitator
Step 3: Mapping the Process of Scheduling
Step 4: Identify Failures in the System • The Team describes the causes and the consequences of each failure using the IHI FEMA interactive tool kit
Step 4: Identify Failures in the System
Step 5: Risk Priority Number • RPN Calculation • On a scale of 1 -10, the Team rates how often the failure occurs, the severity, and how likely it is detected. • IHI Interactive Toolkit calculates RPN
Step 5: Risk Priority Number
Step 6: Evaluate the Results • Top 3 RPNs 1. Patient must initiate a call to reschedule 2. The robo re-call to remind patient’s to re-schedule is not placed. 3. PCP does not identify when, with whom and what the visit is for on visit summary
Step 7: Planning Improvement • Pre-Measurement of Continuity of Care Ratios • Implement Process Improvement Plan • Post Measurement of Continuity of Care Ratios
Lessons Learned and Future Directions • Balancing Access of Care with Continuity • Balancing panel sizes between providers • Leadership buy-in and engagement
Please evaluate this presentation using the conference mobile app! Simply click on the "clipboard" icon on the presentation page.
- Slides: 16