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Better preventative care documentation helps practice exceed benchmarks

SIU Medicine, a university-owned physician practice, credits a stronger focus on documenting preventative care screenings and quality measures to standardize documentation, increase compliance and improve base quality measures.

Here are just some of the team’s achievements since launching Allscripts TouchWorks® EHR in 2017:

  • Fall risk screening: From 17% in 2016 to nearly 78% in 2017, surpassing the national benchmark of 57%
  • Screening for clinical depression: From 3% in 2016 to 49% in 2017, nearing the national benchmark of 52%
  • Pneumococcal vaccination status in older adults: From 65% in 2016 to 80% in 2017, surpassing the national benchmark of 54%

Here are the steps they took to improve preventative care documentation:

1. Setting goals

According to the Deputy Director of Clinical Informatics & Analytics Krissey Greene, “We needed to be able to document, so we could pull the information and do real-time reporting to improve our performance and deliver better patient care.”

 2. Establishing and designing

SIU Medicine developed a workgroup that included representatives from quality, safety and clinical informatics teams and more. The team used Lean Six Sigma methodology to develop a sustainable documentation process that benefited providers and staff.

“We focused on building an efficient flowsheet, where providers and staff could easily reference the information, and everything flowed around that,” Greene said.

After the group listed all items that would require documentation, it determined which clinical role would be responsible for entering the data elements into the EHR, and where to place the data.

3. Testing

To test the workflows, teams timed the nursing and provider input to reveal results, like the reduced documentation time from adding a standardized intake form.

SIU Medicine piloted the solution in three primary care locations and monitored progress with manual audits and by reinforcing standard workflows.

“After the pilot, we went and talked to other departments and left it up to leaders and physicians in each group on when they wanted to push it out,” Director of Quality and Performance Improvement Darren Barnes said.

4. Surpassing national benchmarks

SIU Medicine used the Quality and Resource Utilization Report from the Centers for Medicare and Medicaid Services (CMS) as the national benchmarks for preventative care quality measures.

“We had a tool for screening for depression and fall risk in our aged population, but it wasn’t documented in a standardized location,” Barnes said.

By standardizing the location of this tool and documentation process, SIU Medicine increased its screening for fall risk and depression. “We’re pleased with our initial results and we have the right team in place to keep doing better,” Barnes said.

5. Planning for future successes

As for the future, SIU Medicine is building templates for each specialty, and working with those groups to select the quality measures they want to focus on.

“We’re going to use these to create a chart prep document, so groups can run reports on which patients are due for certain screenings each month, to help make sure patients are getting what they need,” Clinical Practice Data Analyst Coordinator Christine Nienajadly, RN, BSN, said.

A recent case study details how SIU Medicine used TouchWorks EHR to obtain groundbreaking results. To learn more, download a case study.

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