Wednesday, July 12, 2017

A Spotlight on QI Success!

Muskingum Valley Health Centers

When looking at Muskingum Valley Health Center’s (MVHC’s) Colorectal Cancer Screening outcomes, many ask, “What are they doing over there?!?”. Like many of you, we wondered what they were doing to achieve such success in this measure and therefore we interviewed them to gather some clues. We hope that what we share will encourage and inspire you as well.

In the first quarter of 2015, Jeanie Blake, RN, Chief Quality Officer at MVHC, noted their Colorectal Screening rate was 17.14%. So she gathered all of their Care Coordinators to just be “more cognizant” about asking about colonoscopies and making sure they document it in the proper locations in their Health Maintenance Module.

After a few months of these minimal efforts, they again pulled their reports and the screening rate was up to 24%. In their eyes, this was not much better and so they called the staff together again. This time they called all their care coordinators (they have 12) together and they began to brainstorm about how to solve this problem. Together they decided that they would purchase Fecal Immunochemical Test (FIT) kits and alter their visit procedures. MVHC had established a Patient Care Charitable fund and decided to utilize those funds to purchase the FIT tests. Moving forward, the Care Coordinators decided to pull each day’s schedule the day before and “flag” any patient who might be eligible for colorectal cancer screening. They would then review the chart to see if they had a documented screening and then offer the FIT kit to the patient when they came in for their visit. They would discuss the benefits and how to use the test and then follow-up with them to make sure they returned their kits.

At the end of 2015, MVHC reported their Colorectal Cancer Screening outcomes to UDS as 50.59%. The team continued to refine their processes and in 2016 they reported their UDS measure rate as 77.67%. As of Quarter 1 or 2017, their rates are still high at 75%.

The MVHC has already seen some incredible patient results that have motivated the staff and encouraged them to continue their efforts. Mrs. A, a female patient in her late 60s took the FIT kit home just a few months ago and then returned the kit. The patient was found to have advanced colon cancer and went through surgery and treatment shortly after and survived the episode. This finding really helped the staff see that what they were doing was worthwhile and life-saving!

Take-Aways

We asked Jeanie what her key take-aways from this project and she outlined the following:
•    Pick 1-2 areas to focus on and devote yourself to improving them
•    Make small changes and see if it works
•    One-on-one, personal interaction is key
•    Involve frontline staff in brainstorming
•    Acknowledge/look for successes to build motivation
•    Invest in care coordination staff

Health Center Details:

Name/Location: Muskingum Valley Health Centers, Zanesville, Ohio
Provider Productivity Goals: 2.675 patients/hour for MDs, 2.25 pts/hr for NPs/Pas
Staffing Model: 1 provider with a “roomer” (MA), a “discharge nurse” (LPN), and shares a Care Coordinator with another provider.
Sites/Volume: 4 sites, 100,000 visits per year
EMR: Epic


Blog Post Provided by Kyle Vath & Jeanie Blake of Muskingum Valley Health Centers

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