0000002947 00000 n 0000044620 00000 n 0000007153 00000 n 0000054116 00000 n 0000008676 00000 n 0000028071 00000 n 0000225874 00000 n Care Process Model AUGUST 2013 !is care process model (CPM) and accompanying patient education were developed by a multidisciplinary team including primary care physicians (PCPs), mental health specialists, registered dietitians, and eating disorder specialists, under the leadership of Intermountain Healthcares Behavioral Health Clinical Program. Addressing unwarranted variance in care protocols and embedding those processes in the electronic health record (EHR) can be an effective way for healthcare leaders to impact both quality outcomes and their bottom lines. 0000084970 00000 n The multidisciplinary team is tasked with asking how they can improve the care processes within the programme. ALL RIGHTS RESERVED. 0000226638 00000 n 0000025653 00000 n 0000070461 00000 n 0000087852 00000 n xref Of all the approaches leaders can leverage to address these issues, reducing unwarranted clinical variance is receiving increased attention. <<5BE851667CC40543996F5A9ED21E16D8>]/Prev 646447/XRefStm 3820>> Screen for child traumatic stress. 0000060798 00000 n 0 0000179407 00000 n If the parent is completing the screener, they will receive a different version. All rights reserved. We recommend that child or caregiver complete the child traumatic stress screener while in the waiting room, prior to their appointment. One of the best features of the child traumatic stress care process model is that it can be administered by people who don't have a clinical background. * 0000087649 00000 n Prnom. h1 01!\Ax'MF[!!z 1- 0000005079 00000 n 0000059623 00000 n Each pathway is redesigned in a series of at least two workshops and then iterated upon using Plan, Do, Study, Act (PDSA) cycles and Institute for Healthcare Improvement (IHI)-based Quality Improvement methodology. 0000006529 00000 n At two of our sites, we were immediately able to capture data-driven outcomes from the newly digitised pathways, said Dr Streather. Deming, who trained as an electrical engineer, believed that quality and cost are inextricably linked, and creating efficiencies in any process would lead to reduced costs and increased quality. 0000079460 00000 n 0000110760 00000 n 0000066218 00000 n 0000073570 00000 n Incorporating the newly redesigned pathways into the EHR has had an immediate impact for RFL. 0000023543 00000 n Intermountain Healthcare is a Utah-based, not-for-profit system of 33 hospitals (includes "virtual" hospital), a Medical Group with more than 3,800 physicians and advanced practice clinicians at about 385 clinics, a health plans division called SelectHealth, and other health services. 0000014401 00000 n Its good to see that even after 18 months of introducing a complex programme, we see the general enthusiasm growing daily.. 0000006531 00000 n 0000021193 00000 n Follow Up at Regular Intervals 1736 111 0000075636 00000 n Ive rarely seen in the NHS such buy-in from the clinical community, he said. Intermountain Healthcare in Salt Lake City, Utah, recognised the link between variance, quality and cost early on thanks in part to Dr Brent James. 0000050475 00000 n 0000005250 00000 n If you will still be using Intermountain's network, systems or data, information about your use may be reviewed, 0000032127 00000 n <<3AE4BE8F4CF5524D9372135619CC8848>]/Prev 518892>> hSYPW>G&$B% i}(!IA|C;N3mJd1 @EbBBDQ(+ Copyright 2023, Intermountain Healthcare, All rights reserved. 0000050398 00000 n Intermountain Health Care (IHC), an integrated delivery system based in Utah, has adopted a new strategy for managing health care delivery. Learning some of these differences has provided insight for Intermountain into what may be possible in the future. At Intermountain Healthcare, we are looking for Medical Assistants who are patient-focused and engaged. 0000006950 00000 n 0000168976 00000 n [EV~P\>Qr78vJ|;w,qdP7Q)N/(5kJ[;zXG$Ai?"s nBg5S9"{Y(^rS4w7,!l2"O+^y'UvvBbS=&r65[8gx&DnyegC_oWvem$,kN %PDF-1.7 % 0000258879 00000 n 0000015820 00000 n There is quite a lot of admiration in the United Kingdom for some of the system-wide approaches for improving quality in the United States, said Dr Streather. The Services Directory has information about Nationwide providers. 0000013048 00000 n 0000228696 00000 n Care Process Model AUGUST 2016 The inside pages of this tool provide an algorithm and associated notes and can be folded open and posted in your office or clinic. 0000023486 00000 n by Amy Bowen | Kaye Coholan Salt Lake City, UT/Broomfield, CO (April 5, 2022) - Intermountain Healthcare and SCL Health, two leading nonprofit healthcare organizations, have completed their merger, creating a model health system that provides high-quality, accessible, and affordable healthcare to more patients and . Franklin G. Miller, Ph.D., and Ezekiel J. Emanuel, M.D., Ph.D. 0000010567 00000 n 0000029880 00000 n It is not a prescription for every physician or every patient, nor does it replace clinical judgment. 0000003093 00000 n Dr James was hired by Intermountain in 1986 as the director of medical research and continuing medical education. Helping people live the healthiest lives possible, Intermountain is widely recognized as a leader in clinical quality improvement and efficient healthcare delivery. Care Process Model JUNE 2019 2019 Update GOALS & MEASUREMENTS The goal of this CPM is to improve the . 1660 0 obj <> endobj 0000079372 00000 n %%EOF 0000128388 00000 n 0000069209 00000 n 0000016002 00000 n We are already on our way to digitising 20 of those 44 pathways and will eventually have all 44 in the EHR.. endstream endobj 1661 0 obj <>/Metadata 177 0 R/Names 1662 0 R/Outlines 155 0 R/PageLayout/SinglePage/Pages 176 0 R/StructTreeRoot 179 0 R/Type/Catalog/ViewerPreferences<>>> endobj 1662 0 obj <> endobj 1663 0 obj >/PageWidthList<0 612.0>>>>>>/Resources<>/ExtGState<>/Font<>/ProcSet[/PDF/Text]/XObject<>>>/Rotate 0/StructParents 0/Thumb 171 0 R/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>> endobj 1664 0 obj [1665 0 R 1666 0 R 1667 0 R 1668 0 R] endobj 1665 0 obj <>/Border[0 0 0]/H/N/Rect[131.157 415.338 170.914 404.138]/StructParent 17/Subtype/Link/Type/Annot>> endobj 1666 0 obj <>/Border[0 0 0]/H/N/Rect[460.652 162.428 475.529 151.48]/StructParent 1/Subtype/Link/Type/Annot>> endobj 1667 0 obj <>/Border[0 0 0]/H/N/Rect[509.976 162.428 537.031 151.48]/StructParent 2/Subtype/Link/Type/Annot>> endobj 1668 0 obj <>/Border[0 0 0]/H/N/Rect[187.84 256.725 212.127 244.468]/StructParent 18/Subtype/Link/Type/Annot>> endobj 1669 0 obj <> endobj 1670 0 obj <> endobj 1671 0 obj <> endobj 1672 0 obj <> endobj 1673 0 obj <> endobj 1674 0 obj <>stream 0000015005 00000 n 0000086355 00000 n The Child Traumatic Stress Care Process Model (CPM) was developed through a collaboration of the Department of Pediatrics at the University of Utah and the Center for Safe and Healthy Families at Intermountain Healthcares Primary Childrens Hospital. Inscrivez-vous pour postuler au poste de Medical Assistant chez Intermountain Health. Treesa Carter and James Hitter share their experiences of working on the transformation of health and social care integration at Suffolk County Council. 0000045671 00000 n 0000005140 00000 n There can be reticence to learn from others and there can sometimes be the resistance to adopting something that was someone elses idea. 0000005233 00000 n <]/Prev 276186/XRefStm 2368>> 0000038525 00000 n This is the healthcare-specific version of what is known in lean terminology as "mass customization." 0000179788 00000 n Published August 9, 2007, Quality- Improvement Research and Informed Consent. hb```b``_` B,7v`P*u@O@PW]DATCSJVNR.1FZ;@'D0_EVSE:UH]d(GgP{/a{zI)yi=rzfL<5)C^AF^B,fV]yU\/_]*E@'2YS,]C0= xEP+h@E9PH[ B*U^F5k|}j2X6@i+, j-1,(>p*rbPr ']4Odg 0000128347 00000 n 1425 82 0000179100 00000 n RFL has upwards of 80 clinicians involved in this process in each of the four divisions and has digitised seven pathways with plans to digitise additional pathways two at a time through a standard process. 0000003817 00000 n 0000012208 00000 n 0000063087 00000 n CPM uses several different tools to look for trauma exposure (recent and remote events), suicidality and self-harm, and traumatic stress symptoms. 0000011835 00000 n 0000010167 00000 n Users are prohibited from doing any of the The back page summarizes antibiotic recommendations and notes . 0000018713 00000 n ALL RIGHTS RESERVED. 0000177828 00000 n This care process model (CPM) outlines the recommended approach. 0000002244 00000 n 0000056318 00000 n 0000087726 00000 n 0000071295 00000 n 0000008837 00000 n 0000010991 00000 n It takes humility to recognise that you dont have all the answers and seek out people who are leaders in their field, he said. 0000066042 00000 n 1846 0 obj <>stream 0000007049 00000 n The way Royal Free reaches out to the community, thats a big push for Intermountain right now. . Additional assistance with risk assessment: iCentra order algorithm, Score Line 801-50-SCORE ( providers only ), and Connect Care 801-442-4457. 0000129774 00000 n bPatients who had at least 1 outpatient visit with a primary care physician (family medicine, internal medicine, geriatric, or pediatric specialty) during the period of 2003-2005 and a continuous service encounter from an Intermountain delivery location (either acute, ambulatory, radiologic, or laboratory services) at least once a year for each 0000043331 00000 n 0000002388 00000 n The Intermountain Care Process Model recently developed the Pediatric Traumatic Stress Screening Tool to assess traumatic stress in children in the primary care setting and to help identify diagnostic criteria for PTSD. Amy Bowen and Kaye Coholan share their thoughts on how North Central London (NCL) has taken a different approach to managing NHS waiting lists for their Integrated Care System (ICS). 1736 0 obj <> endobj 0000170459 00000 n 0000072898 00000 n 0000034112 00000 n %2O92qx`x@7l* eLBX&4*p*x 9`%jX,/p*x2 aWbL dTK`rX/i-'bT Df`9D3hA9@@!N Hg1pfM_:+.y- iM=5{*g2msZ:G3Lrtwsut e5b1L & 0000072266 00000 n 0000012710 00000 n 0000007942 00000 n At the end of March 2022, the Cerner European Collaboration Forum brought together 300+ attendees from over 16 countries. The clinical leadership for the digitisation programme is divided into RFLs four clinical divisions: Medicine, Surgery, Specialist Services, and Womens, Childrens and Diagnostics. 0000005596 00000 n 0000017841 00000 n The partnership has provided value to RFL on many levels. 0000021255 00000 n 0000066119 00000 n 0000064797 00000 n 0000198367 00000 n 0000000016 00000 n Provides patient education as directed (content reflects specific MA training, guidelines, care process models, protocols). * This CPM presents a model of best care based on the best available scientific evidence at the time of publication. by Treesa Carter | James Hitter 0000026834 00000 n 0000048189 00000 n 0000064758 00000 n 0000011030 00000 n 0000003519 00000 n 0000023018 00000 n 0000002361 00000 n 0000072478 00000 n CPMs are meant to provide an evidence-based and standardised way to address the core clinical processes that matter most to their patients and clinicians. Failing to address variations can negatively impact the ability to provide quality, consistent, safe and cost-effective care. 268 0 obj <>stream Seeing their institutional processes adapted by other health systems is a validation of the approach. 0000022567 00000 n 0000031343 00000 n 0000002048 00000 n 0000009527 00000 n Organising care in this way facilitates a broader, more longitudinal view of whats necessary to treat a condition. 0000008976 00000 n 0000208680 00000 n 0000072122 00000 n 3175 102 0000007843 00000 n 0000177263 00000 n 0000017996 00000 n 0000079708 00000 n 0000176241 00000 n 0000005742 00000 n %PDF-1.7 % We already have resource guides developed for many counties in Utah. Intermountain will use a regional deployment strategy to bring all acute care facilities, ambulatory . 1425 0 obj <> endobj 0000005788 00000 n This care process model (CPM) is maintained by Intermountain Healthcare's Lower Respiratory Tract Infection Team, . 0000072821 00000 n 0000006999 00000 n It is based on expert opinion and clinical practice guidelines from the Infectious Disease Society of America (IDSA), the American Academy of Pediatrics (AAP), and the American Academy of Otolaryngology (AAO). 0000005681 00000 n 0000027605 00000 n The approach focuses management attention not only on the facilities where care takes place but also on physician decision making and the care process itself, with the aim of boosting physician productivity and improving care quality, while saving money. 0000004619 00000 n Intermountain Healthcare Delivery Institute, Skip to Intermountain Healthcare company wide navigation, Skip to Intermountain Healthcare company wide footer navigation, Sustaining and Extending Clinical Improvements: A Health 95 Systems Use of Clinical Programs to Build Quality Infrastructure, by Brent C. James, Joel S. Lazar, Clinical Programs, Development Teams, and CPMs, Guidebook for Implementation of a Clinical Work Process-Based Organizational Structure, Managing for Ethical Health Care Delivery, The Hastings Center - Health Care Quality Improvement: Ethical and Regulatory Issues, Quality Improvement and Ethical Oversight, The Tension Between Needing to Improve Care and Knowing How to Do It. Get care for low-level urgent conditions through a video chat with a provider, 24/7, on your computer or mobile device.Learn More. Still not finding what you are looking for? 0000015259 00000 n What if the child or parent asks me a question about the screener while they are filling it out? trailer 0000008058 00000 n 0000034579 00000 n height, weight, OFC, care process model data, etc.). 0000004256 00000 n If different clinicians in the same health system are using widely varying protocols to treat the same conditions, the result will be poorer patient outcomes and a less-than-clear picture of what it truly costs to treat the condition. 0000072602 00000 n 0000063001 00000 n 0000004300 00000 n P.O. trailer 0000176611 00000 n 0000008500 00000 n The Royal Free London NHS Foundation Trust (RFL) is one of the largest hospital Trusts in the NHS, employing more than 10,000 staff and serving 1.6 million patients across 20 sites in north London and Hertfordshire. First, primary care providers and care teams can meaningfully respond to family needs that may prevent trauma exposure in children (0 5 years) through the use of the SEEK questionnaire and Road Map of Care for Pediatric Trauma Prevention. 0000033836 00000 n 0000053054 00000 n 0000084446 00000 n 0000226561 00000 n 0000058232 00000 n 0000079895 00000 n trailer 0000066035 00000 n Groundbreaking population health and value model will improve affordability and access to care. 0000025573 00000 n The FSI Academy is focused on the onboarding of new hires who will be trained as interface engineers; responsible for implementing the technical mechanisms that allow the exchange of information between solutions and external systems. 0000033890 00000 n %PDF-1.7 % Intermountain used this philosophy to organise its most common care processes under the direction of an operations structure called clinical programmes. 0000041187 00000 n 0000019636 00000 n startxref 0000010857 00000 n 0000071218 00000 n During development of the care process model, the authors found many aspects of ICU care that required substantial change. 0000005227 00000 n 0000037253 00000 n With healthcare costs continuing to rise and clinical outcomes increasingly linked to reimbursement, optimising care and lowering costs are critical factors in determining the competitiveness and effectiveness of hospitals and health systems. 0000177088 00000 n 0000177729 00000 n 0000004619 00000 n 0000005907 00000 n 0000021074 00000 n 0000066508 00000 n 0000006077 00000 n trailer 0000035552 00000 n 0000033986 00000 n Involving patients and clinicians in the design of care pathways has also given them a stake in the success of the project. 0000018590 00000 n 0000176282 00000 n Although physicians are encouraged to follow the CPM to help focus on and measure quality, deviations are a means for discovering improvements in patient care and expanding the knowledge base. 0000005695 00000 n Special attention is also paid to who attends each visit to ensure all stakeholders are involved. endstream endobj 207 0 obj <>>>/Metadata 204 0 R/Names 209 0 R/OpenAction 208 0 R/Outlines 197 0 R/PageLayout/TwoPageRight/Pages 203 0 R/Type/Catalog/ViewerPreferences<>>> endobj 208 0 obj <> endobj 209 0 obj <> endobj 210 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text]/Properties<>/XObject<>>>/Rotate 0/Tabs/W/Thumb 198 0 R/TrimBox[0.0 0.0 792.0 612.0]/Type/Page>> endobj 211 0 obj [212 0 R 213 0 R 214 0 R] endobj 212 0 obj <>/Border[0 0 0]/H/N/Rect[647.403 349.775 697.152 339.065]/Subtype/Link/Type/Annot>> endobj 213 0 obj <>/Border[0 0 0]/H/N/Rect[647.905 312.2 690.6 301.535]/Subtype/Link/Type/Annot>> endobj 214 0 obj <>/Border[0 0 0]/H/N/Rect[32.9 392.516 116.959 379.171]/Subtype/Link/Type/Annot>> endobj 215 0 obj <> endobj 216 0 obj <> endobj 217 0 obj <> endobj 218 0 obj <> endobj 219 0 obj [/ICCBased 246 0 R] endobj 220 0 obj <> endobj 221 0 obj <> endobj 222 0 obj <> endobj 223 0 obj <> endobj 224 0 obj <>stream 0000193542 00000 n <<7D7E07AF05D25B429403B179B549C510>]/Prev 735917/XRefStm 3093>> We found that there was a great deal of unwarranted variation in the way we delivered care that created less than ideal quality care for patients, and there were operational inefficiencies baked into that, said Dr Chris Streather, chief medical officer at RFL. \H6Hl7% K{X0(%p* *\y~b!o^%CIe%'jR$b $zoE)fPBgf+"jf6yy/i>>XmHm!$ Administers screening tests to . %PDF-1.7 % Its purpose is to summarize and promote evidencebased approaches to lifestyle and weight management, and to facilitate implementation in routine . 0000057752 00000 n It is extremely important to screen patients until there are no further limitations on testing capacity. Intermountain Healthcare: Towards an integrated, value-based model Intermountain (US) UH Bristol (UK) TTSH (Singapore) VCHI (US) Show sources Briefing paper Tackling waste is a difficult but. 0000015624 00000 n 0000014981 00000 n 0000008863 00000 n Published February 21, 2008. 0000005644 00000 n 0000086222 00000 n 0000070354 00000 n 0000052164 00000 n 0000012852 00000 n How old does a child need to be to complete the traumatic stress screener? WARNING: Intermountain Healthcare's Information Systems resources are for Intermountain approved purposes only. 0000014338 00000 n WARNING: Intermountain authorized users only. However, EHR-based processes will typically need to be matched with a system strategy that unlocks the potential of front-line clinical teams who are informed by good clinical data and a culture of improvement, quality and safety. 0000032530 00000 n 0000001556 00000 n CARE PROCESS MODEL JANUARY 2021 Chronic Obstructive Pulmonary Disease (COPD) Diagnosis, Treatment, and Resources ALGORITHM NOTES ALGORITHM: DIAGNOSIS OF COPD . %%EOF When we visit Intermountain, we bring senior-level executives, but we also take people who are directly involved in care, said Dr Streather. 0000004293 00000 n 0000008676 00000 n Additionally, the PIPS team has clinicians available for consultation when needed. 0000045545 00000 n "I`IvWdZ>B.nJ.o}LVL:}T{&!Qd4l;( q& Q/b2N$5%/wTg?8YSneUE+ It turns out that clinical process management and improvement is our core business strategy.. %%EOF Mild range scores (0 10) protective approach, Moderate range (11 20) resilient approach, Severe range (21 or higher) restorative approach. Part of the partnership has been learning that it is not a one-to-one process of dropping in methodology from Intermountain to RFL, and that the Trust has adapted the ideas to their own circumstances. 0000008244 00000 n 0000007263 00000 n Chief among these is the willingness to be open to change and new ideas. 0000081734 00000 n :x-)KYYY"3%C_hS! %PDF-1.7 % 0000033569 00000 n 0000177977 00000 n 0000045738 00000 n The partnership between Intermountain and RFL involves teams from each organisation visiting the other to observe and attend workshops and monthly teleconferencing so that Intermountain can provide remote support to RFL as the Trust implements clinical practice groups (CPGs), RFLs version of CPMs. 0000019314 00000 n Deming was also an advocate of considering systems as a whole, not as disparate smaller component parts that could be changed without influencing an entire operation. In the 5 phase III alvimopan efficacy trials, a simple standardized accelerated postoperative care pathway was used rather than a comprehensive, multidisciplinary colon surgery care process model that is used by Intermountain Healthcare. 0000008313 00000 n hWkTSsH LB%A h oIBxH P,ZA 0000005756 00000 n 0000045214 00000 n The report also estimated that approximately 75,000 deaths might have been prevented in 2005 if every U.S. state had provided care at a quality level on par with the best performing state. 0000005602 00000 n 0000029472 00000 n 0000006066 00000 n Intermountain Healthcare and Royal Free London are working toward a common goal of reduced clinical variance. trailer 0000005448 00000 n 0000008541 00000 n 0000176762 00000 n 0000065867 00000 n !C4@$8 y Together, these components have allowed Intermountain to create integrated CPMs to manage practice guidelines and digital workflows that actively guide doctors toward the clinical decisions that will improve outcomes for patients. 0000008748 00000 n 0000009576 00000 n 0000071068 00000 n How to address things like education, food and transportation, these are things the British government has been doing aggressively since WWII.. 0000008686 00000 n This care process model was developed to help guide the general practitioner on outpatient screening for diabetes and management of type 2 diabetes in patients within the University of Utah and Intermountain Healthcare systems. A 2012 report from the Institute of Medicine found that inefficiencies in the U.S. healthcare system resulted in up to $750 billion of wasted spending in 2009, roughly 30 percent of total healthcare spending in that year. <<969DFD35F0E1574DA86361927245C514>]/Prev 975812/XRefStm 3817>> Fortunately Intermountain Healthcare (among others) publishes their Care. 0000065716 00000 n 0000066307 00000 n 0000006783 00000 n Two of the first clinical programmes developed were cardiovascular, and women and newborns. 0000000016 00000 n 0000045274 00000 n It doesnt make sense to imagine that you can do a fundamental change programme without working with other people., Dr Wood agrees that creating partnerships is key to future growth. 0000015816 00000 n The programme has evolved over the years, but the core philosophy is still the same the science of process management and change leadership is applied to healthcare leading to better quality, safety, cost and services outcomes. 0000176512 00000 n 0000071811 00000 n following: (1) modifying Intermountain data on any of Intermountain information systems; 0000004772 00000 n 0000088537 00000 n Behaviors, Attention-Deficit/Hyperactivity Disorder (ADHD) & Mood Disorders, Fetal Alcohol Spectrum Disorder Distinguished from Autism, Mucopolysaccharidosis Type I & Motor Development, Mucopolysaccharidosis Type I (MPS 1) Genetics, Mucopolysaccharidosis Type I (MPS 1) Hematopoietic Stem Cell Transplantation & 206 0 obj <> endobj For children 6 18 years who report a potentially traumatic experience on the Pediatric Traumatic Stress Screening Tool (more information on this screening tool available in full CPM), the process of responding effectively to child traumatic stress involves three steps: Based on screening tool results, a brief in-office intervention targeting their most prominent symptom(s) has been shown to make a big difference for many children. Only authorized users with an appropriate business need and legal right may use these resources. 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