r.e.a.l (results and evidence for action based learning)€¦ · team to follow when we have a...
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© 2020
R.E.A.L Solutions (Results and Evidence for Action‐Based Learning)
Advancing Palliative Care
Content Lead – Louisiana Health Care Quality Facilitator – Network for Regional Healthcare ImprovementCase Presenter – Stratis Health
February 25, 2020
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NRHI
A Few RemindersPlease mute / unmute when not speaking
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Today’s agenda
• Overview of objectives for REAL Solutions• Didactic on Advancing Palliative Care• Case presentation • Facilitator asks for clarifying questions from audience and
content lead • Facilitator asks for recommendations and impressions
from audience and content lead• Facilitator summarizes recommendations• Open discussion• Closing announcements
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Objectives
• Increase member connections• Explore topics of shared member interest• Provide opportunity for shared learning and problem
solving
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Today’s Speakers
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Case presenter – Janelle Shearer, RN, MA, CPHQProgram Manager, Stratis Health• Previous rural home care/hospice director• Passionate about helping rural
communities provide palliative care to the people they serve
Didactic Presenter – Cindy Munn, MHACEO, LHCQFCindy Munn has been the CEO of Louisiana Health Care Quality Forum (LHCQF) since 2010. She has more than 25 years of experience in health care leadership and operations management.
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Today’s didactic
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Advance care planning (ACP) helps design a
treatment strategy or plan for our health care
team to follow when we have a sudden
devastating illness or a serious advanced
illness. This planning allows health care
professionals to understand our goals of care
so they match the type of care that we receive.
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How did you do it
How did you get the community on board?• Physician Champion• LaPOST CoalitionHow did you build the will?• Input/support from Coalition and Provider Associations• Statewide education via provider associations• Prioritize providers for ‘onboarding’ • Developed turnkey training materialsDescribe any challenges you experienced• ROI for early adopters
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How are you measuring success?
• Monthly reports generated by the platform
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Results
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Results
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Today’s Case
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Significant need: Rural populations disproportionately aging and with chronic disease
Unique challenges:• Limited availability of board‐certified palliative
care clinicians • Lack of models designed specifically for rural care delivery
(most palliative care clinical models developed for large, tertiary care hospitals)
• Reimbursement challenges often amplified due to different infrastructure and payment systems (rural is not small urban)
Pallia ve care in a rural context
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Goal: Assist rural communities in establishing or strengthening pallia ve care programs
How: Bring together rural communities in a structured approach focusing on community capacity development (typical intervention period is 18‐24 months)
Who: Community‐based interdisciplinary teams from rural communities.
• More than 20 communities in Minnesota (since 2008)• Nearly 20 communities across North Dakota, Washington,
and Wisconsin (since 2017, working with local partners)
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Stratis Health rural palliative care initiatives
Rural Palliative Care Resource Center: www.stratishealth.org/palcare
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Formula for program development
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• 15 of 23 Minnesota communities that participated providing palliative care services
• Settings: home care, outpatient, nursing home, assisted living, inpa ent, community
• All participating teams implemented program development and structural and clinical interven ons including:
• Pallia ve care educa on • Advanced care planning • Care coordina on
• Community reported change:• Increase in level of expertise in pain management consultation
and staff educa on on pallia ve care • Increase in belief that pain and symptom management
needs are being met • Increase in belief that care transition processes meet
the needs of pa ents
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Results in Minnesota
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Currently using a multi‐faceted evaluation approach:• Patient level data (clinical and patient/caregiver experience) when
available • Pre‐post community assessment of assets and gaps in palliative care
skills and confidence• Operational assessment looking at implementation of key structure
and processes• Case studies/stories (challenging to capture)
Challenges:• Small numbers, and limited time window for patient level data
capture• Starting point of individual community teams varies widely • Opportunity to better capture stories – community, provider,
patient and caregiver
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Evaluation: Looking for suggestions to help capture impact and tell the story!
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• Do you have suggestions on how to show impact of a program when the patient numbers are small?
• What successful strategies have you used to capture and share patient/caregiver, community, or provider stories?
• One of our challenges in showing impact is the wide variation in the starting points for different communities. Progress can look different based on where you start. o Have any of you identified ways to address this type of
variation when evaluating programs? • Do you have other suggestions for data that may be valuable
in this type of program evaluation, or for capturing data from small rural communities?
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Guidance Needed – Other Strategies?
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Summary of Recommendations
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Closing Announcements
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NRHI Governance Committee
• NRHI is seeking 2‐3 governance committee members to address topics related to NRHI Bylaws, membership guidelines and governance processes.
• The committee is responsible for keeping the board informed of current governance trends, overseeing nomination and approval of new board members and NRHI members, and overseeing orientation and training of new members.
• If you’re interested in participating on the committee, please complete a brief interest form here.
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Request for Member’s Strategic Plans
• To help inform NRHI’s efforts in 2020, we are requesting information on each Member’s strategies and priorities.
• If your organization has not yet submitted your plan, please access the request via this link
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Upcoming R.E.A.L. Solutions
Implementing a Health Equity Survey Tuesday, March 24 from 2:00 – 3:00 p.m. ETDidactic Presenter: Wade Norwood, Common Ground Health Case Presenter: TBDRegister Today
Using the ECHO Model for Further EngagementTuesday, April 28 from 2:00 – 3:00 p.m. ETDidactic Presenter: Sandra DeBry, Comagine HealthCase Presenter: TBD
Seeking an NRHI members to participate as a Case Presenter for March & April events.
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