women’s health leadership - hcpro · provides intuitive navigation across the 10 major areas of...

Women’s Health LeadershipBest Practices and Reducing Perinatal Variability:

Geisinger’s ProvenCare® Model

HealthLeaders Media LIVE fromGeisinger Health System

A live event on September 18, 2013

12:00 p.m.–3:00 p.m. EST

Geisinger Health System,

Danville, Pa.

Women’s Health LeadershipBest Practices and Reducing Perinatal Variability: Geisinger’s ProvenCare® Model

HealthLeaders Media LIVEfrom Geisinger Health System

A live event on September 18, 2013

12:00 p.m.–3:00 p.m. EST

Geisinger Health System,

Danville, Pa.

The HealthLeaders Media Live From Geisinger Health System: Women’s Health Leadership: Best Practices and

Reducing Perinatal Variability: Geisinger’s ProvenCare® Model Workbook is published by HCPro, Inc.

Copyright © 2013 HealthLeaders Media.

Various materials in this workbook are copyrighted by HCPro, Inc., as noted.

All rights reserved. Printed in the United States of America.

Except where specifically encouraged, no part of this seminar or publication may be reproduced, in any form or

by any means, without prior written consent of the copyright holders. Advice given is general, and readers should

consult professional counsel for specific legal, ethical, or clinical questions.

HCPro, Inc., and The Greeley Company, a division of HCPro, Inc., are not affiliated in any way with The Joint

Commission, which owns the JCAHO and Joint Commission trademarks.

Magnet™, Magnet Recognition Program®, and ANCC Magnet Recognition® are trademarks of the American Nurses

Credentialing Center (ANCC). The products and services of HCPro, Inc., and The Greeley Company are neither

sponsored nor endorsed by the ANCC. The acronym MRP is not a trademark of HCPro or its parent company.

Recordings: Attendees are prohibited from recording the symposium by video or audio.

Use of attendee list: Attendees may not use the attendee list of this program for any commercial or

promotional purposes.

For information about publications, contact the customer service department at 800-650-6787 or

email [email protected].

For information about seminars and educational programs, contact:

HCPro, Inc.

P.O. Box 3049

Peabody, MA 01961-3049

Telephone: 800-650-6787

Fax: 800-639-8511

Email: [email protected]

iii©2013 HealthLeaders Media. All rights reserved. Women’s Health Leadership

FRONT OF THE BOOK BACK OF THE BOOK

Speaker 1Presentations

Resources 13

Who We Are iv

Faculty v

Agenda vii

For more information, please visit us at www.healthleadersmedia.com/live

CONTENTS

iv Women’s Health Leadership©2013 HealthLeaders Media. All rights reserved.

ABOUT HEALTHLEADERS MEDIAA DIVISION OF HCPRO, INC.

HealthLeaders Media is the recognized brand leader in the healthcare arena, providing information and guidance on industry trends and real-world solutions for senior execu-tives. HealthLeaders Media offers unmatched access to all areas of healthcare business intelligence through a suite of unparalleled products and platforms. With award-winning, original editorial content, HealthLeaders Media is the trusted source for 200,000 subscribers in print and online.

As an integrated media company, HealthLeaders Media consists of the following entities: HealthLeaders maga-zine, Daily News & Analysis and free e-newsletters, books, webcasts, audio features, industry surveys, live events, and California HealthFax.

HealthLeaders Media Online is the healthcare industry’s des-tination of choice for online news and analysis. The website provides intuitive navigation across the 10 major areas of the industry that HealthLeaders Media covers. These topics include: leadership, finance, technology, physicians, communi-ty hospitals, health plans, marketing, quality, HR, and nursing.

New additions to the HealthLeaders Media family of products include HealthLeaders Media Rounds and HealthLeaders Media Breakthroughs. The HealthLeaders Media Intelligence Unit is the premier source for executive healthcare business research. The HealthLeaders Media Intelligence Unit is powered by the HealthLeaders Media Council, select members of the HealthLeaders Media audi-ence of more than 200,000 healthcare executives.

All are available at www.healthleadersmedia.com.

ABOUT HCPRO, INC. For more than 20 years, HCPro, Inc., has been a leading provider of integrated information, education, training, and consulting products and services in the vital areas of healthcare regulation and compliance. The company’s mis-sion is to meet the specialized informational, advisory, and educational needs of the healthcare industry. To accomplish this mission, HCPro provides this specialized information in its newsletters, books, videos, audio conferences, training handbooks, e-newsletters, online courses, and seminars.

As an acknowledged industry authority in healthcare regulation and compliance, HCPro focuses on providing its clients with assistance and expertise in the areas of accreditation, medical staff affairs, credentialing, privileg-ing, medical record management, regulatory compliance, finance and revenue cycle, nursing, quality/patient safety, infection control, and workplace safety.

WHO WE ARE

v©2013 HealthLeaders Media. All rights reserved. Women’s Health Leadership

HANS P. CASSAGNOL, MD Dr. Cassagnol, associate chief quality officer of Geisinger Health System and director of obstetrics and gynecology at Geisinger Medical Center Northeast, joined Geisinger in 2002 and also chairs the Performance Improvement Committee and cochairs the Ethics Committee. He is a member of the teaching staff for the Geisinger Obstetrics and Gynecology Residency Program and has served on the ProvenCare® Perinatal Initiative. Dr. Cassagnol earned a bachelor of biology degree from St. John’s University, a Master of Medical Management from the University of Southern California, an MD from the University of Connecticut School of Medicine, and completed his residen-cy at Flushing Hospital Medical Center.

HARRY O. MATEER JR., MD A physician lead for the ProvenCare® Perinatal Initiative and a member of the teaching staff for the Geisinger Obstetrics and Gynecology Residency Program, Dr. Mateer, director of obstetrics and gynecology, received the Quality Award in 2011 for patient safety initiatives recognizing his involvement in a postpartum hemorrhage protocol for the system. He holds a bachelor of biology degree from Washington & Jefferson College, a medical degree from Jefferson Medical College, and completed his residency at the Reading Hospital and Medical Center.

JOHN D. NASH, MDDr. Nash joined Geisinger in 2009 as chairman of the Women’s Health Service Line. Prior to Geisinger, he directed the Gynecology Oncology Program at the University of

Connecticut and conducted ovarian cancer research. He began his career in the U.S. Navy, eventually chairing the National Naval Medical Center’s Department of Obstetrics and Gynecology. He received his BS from the United States Naval Academy, served as an officer in the nuclear subma-rine force, and earned his MD from the Medical University of South Carolina. Dr. Nash completed his residency in obstetrics and gynecology at the National Naval Medical Center and his fellowship in gynecologic oncology at the National Naval Medical Center, Walter Reed Army Medical Center, and the National Cancer Institute.

KERRI POTSKO, RN, BSNA member of the Geisinger Health System for 21 years, Potsko began her career as an inpatient nurse in hematol-ogy/oncology at Geisinger Medical Center. She went on to hold several operations positions, including regional direc-tor of operations for cancer services. She received her BS in Nursing from Misericordia University and her Master of Health Administration from King’s College.

KIMBERLY A. SKELDING, MDDr. Skelding is a board-certified cardiologist who is widely published on heart-related topics. She earned her medical degree from Northwestern University School of Medicine and completed her residency at Geisinger Medical Center. She completed a fellowship in interventional cardiology at the Mayo Clinic.

FACULTY

vii©2013 HealthLeaders Media. All rights reserved. Women’s Health Leadership

11:30 AM–12:00 PM REGISTRATION AND NETWORKINGJoin us for a light meal and network with speakers and attendees before the event’s start

12:00 PM–1:15 PM Panel 1: Best Practices and Reducing Perinatal Variability: The ProvenCare® Model• Defining a set of best practices

• Tool for process consistency and accountability

Speakers:

• JohnD.Nash,MD,Chairman,Department of Obstetrics and Gynecology

• HarryO.MateerJr.,MD,Director of Obstetrics and Gynecology

• HansP.Cassagnol,MD, Associate Chief Quality Officer

• KerriPotsko,RN,BSN,Associate Vice President, Women’s Health

1:15 PM–1:30 PM BREAK

1:30 PM–2:15 PM Panel 2: Redefine Patient Engagement: Standardize Education and Empower Interaction

• Assessing the message from the patient’s perspective

• Using the patient portal for secure communication and enhanced education

Speakers:

• JohnD.Nash,MD,Chairman,Department of Obstetrics and Gynecology

• HarryO.MateerJr.,MD,Director of Obstetrics and Gynecology

• HansP.Cassagnol,MD, Associate Chief Quality Officer

• KerriPotsko,RN,BSN,Associate Vice President, Women’s Health

2:15 PM–3:00 PM Panel 3: Integration Techniques for Women’s Cardiovascular Care • Electronic health records, hardwired referrals, and enhanced patient communication

Speakers:

• KimberlyA.Skelding,MD,Interventional Cardiologist and Director of Women’s Heart & Vascular Health

Agenda subject to change.

AllagendatimeslistedbelowareEST.

AGENDA

1

www.healthleadersmedia.com/live

©2013 HealthLeaders Media. All rights reserved. Women’s Health Leadership

1

September 18, 2013 | Geisinger Health System

Women’s Health Leadership Best Practices and Reducing Perinatal

Variability: Geisinger’s ProvenCare® Model

2


Copyright Information

Copyright © 2013 HealthLeaders Media

The HealthLeaders Media Rounds From Geisinger Health System: Women's Health Leadership: Best Practices and Reducing

Perinatal Variability: Geisinger’s ProvenCare® Model webcast materials package is published by HealthLeaders Media,

a division of HCPro, Inc. For more information, please contact us at: P.O. Box 3049, Peabody, MA 01961-3049.

Attendance at the webcast is restricted to employees, consultants, and members of the medical staff of the Licensee. The

webcast materials are intended solely for use in conjunction with the associated HealthLeaders Media webcast. The

Licensee may make copies of these materials for internal use by attendees of the webcast only. All such copies must bear

the following legend: Dissemination of any information in these materials or the webcast to any party other than the

Licensee or its employees is strictly prohibited.

In our materials, we strive to provide our audience with useful and timely information. The live webcast will follow the

enclosed agenda. Occasionally, our speakers will refer to the enclosed materials. We have noticed that non-HealthLeaders

Media webcast materials often follow the speakers presentations bullet by bullet and page by page. However, because

our presentations are less rigid and rely more on speaker interaction, we do not include each speaker s entire presentation.

The enclosed materials contain helpful resources, forms, crosswalks, policies, charts, and graphs. We hope that you will find

this information useful in the future.

Although every precaution has been taken in the preparation of these materials, the publisher and speaker assume no

responsibility for errors or omissions, or for damages resulting from the use of the information contained herein. Advice given

is general, and attendees and readers of the materials should consult professional counsel for specific legal, ethical, or

clinical questions.

HealthLeaders Media, a division of HCPro, Inc., is not affiliated in any way with The Joint Commission, which owns the

JCAHO and Joint Commission trademarks; the Accreditation Council for Graduate Medical Education, which owns the

ACGME trademark; or the Accreditation Association for Ambulatory Health Care (AAAHC).

3


Today’s Interactive Session

•  Our roundtable today is designed to be a discussion

involving you. For our virtual audience, please ask any

question of the presenters at any time by typing your

question into the chat box on your screen. Please

note that your questions will remain anonymous. We

will address as many questions as we can during each

of the four panels of today’s program.

2 Women’s Health Leadership


©2013 HealthLeaders Media. All rights reserved.

4


PANEL 1

Best Practices and Reducing Perinatal Variability:

The ProvenCare® Model

Speakers: John D. Nash, MD Harry O. Mateer Jr., MD Hans P. Cassagnol, MD Kerri Potsko, RN, BSN

5


Presented by:

John D. Nash, MD

Dr. Nash joined Geisinger in 2009 as Chairman, Women’s

Health Service Line. Prior to Geisinger, Dr. Nash directed the

Gynecology Oncology Program at University of Connecticut

and conducted ovarian cancer research. He began his

career in the US Navy, eventually chairing the National

Naval Medical Center’s Department of Obstetrics and

Gynecology. He received his BS from the United States Naval

Academy, served as an officer in the nuclear submarine

force, and earned his MD from the Medical University of

South Carolina. Dr. Nash completed his residency in

obstetrics and gynecology at the National Naval Medical

Center and his fellowship in gynecologic oncology at the

National Naval Medical Center, Walter Reed Army Medical

Center, and the National Cancer Institute.

6


Presented by:

Harry O. Mateer Jr., MD

A physician lead for the ProvenCare® Perinatal initiative

and a member of the teaching staff for the Geisinger

Obstetrics and Gynecology Residency Program, Dr. Harry

O. Mateer, Jr. received the Quality Award in 2011 for

patient safety initiatives recognizing his involvement in a

Post-partum Hemorrhage Protocol for the System. He holds

a Bachelor of Biology degree from Washington & Jefferson

College, a medical degree from Jefferson Medical

College, and completed his residency at the Reading

Hospital and Medical Center.

3



7


Presented by:

Hans P. Cassagnol, MD

Dr. Cassagnol joined Geisinger in 2002 and also chairs the

Performance Improvement Committee and co-chairs the

Ethics Committee. He is a member of the teaching staff

for the Geisinger Obstetrics and Gynecology Residency

program and has served on the ProvenCare® Perinatal

Initiative. Dr. Cassagnol earned a Bachelor of Biology degree

from St. John’s University, a Master of Medical Management

from the University of Southern California, an MD from

the University of Connecticut School of Medicine, and

completed his residency at Flushing Hospital Medical Center.

8


Presented by:

Kerri Potsko, RN, BSN

A member of the Geisinger Health System for 21 years,

Ms. Potsko began her career as an inpatient nurse in

Hematology/Oncology at Geisinger Medical Center. She

went on to hold several operations positions, including

Regional Director of Operations for Cancer Services.

Ms. Potsko received her BS in Nursing from Misericordia

University and her Masters of Health Administration from

King’s College.

9


New Spaces, Same Issues

“The basis behind ProvenCare® is that we know that for

certain procedures, whether it’s a surgical procedure or

a complex nine-month ordeal such as pregnancy, that

there are certain aspects of care that should be offered

to all patients at various points during the procedure.”

—Harry O. Mateer Jr., MD, Director of Obstetrics and

Gynecology at Geisinger Medical Center




10


“Most physicians know what they have to do. It’s just really making sure that it does get done.”

—Harry O. Mateer Jr., MD, Director of Obstetrics and Gynecology at Geisinger Medical Center

11


Perinatal ProvenCare® Goals

•  103 discrete evidence-based elements of care were incorporated, measured, and tracked for compliance

•  Redesign, from the ground up, all aspects of provider workflow

–  Drive fundamental efficiency improvements

–  Increase patient safety and process reliability

–  Reduce/eliminate documentation redundancy

–  Streamline patient education and cut costs

•  Seek observable reductions in C-section rates and premature births

•  Enhance management of comorbid conditions

•  Improve fetal/child health and wellness

12


Key Process Redesign Principles

•  Eliminate any care steps that can be eliminated

•  Automate any work that can be automated

•  Delegate work to appropriately trained nonphysician staff when possible

•  Innovate by creating tools to enhance the reliability or efficiency of the care provided

•  Activate and engage the patient

5



13


Create eForms

•  eForms now enable nurses and providers to complete documents electronically

–  Care Coordination Record

–  Home Health Referral for Healthy Beginnings

–  OBNA for MA insurance

–  Cervical Ripening—Scheduled Induction

14


Provider and Nursing Roles

Non Provider (Nurse) Work Flow

Initial Visit Return Visit Post Partum Visit

Best Practice

Episode Create Episode.

Confirm encounter is

linked to Episode

Confirm encounter is

linked to Episode

Encounter will not be

linked to Episode

Chief

Complaint

Enter Chief Complaint Enter Chief Complaint Enter Chief Complaint

Dx and Orders Enter single Urine Dip

order or enter Urine Dip

standing order.

Remember to Enter/Edit

the results.

Enter or release Urine

Dip order. Remember

to Enter/Edit the results.

Rooming Tool Complete Rooming

Tool

Complete Rooming

Tool

Complete Rooming

Tool

Allergies Review and update if

needed

Review and update if

needed


needed

Med List Review and update if

needed.


needed.


needed.

15


Utilize All Appropriate Resources to Overcome Barriers •  Challenge the team to think creatively

•  Count steps, clicks, etc., and ask yourself if the team will follow the workflow

•  Recognize problems and develop solutions—don’t pretend they will resolve on their own




16


Standardization Across Women’s Health Service Line •  Orders and vitals by gestational age with trending

•  Joint Commission/DOH intake questions

•  Smoking cessation

•  Initial prenatal visit screening

–  Positives requiring follow-up are presented to provider

•  Provider exams (initial prenatal and postpartum)

•  Standard new patient, return, and postpartum visit workflows

•  Postpartum screening—Edinburgh Postnatal Depression Scale

•  Patient education in each trimester—“Just in time”

17


Best Practice Bundles

•  Diabetes

•  Preeclampsia/eclampsia/HELLP

•  Preterm labor

•  Primary cesarean section rate

•  Maternal wellness

•  Fetal/newborn wellness

•  Maternal history, physical exam

18


Current Status

•  Process reliability

•  C-section rates

•  Harm scores

7



19


Break

We will reconvene at:

1:30 p.m. (Eastern)

12:30 p.m. (Central)

11:30 a.m. (Mountain)

10:30 a.m. (Pacific)

20


PANEL 2

Redefine Patient Engagement: Standardize Education and Empower Interaction

Speakers: John D. Nash, MD Harry O. Mateer Jr., MD Hans P. Cassagnol, MD Kerri Potsko, RN, BSN

21


“We found something like 120–130 different educational materials that different providers in different clinic sites

were giving either at different stages of pregnancy or all at once during the pregnancy.”

—Hans P. Cassagnol, MD, Associate Chief Quality Officer of Geisinger Health System,

Director of Obstetrics and Gynecology at Geisinger Medical Center Northeast




22


Patient Education

Number of Prenatal Education Materials: Before & After Standardization

0

50

100

Num

ber o

f edu

. mat

eria

ls

Before 25 122 44

After 0 10 10

Material not appropriate for

antepartum periodMaterial applicable to all patients

Material applicable to specific

conditions

23


Patient Education Savings

Cost Reduction in Education Packets

$11,574.86

$38,309.67

$26,734.81 $27,905.74

$4,340.57

$23,565.17

$0.00

$7,500.00

$15,000.00

$22,500.00

$30,000.00

$37,500.00

$45,000.00

Materials Labor Total Cost

Old PacketsNew Packets

*Annual projected cost reduction of $10,400

24


Perinatal Education

•  Specific education for each trimester

•  Agreed upon by core team

•  Implemented across the system

9



25


Patient Engagement

MyGeisinger

•  Provides direct access to providers

•  Allows tracking of GDM glucose reporting/monitoring

•  Appointment reminders

OpenNotes

•  Better understanding of plan of care

•  Transparency

26


PANEL 3

Integration Techniques for Women’s

Cardiovascular Care

Speakers: Kimberly A. Skelding, MD

27


Presented by:

Kimberly A. Skelding, MD

Dr. Skelding is a board-certified cardiologist who is widely

published on heart-related topics. She earned her medical

degree from Northwestern University School of Medicine

and completed her residency at Geisinger Medical Center.

She completed a fellowship in interventional cardiology at

the Mayo Clinic.




28


“After her delivery, a patient’s pregnancy-related issues vanish and she goes on her way, not realizing that she’s

at risk in the next 20 years for heart disease.”

—Kimberly A. Skelding, MD, Interventional Cardiologist and

Director of Women's Heart & Vascular Health

29


“Women may not see an internist for primary care until middle age. Early counseling regarding cardiovascular

risk and prevention may save lives.”

— Kimberly A. Skelding, MD, Interventional Cardiologist and Director of Women's Heart & Vascular Health

30


“Obstetrical history (like any other aspect of a women’s past medical history) should be readily available to all

providers. Electronic health record links can make transitions of care seamless.”

— Kimberly A. Skelding, MD, Director, Women’s Heart and Vascular Health Program, Geisinger Health System

11



31


All female patients—and each provider that cares for them—need education on the unique risks unmasked in pregnancy.

–  MyGeisinger.org

–  EHR

–  Electronic media

–  CMEs, grand rounds, health forums

— Kimberly A. Skelding, MD, Director, Women’s Heart and Vascular Health Program, Geisinger Health System

32


Women’s Cardiovascular Services

•  Dissemination of best practices throughout disciplines that connect to women’s health

•  Electronic health record link for all providers

•  Community and patient education

•  Recognizing the unique needs of women in cardiovascular service

•  Growth and strategic opportunity

33


Thank You

13



RESOURCES

HealthLeaders MagazineNamed 2010 magazine of the year by the American Society of Healthcare Publication Editors (ASHPE), our flag-ship publication reports on the issues and trends that are shaping the busi-ness of healthcare today. More than 40,000 high-level healthcare execu-tives rely on HealthLeaders as one of the industry’s foremost resources for leadership and management informa-tion. HealthLeaders Magazine engages healthcare professionals looking for ideas and better ways to run their organizations.

Qualify for your free copy at www.healthleadersmedia.com/new.

HealthLeaders Media free e-NewslettersHealthLeadersMedia.com is the healthcare industry’s destination of choice for online news and analysis. The website provides intui-tive navigation across the 10 major areas of the industry that HealthLeaders Media covers. These topics include: leadership, finance, technology, physicians, community hospitals, health plans, marketing, quality, HR, and nursing. Online and e-Newsletter options also include our award-winning HealthLeaders Media Daily News & Analysis—updated every day, throughout the day.

Visit www.healthleadersmedia.comand click on the e-Newsletters link on the left to sign up for any of our free e-Newsletters.

HealthLeaders Media BreakthroughsUnlike anything you’ve experienced before HealthLeaders Media Breakthroughs, named ASHPE 2010 best digital publication, brings industry intelligence to life through multimedia-rich case studies that showcase today’s most progressive organizations. Free to download and save to your desktop, readers will find criti-cal solutions from top executive teams, go behind the trends with interactive charts and graphs, dive into the insights from more than 20 healthcare executives, and hear and view their advice in on-demand audio and video clips.

For more information and complete access to the entire HealthLeaders Media Breakthroughs library, go to www.healthleadersmedia.com/breakthroughs.

HealthLeaders Media Intelligence Unit, a division of HealthLeaders Media, is the premier source for executive health-care business research. It provides analysis and forecasts through digital platforms, printed publications, custom reports, white papers, conferences, roundtables, peer networking opportunities, and presentations for senior management.

The HealthLeaders Media Intelligence Unit is powered by the HealthLeaders Media Council, select members of the HealthLeaders Media audience of more than 200,000 healthcare executives. If you are interested in becoming a member, go to www.healthleadersmedia.com/intelligence.

C uncilHEALTHLEADERS MEDIA

Access. Insight. Analysis.

HealthLeaders MediaTelephone: 800/753-0131 | Fax: 800/639-8511E-mail: [email protected] Web: www.healthleadersmedia.com/live

women’s health leadership - hcpro · provides intuitive navigation across the 10 major areas of...

Documents