Practice Support Program Central Okanagan Work Smarter not Harder An Evening of Shared Learning Tris

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Practice Support ProgramCentral OkanaganWork
Smarter not Harder An Evening of Shared
LearningTristan Smith
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Purpose

• Introduce Common Themes of Efficient Primary Care
  Sites

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Introductions

• Practice Support Program Team
• Dr Rob Wedel

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PSP Goals / Objectives

• Outline Primary Care Environment
• Review Improvement Strategies
• Provide Tools and Support for your Primary Care
  Initiatives
• Create an Environment for Information Sharing

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Practice Support Program

• Over Arching Theme
• Improve
• Provider quality of life
• Patient Care

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Dr George Wray
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• 0800 hospital rounds 1 new pt in ER for
  assess
• 0900 office starts Dr. still in hospital
• 0930 Dr. arrives at office informed specialist
  on phone
• 0935 Dr. sees first pt list of 7 concerns
• 0956 Home care RN on phone
• 1000 Medical student arrives for day of
  teaching
• 1101 Nursing facility faxes wants reply asap
• 1110 courier arrives with bundle of 200
  documents
• 1200 MOA wants to leave for lunch - still 4 pts
  to see
• 1207 Medical student finishes with 1st pt
• 1240 Dr. finishes morning pt roster
• 1255 Medical student has lunch-Dr. starts
  paperwork 1320 Dr. has muffin and coffee
• 1330 afternoon visits start

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• 6 x complete physicals
• 2 x counseling visits
• Rxd 40 50 individual medicines
• 2-3 x insurance forms
• 2 passports
• 2 4 WCB forms
• 10 diagnostic forms
• 5 6 referral forms
• 1-2 SA forms
• 30 x 0100 billings
• ? 1 house call

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(No Transcript)
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• Dr Neil Baker (Healthcare Improvement Consultant)
• Doctors are trained to respond to patients
  symptoms actively through carefully thought-out
  processes of diagnoses and treatment.
• Doctors receive little, if any, training in
  responding to symptoms of inefficient work flow
  in their own offices.
• Until recent years, advances in techniques to
  improve workflow in other industries had not been
  applied widely in healthcare. Now, there is a
  wealth of experience in healthcare that adapting
  such techniques often saves time, saves
  resources, and improves staff morale. Patient
  outcomes and satisfaction can also be positively
  impacted.

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• Working Smarter not Harder
• 94 of poor quality is due to work processes, not
  people doing a bad job (Deming)
• All Teach All Learn
• No Experts All have Expertise
• Share Generously Steal Shamelessly

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Where do we start?
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Lets Describe the local Primary Care Environment
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Family Practice Office 1234 Pandosy Street
2 unique P/T docs 1.4 unique MOAs
2500 unique patients
Unique Work flow and processes
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Drug Reps
Residential Care
Committees
Specialists
Maternity/Obstetrics And why cant babies be born
during work hours?
Hospital
Palliative Care
Community Health Care
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Practice Support Program
Networks
Tele-health
Nurse Practitioner Program
Physician Office Integration Project
UBCO Medical Program
Divisions of Family Practice
PITO- EMRs
COPD Service Framework
Specialists Service Committee
CME
Mental Health Initiatives- Bounce Back
Seniors at Risk
Medical Home Concept
New Fee Codes
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Office Efficiency Easier Integration with
Environment
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Office ProcessesDoesnt matter how good the
driver is or how much gas you put in

• Ford Pinto
• Family

• Sports
• Off Road

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Family Practice Office 1234 Pandosy Street
2 P/T Drs 1.4 MOAs
2500 patients
Unique Work flow and processes
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List of Office Efficiency Techniques

• Care Teams / Daily Huddles
• Flow Mapping
• PDSA- try something small first
• Access/Continuity
• Measurements
• Know your Panel
• Expanding Scope of Care Team members
• Pre-Active Patients

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Dr Rob Wedel
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What is Working for you?
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Dinner and Table Conversations
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What are your Challenges?
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What is One Small test of change that you can
try a few times to overcome a Challenge in your
office?
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(No Transcript)
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List of Office Efficiency Techniques

• Care Teams / Daily Huddles
• Flow Mapping
• PDSA- try something small first
• Access/Continuity
• Measurements
• Know your Panel
• Expanding Scope of Care Team members
• Pre-Active Patients

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Where to next?

• What would you like to do with this new
  information?