Clinical Research Oriented Workshop (CROW) Meeting: Oct 4, 2018

Present:   Levi Bonnell, Jessica Clifton, Justine Dee, Nancy Gell, Juvena Hitt, Ben Littenberg,  Gail Rose, Connie van Eeghen, Jen LaVoie, CR Macchi (GTM), Kairn Kelley (GTM)

1.                   Warm Up: CR Macchi from ASU

2.                   Connie & CR -   Our audience will consist of a mix of integrated behavioral health providers, medical providers, researchers, healthcare managers, and psychology/social work, medical family therapy students.  Our main objective is to train attendees to identify their own integrated clinic needs using validated measures (like the Practice Integration Profile of clinic-level integration) and LEAN QI processes to perform systematic quality improvement processes to address those needs

a.       Instructions: We plan to run this as intended for the first 21 slides (which is supposed to take us 20 minutes) and then get feedback on two things:

1)      The presentation: is it clear, understandable, and makes the points we are trying to get across?

2)      Does the handout provide sufficient support for the interactive part of the presentation?

Presentation:

Need an outline prior to presentation..this may include segments

Slide 1:

Slide 2: Process and tools to use (may want to provide a little more grounding)

Slide 3: May change operations to practice…an example practice profile (may want to expand verbally on what this is)

·         Need to orient to PIP and BH services within this

Slide 4: Too much text;

Slide 5: Love this page, simple visual to prompt up presentation

Slide 6: Great quote

Slide 7:

Slide 8:

Slide 9: Waste in Health Care (over-ordering); excess motion; defects and corrections (may consider taking out logos)

Slide 10: Lean A3 Problem-Solving (tool in the tool kit)…plan do study act (PDSA)

Slide 11: Lean & IBHPC …A3 = three stages…planning, design, implementation…

Slide 12: Stage 1 -Plan: I like how you tie the PIP in here

Slide 13: PIP Report…need to practice more to make more engaging (does this audience want the methodology background in variance…weighting…etc)

Slide 14: Registry Tracking

20 MINUTES

Slide 15: Stage 2-Design

Slide 16: Case Scenario…too much text

Slide 17: Current State (the visual is great)

Slide 18: Analyze Current State…I like the visual…but need to work on streamlining the explanation…make simpler

25 MINUTES

Handout

Slide 19

Slide 20: Tactics (something went funny with the text…blurred)…systematic way of identifying patients and following up

Slide 21: Assignment…too much text…Discuss possible solutions; List patient engagement activities; Draw the new workflow

29.40 MINUTES

COMMENTS

Ben: You have a lot of stuff crammed into 20 minutes. What do you want them to understand for their exercise? What is related to BHP? You can use Lean without PIP to great advantage…we recommended the PIP for assessment, but let's start from the point, you have lousy PIP score; ow you have baseline data, you don't have registries; here is the current state and there is nothing in the image that makes me think of registries…if we all get together and say we don't have a registry here is the problem…I would think case identification versus patient registries. You show workbook one tactics, but they don't need that. Plus they don't have enough time to do anything. If you can get them to understand how to do an A3 workflow description and get them to the loop they can get rid of gets them to the ah-ha moment. You need quantifiable data to point the problems…the PIP is designed to do that, but this is not a time to explain the PIP…it's a tool that is cheap/easy..your practice did it

CR Response

·         About 95% understand integration at this conference.

·         Your question about the PIP and orientation up front si a good one

·         IF you are involved in a clinic how to do you go through a systematic process to identify the need and measuring as you move through that process…basic process that's focused on a specific need…

·         They will need to get more training on lean and the PIP; but hopefully they walk away conceptually understanding LEAN…

·         Main Point: Taking people through a process they can replicate…it is the PIP/Lean Redesign process…

Connie:

·         I can change the example to make it clearer

Nancy:

·         I was lost on where we were going

·         The quotes were helpful

·         Know the exercises up front…I am going to do something

·         Setup the team activities up front

Jen

·         I like that you bring me back from the team, you are going to use this for that

Gail: I like how you say this is how and why you are going to do, you are going to discuss, list, and draw…here are the steps.

CR: I am thinking of a roadmap and this is what we are going to accomplish as a team in the 40 minutes that follow. Whatever the roadmap is needs to be the tool they use.

Jen: Flip your presentation, tell them what you are going to do and what you know, and then bring in the tools

Kairn: Simplify the task that the groups are going to do together; a simple puzzle where they put the pieces in the right spot; do the workshop activity…where are you going to get that information, what can you do…there was a point of what you can do and it seems complicated. You can say you already know how to do this, we will sketch out a plan, and we'll come together to reflect on what they learned already…that is one option of how to do it. Otherwise the way you provide the information I agree with the group.

Justine: A couple of slides seem disjointed (see notes). Start with the patients experience and come back to it.

b.        

3.                   Next week: Jen and Gail on PCORI Poster

4.                   Future topics: TBD

Recorded by: Jessica