outine diabetic/CHF check.  Christine had been doing all of the work around this measure and to be honest I was dreading it a bit.  Knowing how busy the staff are in the pilot sites I was not looking forward to interrupting their day.  To say the least they were all very VERY helpful and my unease quickly subsided.  Some questions did arrise on how some of the calculations were performed and their opperational definitions.  I will be attempting to touch base with Christine about these.

The holidays will play a role in the stats for this month, as many clinic staff will be out of the office a lot over the next few weeks.  Will be sure to put a footnote on the graph to make a note of this effect.

2) Patient Surveys: Depression Measure, Physical Function, and Activated Pt.

Worked closely with Bill Mahoney and Sara Jane Satre, both of the Methods Outcomes Measurement and Statisitics team to analyze or implement the above listed surveys. 

With both, the Depression and Physical Function Measure we completely analyzed the results and then met with the Clinical Care Specialists to walk them through how to interpret and act on the results.  Bill provided a wonderful tool that attempts to utilize a pts score to determine what level of intervention, if any, is required from the CCS.

The Activated Pt survey was finalized and a Teleform, form that allows the survey to be read as a fax and automatically stores it in a data file, was created.  An initial process was established on how to score the survey.  In some instances the CCS will score the completed survey with the pt and they will then discuss the results.  The CCS will then return the survey to us so we can perform a more detailed analysis and provide that to the CCS as well.

Feedback from the CCSs was positive and thankful for having such excellent tools at their fingertips.

3) In an attempt to address the concerns that were expressed at the 12/4/02 Implementation Meeting about the Clinic Pt Satisfaction Survey I created a rather thorough document with the intent of this document being: to provide background knowledge of Rasch, clinic PSAT, and HCCC.  It was designed to provide the reader with as much detail that was desired, no more no less. ie simple overviews with links to further detailed description.  The link to this document is: 

http://www.peacehealth.org/apps/p2/document/DocumentDisplay.asp?DocumentID=178
 
This is being stored on the Hinet based site so it may not be accessible to the entire WWW.

4) Worked with the Clinical Care Specialists to brainstorm and create an informal survey that we will use to gather feedback from the patients, and members of their care team, who have been admitted to a CCS.  The basic rules that we followed were:
1) Keep it short
2) Keep it simple
3) 1 page front and back
4) Anonymous with option to provide id if pt wished to discuss the survey results and/or feedback about the survey itself.
5) One version for the pts and one version for members of their care team.  The same questions but worded differently.

5) P2 Goes to Orlando
 
Much of the time spent the few days prior to the IHI Conference in Orlando was focused on producing charts and graphs for the presentation storyboard and other meetings/learning huddles.

End product of the storyboard was most impressive!

6) Continued work on System Dynamics – Congestive Heart Failure data pull. 

Except for financial and procedure data we have completed both the SJH CHF and Center for Senior Health CHF data pull.  Pulled all visit and pt info and sent off to finance.

Had extensive discussions, in person and over email, around the procedure data that has been requested.  More specifically, what are the relevant cardiac/cath lab procedures that we are to pull.  After getting feedback from the Nancy and Dr. Lomabardi I think we have identified what it is we are trying to pull.  Also worked with Dee Garcia, SJH Coding Manager, to identify the correct corresponding procedure codes.  As always, Dee provided very timely and valuable information.

7) Completed the monthly Diabetes and CHF report for IHI as well as the Pilot Site Specific reports.  These were submitted to IHI and to each clinic. Still have been unable to cement a meeting date with the Bellingham Fire Department to discuss the sharing of Emergency Medical Information

8) Have been intermittently doing a significant amount of research into the new HIPAA regs (Federal confidentiality laws).  New regs go into effect April 1, 2003 and am hoping to have a very solid handle on what is ok, what is not ok, and also what is changing.
9) Pt Satisfaction Data for SJH-Inpts was received for the month of September.  Survey questions specific to P2 were analyzed and the results were distributed to the hospital guidance team.
10) We continue to report the number of clinic PSAT surveys completed per day.  Although variable from day to day the results are beginning to show a stable pattern.  Overall it looks as if we are receiving enough completed surveys to meet the minimum requirements for analysis.