intermountain care process model

0000045671 00000 n 0000017200 00000 n 0000021074 00000 n 0000006219 00000 n 0000041187 00000 n The partnership with Intermountain has allowed us to learn the positive things, and the things theyve found difficult, the pitfalls and bear traps theyve discovered, and thats made it easier to be open to the perspective of people that have walked the journey before us.. 0000052968 00000 n 0000003264 00000 n 0000179289 00000 n 0000008976 00000 n Involving patients and clinicians in the design of care pathways has also given them a stake in the success of the project. 0000045545 00000 n Important features included creating meaningful alignment around value, building teams to drive the transition and implementing supportive workflows and technological innovations. Ive rarely seen in the NHS such buy-in from the clinical community, he said. 0000018097 00000 n 0000036090 00000 n 0000063119 00000 n 2007-2021 INTERMOUNTAIN HEALTHCARE. By incorporating these pathways into its EHR, RFL will ensure that the methodology behind its care pathways is baked into the systems digital infrastructure, making it easier for anyone, at any site, to follow the recommended method of care. 0000012852 00000 n 0000038376 00000 n bPatients who had at least 1 outpatient visit with a primary care physician (family medicine, internal medicine, geriatric, or pediatric specialty) during the period of 2003-2005 and a continuous service encounter from an Intermountain delivery location (either acute, ambulatory, radiologic, or laboratory services) at least once a year for each 0000017841 00000 n YC@NgR&Qr? >~.>* T`- 0000072671 00000 n 0000008709 00000 n Improving care quality and reducing cost are two of the highest priority goals for healthcare leaders. 0000050398 00000 n 0000039904 00000 n At the end of March 2022, the Cerner European Collaboration Forum brought together 300+ attendees from over 16 countries. Provides patient education as directed (content reflects specific MA training, guidelines, care process models, protocols). 0000007424 00000 n The Intermountain Care Process Model recently developed the Pediatric Traumatic Stress Screening Tool to assess traumatic stress in children in the primary care setting and to help identify diagnostic criteria for PTSD. 0000026052 00000 n %PDF-1.7 % It doesnt make sense to imagine that you can do a fundamental change programme without working with other people., Dr Wood agrees that creating partnerships is key to future growth. 0000006687 00000 n %%EOF 0000079927 00000 n | Dr Chris Wood Attempts to publish pathway development in the peer-reviewed literature are limited by lack of scientific rigor. First, primary care providers and care teams can meaningfully respond to family needs that may prevent trauma exposure in children (0 5 years) through the use of the SEEK questionnaire and Road Map of Care for Pediatric Trauma Prevention. 0000006066 00000 n Care Process Model AUGUST 2013 !is care process model (CPM) and accompanying patient education were developed by a multidisciplinary team including primary care physicians (PCPs), mental health specialists, registered dietitians, and eating disorder specialists, under the leadership of Intermountain Healthcares Behavioral Health Clinical Program. 0000066307 00000 n At two of our sites, we were immediately able to capture data-driven outcomes from the newly digitised pathways, said Dr Streather. 0000165722 00000 n 113021080>ca`labefpe|$X)Cc+G>[.3A/20 0000066119 00000 n 0000079777 00000 n 0000008313 00000 n Organising care in this way facilitates a broader, more longitudinal view of whats necessary to treat a condition. RFL has upwards of 80 clinicians involved in this process in each of the four divisions and has digitised seven pathways with plans to digitise additional pathways two at a time through a standard process. Through our advanced training programme in clinical process improvement, we train senior leaders, middle management and front-line health professionals in the theory and application of cost and quality control. Two of the first clinical programmes developed were cardiovascular, and women and newborns. This care process model (CPM) outlines the recommended approach. 0000042757 00000 n For more information about Perspectives, gohere. 0000075971 00000 n 0000001556 00000 n Amy Bowen and Kaye Coholan share their thoughts on how North Central London (NCL) has taken a different approach to managing NHS waiting lists for their Integrated Care System (ICS). 0000009984 00000 n 0000050364 00000 n 0000050331 00000 n 0000079537 00000 n 0000198367 00000 n 0000005227 00000 n 0000041140 00000 n hSYPW>G&$B% i}(!IA|C;N3mJd1 @EbBBDQ(+ 0000025573 00000 n We want to make it easy to do the right thing and take new measurements from doing the right thing so that its even better the next time.. We apologize that the page you are looking for is not available on our site. 0000058433 00000 n 0000007153 00000 n 0000086104 00000 n 0000023004 00000 n 0000005441 00000 n 0000079460 00000 n 6346 0 obj <> endobj Fact Sheet Published in 2021 Printer-friendly version 0000011835 00000 n 0000165371 00000 n The Child Traumatic Stress Care Process Model (CPM) was developed through a collaboration of the Department of Pediatrics at the University of Utah and the Center for Safe and Healthy Families at Intermountain Healthcares Primary Childrens Hospital. 0000132101 00000 n 0000176359 00000 n 1660 60 CPMs are meant to provide an evidence-based and standardised way to address the core clinical processes that matter most to their patients and clinicians. 0000013703 00000 n For children 6 18 years who report a potentially traumatic experience on the Pediatric Traumatic Stress Screening Tool (more information on this screening tool available in full CPM), the process of responding effectively to child traumatic stress involves three steps: Based on screening tool results, a brief in-office intervention targeting their most prominent symptom(s) has been shown to make a big difference for many children. Copyright 2003-2020. 0000073354 00000 n 0000060798 00000 n 0000002361 00000 n Get care for low-level urgent conditions through a video chat with a provider, 24/7, on your computer or mobile device.Learn More. 0000003519 00000 n 0000087852 00000 n 0000225756 00000 n Do I need to be a therapist to administer the screener or provide in-office interventions? 0000066218 00000 n Each of the eight stages of change has a corresponding pitfall. When we visit Intermountain, we bring senior-level executives, but we also take people who are directly involved in care, said Dr Streather. Addressing unwarranted variance in care protocols and embedding those processes in the electronic health record (EHR) can be an effective way for healthcare leaders to impact both quality outcomes and their bottom lines. 0000008686 00000 n 0000009981 00000 n 0000048189 00000 n Deming was also an advocate of considering systems as a whole, not as disparate smaller component parts that could be changed without influencing an entire operation. 1846 0 obj <>stream by Dr Todd Allen 1 Resources for Parents and Caregivers D dL :G=%C>[wgG5wvorb$j9u>~U'/795}[ucCwOxEQ\hzAR>9d)oHH,YIPxM. Second, primary care providers and care teams can intervene with children (6 18 years) who have experienced a potentially traumatic experience through the use of the Pediatric Traumatic Stress Screening Tool and Road Map of Care for Pediatric Traumatic Stress (see image below). 1425 0 obj <> endobj 0000081734 00000 n 0000016011 00000 n 0000032034 00000 n 0000176282 00000 n 7 September 2022 0000050231 00000 n We are already on our way to digitising 20 of those 44 pathways and will eventually have all 44 in the EHR.. 0000013288 00000 n %%EOF 0000002580 00000 n 0000003820 00000 n 0000086396 00000 n Helping people live the healthiest lives possible, Intermountain is widely recognized as a leader in clinical quality improvement and efficient healthcare delivery. 0000003400 00000 n 0000010514 00000 n 0000056318 00000 n Its good to see that even after 18 months of introducing a complex programme, we see the general enthusiasm growing daily.. <<7D7E07AF05D25B429403B179B549C510>]/Prev 735917/XRefStm 3093>> 0000058232 00000 n 1719 0 obj <>stream 0000044620 00000 n 0000072122 00000 n 0000079241 00000 n 0000128347 00000 n 0000062915 00000 n 0000002797 00000 n 0000004712 00000 n 0000010273 00000 n 0000033890 00000 n 0000045738 00000 n monitored, audited, and stored. 0000011817 00000 n RFL provides specialist services in liver and kidney transplantation, rare cancers, haemophilia, HIV, infectious diseases, plastic surgery, immunology, neurology, Parkinsons disease, vascular surgery, cardiology, amyloidosis and scleroderma. Each visit is centred around a single theme to allow for a focused deep dive into that specialty. 0000012415 00000 n 0000051705 00000 n %%EOF Choose a skill that you are comfortable teaching and share your knowledge with the families you see in clinic. 0000065908 00000 n 0000031343 00000 n The CPM also guides family decision making, links at-risk children to evidence-based trauma therapy, and encourages providers' use of in . 0000004256 00000 n The multidisciplinary team is tasked with asking how they can improve the care processes within the programme. "I`IvWdZ>B.nJ.o}LVL:}T{&!Qd4l;( q& Q/b2N$5%/wTg?8YSneUE+ 0000225874 00000 n 0000004039 00000 n For preschool-age children, the SEEK model for pediatric primary care is recommended to guide providers in screening for, assessing, and addressing problems related to child safety. Additional assistance with risk assessment: iCentra order algorithm, Score Line 801-50-SCORE ( providers only ), and Connect Care 801-442-4457. 2:1b``AY0 tbg(8/C3n0=~ 0 Its okay to answer their questions. xref 206 63 0000128388 00000 n This is the healthcare-specific version of what is known in lean terminology as "mass customization." 0000005534 00000 n 0000005742 00000 n 0000006999 00000 n 0000032127 00000 n 0000002990 00000 n Partnering with and adapting the methodology of an internationally recognised leader like Intermountain signalled to staff that RFL was serious about improving care and has helped create buy in, Dr Streather believes. 0000005596 00000 n We found that there was a great deal of unwarranted variation in the way we delivered care that created less than ideal quality care for patients, and there were operational inefficiencies baked into that, said Dr Chris Streather, chief medical officer at RFL. 0000005294 00000 n 0000208680 00000 n 0000014009 00000 n 0000006375 00000 n 0000005695 00000 n 3175 0 obj <> endobj 0000004556 00000 n 0000007639 00000 n <<099953D8ECDC4449BF4B89817F7FC266>]/Prev 820759/XRefStm 5250>> 0000168976 00000 n 0000007186 00000 n H\@. 0000035663 00000 n 0000022000 00000 n <<969DFD35F0E1574DA86361927245C514>]/Prev 975812/XRefStm 3817>> by Cerner UK 0000043417 00000 n 0000063674 00000 n 0000012208 00000 n It is not a prescription for every physician or every patient, nor does it replace clinical judgment. 0000065800 00000 n 0000081400 00000 n Six Steps to Mass Customization in Healthcare Rather than rely solely on guidelines, healthcare systems should use a clinical management method to develop shared baseline protocols. xref 0000018335 00000 n 0000028737 00000 n 0000005795 00000 n 0000063196 00000 n 0000069209 00000 n 0000007843 00000 n If symptom severity remains unchanged or worsens, consider alternatives such as providing a new brief in-office intervention, reinforcing the need to follow through with treatment for those who have not, or changing the treatment stratification and therapy referral to a more intensive approach. Working with Intermountain and redesigning their methods of care represents a considerable shift for RFL and leaders have been deliberate about how these changes are introduced to doctors, nurses and others who provide care. 0000088156 00000 n The PIPS team can help you identify resources in your area. f-5Y)RqQ],Z*69=nwe.Io(MF ),m((KVorl= 4Yk/T=%AG> "}nrauFS 0000005079 00000 n 0000004246 00000 n xref Behaviors, Attention-Deficit/Hyperactivity Disorder (ADHD) & Mood Disorders, Fetal Alcohol Spectrum Disorder Distinguished from Autism, Mucopolysaccharidosis Type I & Motor Development, Mucopolysaccharidosis Type I (MPS 1) Genetics, Mucopolysaccharidosis Type I (MPS 1) Hematopoietic Stem Cell Transplantation & Its important for them to see what were doing in action somewhere else.. Care Process Model JUNE 2019 2019 Update GOALS & MEASUREMENTS The goal of this CPM is to improve the . 0000021193 00000 n 0000072266 00000 n The back page summarizes antibiotic recommendations and notes . Biometrics. 0000170251 00000 n 0000020693 00000 n How can we help families with children who are 0-5? Mary Ann Baily, Ph.D. 0000057752 00000 n 0000170355 00000 n 0000017396 00000 n We are segmenting clinicians into clinical themes and having them evaluate pathways of care and look at the data that informs those pathways to determine how we can improve them in a systematic way. E-mail. 0000071186 00000 n 0000015124 00000 n 0000054116 00000 n The formalised nature of the partnership agreement has also allowed for knowledge sharing on a granular and practical level that might not have been possible if RFL had passively observed Intermountains processes one or two times. 0000039661 00000 n Special Instructions. 0000002388 00000 n 0000084970 00000 n 0000016002 00000 n 0000019314 00000 n The clinical practice groups are changing the way we provide care in a profound way, said Streather. startxref 0000084446 00000 n 0000016606 00000 n Still not finding what you are looking for? It takes humility to recognise that you dont have all the answers and seek out people who are leaders in their field, he said. 0000016722 00000 n 0000180800 00000 n 0000052164 00000 n 0000055101 00000 n How to address things like education, food and transportation, these are things the British government has been doing aggressively since WWII.. One of the best features of the child traumatic stress care process model is that it can be administered by people who don't have a clinical background. 0000059703 00000 n 0000079428 00000 n 0000078906 00000 n Modified Medical Research Council Breathleness Scale (mMRC) 0000018484 00000 n 0000053140 00000 n 0000048275 00000 n 0000176241 00000 n 0000006007 00000 n 0000059863 00000 n 0000009724 00000 n P , s &v. 0000008535 00000 n 0000084852 00000 n !C4@$8 y Intermountain Healthcare: Towards an integrated, value-based model Intermountain (US) UH Bristol (UK) TTSH (Singapore) VCHI (US) Show sources Briefing paper Tackling waste is a difficult but. How old does a child need to be to complete the traumatic stress screener? A 2012 report from the Institute of Medicine found that inefficiencies in the U.S. healthcare system resulted in up to $750 billion of wasted spending in 2009, roughly 30 percent of total healthcare spending in that year. 0000008058 00000 n 0000008994 00000 n 0000179407 00000 n Prnom. %PDF-1.7 % Intermountain has created care process models (CPMs) within each clinical programme that use a combination of existing evidence-based practice guidelines and historical EHR data. 0000045274 00000 n 0000013362 00000 n 0000014338 00000 n 6440 0 obj <>stream 0000070461 00000 n 0000022567 00000 n 0000072821 00000 n 0000007488 00000 n 0000021680 00000 n 0000007513 00000 n 0000029880 00000 n Dr James was hired by Intermountain in 1986 as the director of medical research and continuing medical education. We already have resource guides developed for many counties in Utah. 0000007049 00000 n 30 June 2022 When should the child or caregiver complete the traumatic stress screener? 0000018590 00000 n 0000006950 00000 n endstream endobj 1718 0 obj <>/Filter/FlateDecode/Index[179 1481]/Length 57/Size 1660/Type/XRef/W[1 1 1]>>stream Users are prohibited from doing any of the Intermountain has also noted value in the partnership. 0000058348 00000 n P.O. 0000004033 00000 n 0000226180 00000 n 0000023553 00000 n 0000015322 00000 n 0000066203 00000 n 0000001979 00000 n Its purpose is to summarize and promote evidencebased approaches to lifestyle and weight management, and to facilitate implementation in routine . 0000027265 00000 n Of all the approaches leaders can leverage to address these issues, reducing unwarranted clinical variance is receiving increased attention. At the end of March 2022, the Cerner European Collaboration Forum brought together 300+ attendees from over 16 countries. 0000023429 00000 n 0000005644 00000 n trailer | Dr Chris Streather 0000054196 00000 n In the 5 phase III alvimopan efficacy trials, a simple standardized accelerated postoperative care pathway was used rather than a comprehensive, multidisciplinary colon surgery care process model that is used by Intermountain Healthcare. The approach focuses management attention not only on the facilities where care takes place but also on physician decision making and the care process itself, with the aim of boosting physician productivity and improving care quality, while saving money. CARE PROCESS MODEL JANUARY 2021 Chronic Obstructive Pulmonary Disease (COPD) Diagnosis, Treatment, and Resources ALGORITHM NOTES ALGORITHM: DIAGNOSIS OF COPD . C-suite leadership has been overwhelmingly supportive of the project, furthering the message that the Trust is serious about reducing variance and improving care. Additionally, the PIPS team has clinicians available for consultation when needed. *kxVQQ6]9@{B%+/Q9a6Q_~Kx1 RX@QF p+h=52hf4f3#`33e{f|@gHXS'U`*}lts}=>;tPJfi5C&L^cI_2I7l8-G-mLvp +y" oE$qy(b9yz|~{kt;a| ~%1e8PKo*>7%T[.4jp+Gq}. 0000004772 00000 n 1425 82 0000007525 00000 n 0000179484 00000 n 0000086355 00000 n Only authorized users with an appropriate business need and legal right may use these resources. This care process model was developed to help guide the general practitioner on outpatient screening for diabetes and management of type 2 diabetes in patients within the University of Utah and Intermountain Healthcare systems. Critical to the relationships success is that Intermountain leaders visit RFL and can provide guidance and feedback in real time and on-site. 0000051827 00000 n * 0000079310 00000 n 0000016612 00000 n 0000044721 00000 n 0000009452 00000 n 0000226561 00000 n 0000084783 00000 n 0000177145 00000 n Dr Streather noted that seeking out partnerships to improve is an essential part of growth, but that it is not always easy. >iDTPTTqbZ]w;$zm3{! hb```b``_` B,7v`P*u@O@PW]DATCSJVNR.1FZ;@'D0_EVSE:UH]d(GgP{/a{zI)yi=rzfL<5)C^AF^B,fV]yU\/_]*E@'2YS,]C0= xEP+h@E9PH[ B*U^F5k|}j2X6@i+, j-1,(>p*rbPr ']4Odg 0000045214 00000 n 0000023458 00000 n If different clinicians in the same health system are using widely varying protocols to treat the same conditions, the result will be poorer patient outcomes and a less-than-clear picture of what it truly costs to treat the condition. 0000009340 00000 n Chief among these is the willingness to be open to change and new ideas. 0000002368 00000 n The FSI Academy is focused on the onboarding of new hires who will be trained as interface engineers; responsible for implementing the technical mechanisms that allow the exchange of information between solutions and external systems. 0000009463 00000 n 0 0000176512 00000 n What if the child or parent asks me a question about the screener while they are filling it out? %PDF-1.7 % Franklin G. Miller, Ph.D., and Ezekiel J. Emanuel, M.D., Ph.D. Screen for child traumatic stress. 0 0000004401 00000 n 0000031920 00000 n 0000178370 00000 n 0000170459 00000 n 0000072478 00000 n 0000006373 00000 n 0000066617 00000 n 0000177263 00000 n 0000066391 00000 n 0000015624 00000 n For many children, belly breathing or mindfulness training (teens) will be able to slow down a racing heart or mind at bedtime to fall asleep easier or reduce the intensity of anxious / fearful or angry feelings. 0000110646 00000 n 0000023543 00000 n 0000020129 00000 n This care process model (CPM) is maintained by Intermountain Healthcare's Lower Respiratory Tract Infection Team, . CPMs are meant to provide an evidence-based and standardised way to address the core clinical processes that matter most to their patients and clinicians. It helps primary care providers identify areas of potential high risk for the child and provide relevant information and support to the parents / caregivers. 0000007263 00000 n 0000034579 00000 n View wait times and save your place in line at an Intermountain InstaCare location near you. 0000010857 00000 n Published February 21, 2008, Harming Through Protection. *(N}L{{./ +A C C9p:nY)-({ ~U 4|VfI)3%N>K, L7 0000064797 00000 n 0000006553 00000 n Deming, who trained as an electrical engineer, believed that quality and cost are inextricably linked, and creating efficiencies in any process would lead to reduced costs and increased quality. As RFL leaders began to search for established models and methods to reduce variance in care, they were introduced to Intermountains clinical programme and CPM approach. 0000026552 00000 n 0000024023 00000 n 0000079372 00000 n 0000006783 00000 n 9-FCr-+| E+dJgx!Ck . 0000007723 00000 n Click for details. 268 0 obj <>stream 0000057953 00000 n 0000005541 00000 n Part of the partnership has been learning that it is not a one-to-one process of dropping in methodology from Intermountain to RFL, and that the Trust has adapted the ideas to their own circumstances. 0000009151 00000 n 0000110685 00000 n 0000011998 00000 n 0000039302 00000 n 0000132822 00000 n 0000017996 00000 n We have 44 pathways in operation, which represents about 60 to 70 percent of our clinical patient-facing activity. endstream endobj 1661 0 obj <>/Metadata 177 0 R/Names 1662 0 R/Outlines 155 0 R/PageLayout/SinglePage/Pages 176 0 R/StructTreeRoot 179 0 R/Type/Catalog/ViewerPreferences<>>> endobj 1662 0 obj <> endobj 1663 0 obj >/PageWidthList<0 612.0>>>>>>/Resources<>/ExtGState<>/Font<>/ProcSet[/PDF/Text]/XObject<>>>/Rotate 0/StructParents 0/Thumb 171 0 R/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>> endobj 1664 0 obj [1665 0 R 1666 0 R 1667 0 R 1668 0 R] endobj 1665 0 obj <>/Border[0 0 0]/H/N/Rect[131.157 415.338 170.914 404.138]/StructParent 17/Subtype/Link/Type/Annot>> endobj 1666 0 obj <>/Border[0 0 0]/H/N/Rect[460.652 162.428 475.529 151.48]/StructParent 1/Subtype/Link/Type/Annot>> endobj 1667 0 obj <>/Border[0 0 0]/H/N/Rect[509.976 162.428 537.031 151.48]/StructParent 2/Subtype/Link/Type/Annot>> endobj 1668 0 obj <>/Border[0 0 0]/H/N/Rect[187.84 256.725 212.127 244.468]/StructParent 18/Subtype/Link/Type/Annot>> endobj 1669 0 obj <> endobj 1670 0 obj <> endobj 1671 0 obj <> endobj 1672 0 obj <> endobj 1673 0 obj <> endobj 1674 0 obj <>stream %%EOF startxref 0000000016 00000 n 0000014673 00000 n 0000220433 00000 n 0000065975 00000 n Care Process Model AUGUST 2016 The inside pages of this tool provide an algorithm and associated notes and can be folded open and posted in your office or clinic. 0000013806 00000 n 0000032530 00000 n 0000176762 00000 n