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CQC Newsletter, Volume 2.2
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Event News / Information |
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In This Issue / Features |
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Breaking News: The California Association of Physician Groups (CAPG) joins CQC in presenting The Optimizing Performance Series (OPS): Managing Change in the Physician Practice A program for physician groups to lead and manage change in their physician practices, OPS provides intensive, interactive education sessions (5 days in 4 months) for group leadership teams to build the skills and infrastructure for clinical integration and clinical IT. National experts and top California performers will share their best practices of getting better faster. Then, through a collaborative, groups will lead a number of their physician practices through changes resulting in significant, measurable performance improvement. Coming in Fall 2005. Resources Diabetes Information Resource Center Teleconference Training What is DIRC? DIRC is a quick and easy web-based portal to find diabetes-related information, tools and materials as well as other organizations working in the area of diabetes prevention and control in California. This 1-hour training will give you a tour of DIRC, where you'll learn how easy it is to become a DIRC partner and submit an organizational profile and how simple it is to search for information, tools and materials. To participate: click here to read the training flyer for more details, send in your RSVP by May 31st. You will need access to a telephone and a computer with internet access. Please note that space is limited to 25 participants per session so register now by sending an RSVP to Sarah Enloe at senloe@dhs.ca.gov or at 916-552-9872 by May 31st, 2005. Upcoming CQC Events Best Practices in Chronic
Care Management: Lessons for the Front Line Diabetes
& Cardiovascular Care Collaborative Other Events New
Directions in Diabetes Care Collaboratory Contact Information California Quality Collaborative Diane Stewart Kara
Cassidy CQC would like to recognize the following organizations for their support: |
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Medication AdherenceFor people with chronic illness, medication adherence is a must, although statistics show that only about 50% of patients actually take their prescribed medications [1]. For instance:
Regardless, medication adherence is a problem that can only be solved by improving patient self-management. Want to try to improve medication adherence in your practice? Try these simple techniques from Collaborative faculty member, Tom Bodenheimer, MD. #1 - A place to start is to ask patients whether they are taking meds. Example: "Have you missed any pills this week?" Dr. Motta at St. Joseph's Heritage Medical Group trained her MA to ask the question before she came into the room. Most patients miss doses for a variety of reasons. #2 - "Close the Loop" to check for patient understanding. Example: "Just to be sure that I am clear, could you let me know how many Metformins I would like you to take?" #3 - If current visit doesn't allow enough time, schedule a medication check. Example: ask patient to bring in all their medication bottles at the next visit. Ask MA or receptionist to remind the patient. #4 - Improve collaborative decision-making. Example: "Your HbA1c is not getting any lower. Do you feel that you would like to get your diabetes under better control?" If patient is in agreement with that goal then say, "One way to improve the HbA1c is to increase your Metformin from 2 each day to 3 each day. What do you think about that idea?" If patient agrees, then ask him to close the loop to make sure they understand. Affordable Medication Resource. The Together Rx Access web site outlines how eligible participants can save approximately 25%-40% on 275 brand-name prescription drugs, a wide range of generic drugs, and other prescription products. Diabetes & Cardiovascular Care Collaborative A Report From the Field: Palo Alto Medical Clinic
Teams in the Diabetes & Cardiovascular Care Collaborative are currently in Action Period 2 where they continue to conduct small tests of change while monitoring results and attempting to implement and spread some of the innovations. Ysidro “Sid” Martinez, an MA and part of the clinical team that includes Dr. Sal AbiEzzi from Palo Alto Medical Clinic, shares his thoughts on changes that have occurred since joining the Breakthroughs in Chronic Care Program. In the last 6 months, the practice has the following results:
CQC: How has being part of the collaborative changed what you do? Sid: Being involved with the CQC collaborative has made many improvements in Dr. AbiEzzi's practice, our clinic's Internal Medicine department, and my personal life. CQC: What type of changes? Sid: I could go on for hours and hours describing what has changed in our practice. A few things that have changed for me are: I provide our patients with what is called a "pre-visit summary," which includes all their meds and recent lab work and review it with them before Dr. AbiEzzi enters the room for the planned visit; I offer information about our DM classes; and I call patients to follow-up on the goals they set during a planned visit with Dr. AbiEzzi. These are all things I didn't do before and these few changes have made a big difference. Add to this the additional work with our roster of patients, and we now work in a more organized and focused way. CQC: Are the patients noticing changes within the office? Sid: Yes. During the collaborative we have learned different ways to try small changes in the office. These changes have led to an improved work flow for our planned appointments. Now, patients receive greater care from a more focused visit and, consequently, are learning how to better control their diabetes and keep it under control.
CQC: How has being a part of the collaborative had an impact on other physicians and staff in your office? Sid: Yes, as the word spreads of what we have done to change our work flow, more people become interested in what we have learned at the CQC collaborative meetings. As other MDs hear about our changes and see the benefit for patients they are becoming more motivated to try changes themselves. CQC: Anything else you'd like to add about the collaborative? Sid: On a more personal note, being a diabetic myself, the CQC has helped me understand that I am not alone in this battle against diabetes and that there are great minds and ideas at work to try and control this epidemic. |
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Identifying
the source of low rates of medication adherence lies in determining the
root of the problem. Is it an issue with the patient (Can't afford meds,
side effects), clinician (prescribing complex medication regimen, not
checking for understanding, not engaging patient in treatment), or system
(10 minute visit too short)?
