Author(s): Lela Frederick, BSN, MPH, RN, CPHQ
Manager Ambulatory Quality Management
CHRISTUS

Competency Domain: Performance & Process Improvement

Description: With the movement of pay for performance healthcare many organizations are turning to proactive ways to support clinicians with meeting quality metrics set by HEDIS and other ACO's. Ambulatory quality teams are being looked at to set the standard to provide guidance and move the needle towards success for these clinics. The methodology of Quality Rounding is an innovative concept that strengthens the partnership between quality teams and clinicians. Quality rounding can play a positive role on not only improvement of quality metric scores but most importantly increased health of patients in the communities that we live in. Problem:To improve quality metrics for clinics in the ambulatory care setting . Measurement:Data was gathered via the EMR and exported into Excel. The pre and 90 day post rounding data was compared to determine if improvement was seen in each quality metric. Analysis:The total number of clinics rounded one was compared with the total number of clinics that saw an improvement in the metric. This was used to calculate the percent of clinics that improved or maintained despite growth. The range of percent of improvement was also documented Implementation:A quality rounding manual was developed that consisted of a timeline, outreach templates, pre/post-rounding checklist, checklist for rounding, tips for debrief.Turnover of quality nurses after post implementation. First set of data was grouped in the statistical analysis. Quality rounding facilitates a partnership between the Ambulatory Quality Team and clinics. Results/DiscussionA retrospective review of the data during the timeframe found that greater than 90 percent (30) of the metrics showed either improvement or maintenance. Tool was updated to align with EMR changes. Piloting education to be implemented in clinics that see no improvement in the 60 days following quality rounding.