Healthcare Systems Roundtable

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Hosting The Roundtable

Northwell Health Roundtable

GED Health Care Systems Roundtable Kick Off

A message from GEDC and West Health

This roundtable took place on Wednesday, August 26th.

Thanks to all who participated in our first GED Health Care Systems Roundtable co-hosted by the GEDC andWest Health, Wednesday, August 26.

Gratitude to our participating systems: Mayo Clinic Health System,
Veterans Health Administration, Northwell Health, Dartmouth-Hitchcock Medical Center and University of California Health Systems Initiative.

A special thanks to the Advocate Aurora team for kicking off the Roundtable Series and helping lead our discussion “How to Evaluate our Practice as we Disseminate the
Geriatric Emergency Department”. We are grateful and excited to continue sharing experiences, strategies, and struggles of spreading GEDs across multiple EDs within a HealthCare system.

Chat Notes Slides
The first Health Care Systems Roundtable hosted by West Health and GEDC. Advocate Aurora Health kicked off this series of discussions with an overview of their Quality Improvement initiatives system-wide.

August 26th Summary – Advocate Aurora Health

AAH’s Geri ED Approach

  • Improving care in the ED and beyond for older adults 
    • Focus on transitions from ED to community 
    • Formalized Evidence-Based Clinical Protocols 
    • Interprofessional Team 
    • Partnership: Pop Health, ACO, Ambulatory 
  • Standardized & Scalable Program Infrastructure 
    • EPIC workflow, metrics, outcomes, and reporting 
    • Geriatric ED Accreditation  
    • Continuous improvement 
  • Site led program & supported by system 

AAH GED Program Metrics

  • Beginning Phase: Geri ED Pilot, 3 sites 
    • Manual extraction and using excel to track data 
    • Implemented a draft of an automated report from lessons learned from manual process 
      • The reports to include daily, weekly, and monthly frequency to support workflow v. retrospective for evaluation of program 
  • Intermediate Phase:  
    • Development of Boost concept 
      • This meeting brings sites together to share challenges/ successes and work on priority items  
    • Creation of Case Management pool to support workflow 
    • Additional clinical procedure development, Falls & Mobility 

To Consider

  1. How do you organize your data? (site V system, who had access? How to we automate the process? Single standardized EHR V site variability, how do we manage important practice variability from site to site) 
    • Most sites are on the same HER, system wide. 
    • Thinking about what sites want to see the most and tinkering with those tools to show outcomes that you want to see on different reports, daily, weekly, and monthly 
  2. How much automation versus manual? (automatic reports, degree of grooming data to present on dashboard) 
    • Started as an all manual approach and same EHR and using a third-party Microsoft product. 
    • Manual was helpful because you can look at all sorts of things and the feedback from each site. 
    • Finding the right mix of what those metrics are, is essential.
  3. What strategies do you deploy to maximize feedback to your teams? (challenges of system data) 
    • Monthly meetings with sites where they discuss data and issues they are having/ had with data. 
    • Consider how to go to the next level with metrics. 
    • Think about what data is really wanted and how to standardize all the data that the sites are receiving. 
  4. How do you deal with practice variability between sites? 
  5. How/ when/ how often do you send communication data to system leadership?