1 / 10

Lahey Clinic

Lahey Clinic. Hospital-based Outpatient Anticoagulation Clinic. Ann Pianka, MSN. Presented November 4, 2008. The Lahey Approach. Staffing 1 RN: 400 patients; 1 AA: 600 patients Collaborate with the provider already caring for the patient; predominantly a telephone-based service

willa-poole
Télécharger la présentation

Lahey Clinic

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Lahey Clinic Hospital-based Outpatient Anticoagulation Clinic Ann Pianka, MSN Presented November 4, 2008

  2. The Lahey Approach • Staffing • 1 RN: 400 patients; 1 AA: 600 patients • Collaborate with the provider already caring for the patient; predominantly a telephone-based service • Space restrictions • Current Annual Statistics: • >2800 active patients seen annually • ~48,000 INRs managed • > 750 new referrals • Does not include full enrollment of CGP patients: ~1200 additional patients • TTR: 70%; TTR +/- 0.2: 84%

  3. Provider Referrals • Hospital-Based Specialists • Cardiology • Hematology • Surgery • Vascular Medicine • Hospital-Based Primary Care • Community-Based Primary Care*

  4. Challenges in Meeting theStandard of Care • Two different models of care • Specialists managing anticoagulation collaboratively with the ACC • not a comprehensive view of patient risks/needs • Providers not able to keep abreast of changes in clinical guidelines • Difficulty justifying adequate staff to meet the volume • Different models of licensing and re-imbursement • Organizational geography and space limitations

  5. Program Success Tips on Achieving Provider Buy-In Ann Pianka, MSN Presented November 4, 2008

  6. Be Realistic • You can’t fix everything all at once • Too much change can result in chaos if not implemented carefully • Avoid frustration of your staff, providers, patients

  7. Choose your Battles • Identify the areas of highest risk or frustration for your providers in your organization and target those areas first • Referral Process (Closed for 18 months; manual system) • Initiation of Warfarin Protocols (no standard) • Bridging Therapy (High frustration) • Reversal of VKA (no standard) • Dosing Protocols (administrative housekeeping)

  8. Set The Stage • Evaluate your current practice • What works? • What doesn’t? • Provide evidence of the problem • Quality Assurance • Provide information about the Standard of Care • Invoke your experts • Include your users in the needs assessment • Advertise your successes

  9. Make it EASY to Comply • Set up systems that are • easy to access • easy to use • easy to troubleshoot • Set the standard of care and advertise it • Educate your providers of changes in • Practice • Process • Expectations • Utilize a respected Provider Champion • Keep it Simple!

  10. Administration • Has a different perspective on the problem than your providers • If your providers are happy, your administration will be, too! • Be honest in your • Needs • Numbers • Expectations • Do your homework • Advertise your successes

More Related