MKES PSY GNYHA-PSYCKES QUALITY COLLABORATIVE BEST PRACTICES IN MEDICATION-FOCUSED CQI Check if CORE PROCESS Present Focus: in this stage, clinic QI teams conduct a variety of activities to establish the foundation for future PDCA cycles. Find opportunity to improve Clinic decides to participate in medication-focused CQl. Organize a Team There is a QI team at the clinic responsible for implementing the project. The Ql team includes clinic leadership. The QI team includes medical leadership or other prescriber to act as project champion. Clarify current knowledge/processes that impact opportunity to improve The QI team identifies existing work processes relevant to the project (e.g. intake/admission, 口 medication review, treatment plan review, consumer education, and prescriber supervision) The QI team reviews the current scientific literature relevant to medication quality concerns. Understand variation that is contributing to the problem The QI team uses data in PSYCKES to measure quality concerns, and identify prescribing 口 patterns at the agency, site, and prescriber level. Select/Start PDCA to improve outcomes The Ql team educates and engages all clinical staff, including therapists and prescribers, about the project (face to face meetings, either 1:1 or in groups). The QI team educates and engages consumers about the quality concern. Leadership at all levels actively and continuously communicates importance of and commitment to the project: e.g. importance of providing clients with minimal-risk treatment, belief that change 口 is possible, willingness to devote resources, ongoing interest in project progress and outcomes Plan: The team begins by examining existing systems to determine what needs to change in order to achieve desired outcomes, defining measures of performance, and developing an explicit action plan. The Ql team develops a written action plan for the Ql project that defines goals, measurable 口 objectives, strategies/actions to influence outcomes, and individual(s) responsible The Ql team identifies administrative and clinical processes that need to be modified or added in 口 order to achieve project goals. The Ql team reviews data to determine source(s) of positive cases (internal or external to clinic). 口 The Ql team develops systems for tracking and sharing the project outcomes that are congruent 口 with clinic workflow. 口 their roles and activities related to project goals. Do: The team implements the Action Plan. There is a system in place for the QI team to identify positive cases each month, using 口 PSYCKES and other methods as needed. There is a system in place to give each prescriber a monthly list of clients who meet criteria for the cardiometabolic risk indicator set. There is a system in place to ensure that every positive case receives a clinical review by the 口 prescriber. There is a protocol in place that defines issues to be considered and addressed during clinical 口 reviews. use in the clinical review. Prescribers use a structured form to document the outcome of the clinical review, including the rationale and plans to address barriers to change if no change is made. There is a process in place for the QI team to receive data on the outcomes of the clinical 口 reviews. There is a system in place for notifying members of the treatment team each month about consumers who meet criteria for the cardiometabolic risk indicator set. its implications for health. There are systems in place involving the clinical team to support consumers and prescribers 口 during medication changes. There are processes in place to re-assess clients for whom a medication change was not made. 口 Check: the Ql team uses objective information to evaluate the effectiveness of actions taken. 口 The QI team meets monthly to review data about the project. 口 The Ql team aggregates and evaluates data about the project at the client, prescriber, and clinic levels (using structured tools such as run charts and Pareto charts) 口 and devel