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Chapter Quality Network ADHD Project Judy Dolins, MPH, Principal Investigator Nancy Adams, MSM, Project Manager Chapter Quality Network Where are we headed on this ADHD Quality Journey?
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Chapter Quality Network ADHD Project Judy Dolins, MPH, Principal Investigator Nancy Adams, MSM, Project Manager Chapter Quality Network Where are we headed.

Jan 18, 2018

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Joy Hampton

 Review how CQN ADHD aligns with other chapter activities  Understand how national, chapters and practices will work together to implement the project  Outline goals and vision of the CQN ADHD project Session Objectives
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Page 1: Chapter Quality Network ADHD Project Judy Dolins, MPH, Principal Investigator Nancy Adams, MSM, Project Manager Chapter Quality Network Where are we headed.

Chapter Quality Network ADHD ProjectJudy Dolins, MPH, Principal InvestigatorNancy Adams, MSM, Project Manager

Chapter Quality NetworkWhere are we headed on this ADHD Quality Journey?

Page 2: Chapter Quality Network ADHD Project Judy Dolins, MPH, Principal Investigator Nancy Adams, MSM, Project Manager Chapter Quality Network Where are we headed.

Judy Dolins Nancy Adams

I have no relevant financial relationships with the manufacturer(s) of any commercial product(s) and/or provider of commercial services discussed in this CME activity.

I do not intend to discuss an unapproved or investigative use of a commercial product/device in my presentation.

Commercial Interests Disclosure

2

Page 3: Chapter Quality Network ADHD Project Judy Dolins, MPH, Principal Investigator Nancy Adams, MSM, Project Manager Chapter Quality Network Where are we headed.

Review how CQN ADHD aligns with other chapter activities

Understand how national, chapters and practices will work together to implement the project

Outline goals and vision of the CQN ADHD project

Session Objectives

Page 4: Chapter Quality Network ADHD Project Judy Dolins, MPH, Principal Investigator Nancy Adams, MSM, Project Manager Chapter Quality Network Where are we headed.

Quality Improvement is becoming a focus for AAP NY 1 Chapter AAP programing.

The AAP NY 1 Chapter, under the direction of Stephen Cook MD lead a successful obesity QI project.

New York 1 AAP Quality Improvement

Page 5: Chapter Quality Network ADHD Project Judy Dolins, MPH, Principal Investigator Nancy Adams, MSM, Project Manager Chapter Quality Network Where are we headed.

AAP NY 1 is doing this CQN project to give tools to primary care pediatricians so they may accurately and efficiently care for children with ADHD.

Why CQN ADHD?

Page 6: Chapter Quality Network ADHD Project Judy Dolins, MPH, Principal Investigator Nancy Adams, MSM, Project Manager Chapter Quality Network Where are we headed.

Starting our improvement journey – together.

Page 7: Chapter Quality Network ADHD Project Judy Dolins, MPH, Principal Investigator Nancy Adams, MSM, Project Manager Chapter Quality Network Where are we headed.

Every child gets the right care, every time.

Quality

Page 8: Chapter Quality Network ADHD Project Judy Dolins, MPH, Principal Investigator Nancy Adams, MSM, Project Manager Chapter Quality Network Where are we headed.

Up-to-Date

Science

Team-Based Care Populatio

n Health

Family Engagemen

tCommunity Connection

s

Performance Data

Health Care Delivery Transformation

Page 9: Chapter Quality Network ADHD Project Judy Dolins, MPH, Principal Investigator Nancy Adams, MSM, Project Manager Chapter Quality Network Where are we headed.

Change is hard.

Page 10: Chapter Quality Network ADHD Project Judy Dolins, MPH, Principal Investigator Nancy Adams, MSM, Project Manager Chapter Quality Network Where are we headed.

Why is change so hard?

Page 11: Chapter Quality Network ADHD Project Judy Dolins, MPH, Principal Investigator Nancy Adams, MSM, Project Manager Chapter Quality Network Where are we headed.

Why ADHD?

Page 12: Chapter Quality Network ADHD Project Judy Dolins, MPH, Principal Investigator Nancy Adams, MSM, Project Manager Chapter Quality Network Where are we headed.

Parent and Teacher Vanderbilt Assessments Used at Diagnosis

56%

90%

Current State Goal0

10

20

30

40

50

60

70

80

90

100

Parents Teachers

56.7% 55.5%

90% 90%

Source: Epstein JN, Kelleher KJ, Baum R, et al. Variability in ADHD Care in Community-Based Pediatrics. Pediatrics. 2014;134:1136-1143.

Page 13: Chapter Quality Network ADHD Project Judy Dolins, MPH, Principal Investigator Nancy Adams, MSM, Project Manager Chapter Quality Network Where are we headed.

Current State Goal0

10

20

30

40

50

60

70

80

90

100

Guideline-Based Treatment: Medication and Behavioral Treatment (for children ages 6+)

30%

80%

Source: http://www.cdc.gov/ncbddd/adhd/play2.html. PLAY Study Findings (Project to Learn About ADHD in Youth)

Page 14: Chapter Quality Network ADHD Project Judy Dolins, MPH, Principal Investigator Nancy Adams, MSM, Project Manager Chapter Quality Network Where are we headed.

Current State Goal0

10

20

30

40

50

60

70

80

90

100

Patients Prescribed Behavioral Treatment (ages 4-17)

44%

80%

Source: http://www.cdc.gov/ncbddd/adhd/play2.html. PLAY Study Findings (Project to Learn About ADHD in Youth)

Page 15: Chapter Quality Network ADHD Project Judy Dolins, MPH, Principal Investigator Nancy Adams, MSM, Project Manager Chapter Quality Network Where are we headed.

Current State Goal0

10

20

30

40

50

60

70

80

90

100

Preschool-Aged Patients Prescribed Behavioral Treatment

47%

80%

Source: http://www.cdc.gov/ncbddd/adhd/play2.html. PLAY Study Findings (Project to Learn About ADHD in Youth)

Page 16: Chapter Quality Network ADHD Project Judy Dolins, MPH, Principal Investigator Nancy Adams, MSM, Project Manager Chapter Quality Network Where are we headed.

Current State Goal0

10

20

30

40

50

60

70

80

90

100

Patients who receive follow-up within 30 days of medication initiation

Source: NCQA State of Health Care Quality Report: http://dnnstage.ncqa.org/ReportCards/HealthPlans/StateofHealthCareQuality/2014TableofContents/ADHD.aspx

40%60%

Page 17: Chapter Quality Network ADHD Project Judy Dolins, MPH, Principal Investigator Nancy Adams, MSM, Project Manager Chapter Quality Network Where are we headed.

That’s where CQN comes in.

Page 18: Chapter Quality Network ADHD Project Judy Dolins, MPH, Principal Investigator Nancy Adams, MSM, Project Manager Chapter Quality Network Where are we headed.

CQN Works at Three LevelsNation

al• Execute large-scale quality

improvement projects

Chapter• Build capacity to engage

in QI work with practices and develop state partners

Practice

• Improve care practices and child health outcomes

Page 19: Chapter Quality Network ADHD Project Judy Dolins, MPH, Principal Investigator Nancy Adams, MSM, Project Manager Chapter Quality Network Where are we headed.

AIM:To build a

sustainable quality improvement

infrastructure within our practice to

achieve measureable improvements in

ADHD care processes.

Page 20: Chapter Quality Network ADHD Project Judy Dolins, MPH, Principal Investigator Nancy Adams, MSM, Project Manager Chapter Quality Network Where are we headed.

•90% of patients assessed for ADHD will receive Vanderbilt assessments from the parent and teacher within 30 days of assessment initiation•Physicians have an initial conversation with parents about ADHD and give an educational booklet to 90% of parents/patients diagnosed with ADHD•60% of patients who are prescribed medication will receive follow-up Vanderbilt assessments from the parent and teacher within 30 days of medication initiation•80% of patients diagnosed with ADHD are prescribed behavioral treatment (where behavioral treatment is available)

Goals for Practices by November 2016

Page 21: Chapter Quality Network ADHD Project Judy Dolins, MPH, Principal Investigator Nancy Adams, MSM, Project Manager Chapter Quality Network Where are we headed.

But how are we going to do that?

Page 22: Chapter Quality Network ADHD Project Judy Dolins, MPH, Principal Investigator Nancy Adams, MSM, Project Manager Chapter Quality Network Where are we headed.

Practice Key Driver Diagram

1. Improved diagnostic accuracy

using evidence-based guidelines

2. Reliable systems that ensure titration of medications and

monitoring of side effects based on parent and

teacher feedback

3. Effective follow-up and surveillance for

co-morbidities

4. Partnerships with parents and teachers for effective behavior

management

5. Use of population health strategies to

manage children with ADHD and associated

co-morbidities

6. Active participation in a peer-to-peer

learning network (or learning

collaborative) with transparent data

6 Key Drivers

Page 23: Chapter Quality Network ADHD Project Judy Dolins, MPH, Principal Investigator Nancy Adams, MSM, Project Manager Chapter Quality Network Where are we headed.

Improved diagnostic accuracy using evidence-based guidelines.

Focus: Practice Key Driver 1

Page 24: Chapter Quality Network ADHD Project Judy Dolins, MPH, Principal Investigator Nancy Adams, MSM, Project Manager Chapter Quality Network Where are we headed.

Reliable systems that ensure titration of medications and monitoring of side effects based on parent and teacher feedback

Focus: Practice Key Driver 2

Page 25: Chapter Quality Network ADHD Project Judy Dolins, MPH, Principal Investigator Nancy Adams, MSM, Project Manager Chapter Quality Network Where are we headed.

Effective follow-up and surveillance for co-morbidities.

Focus: Practice Key Driver 3

Page 26: Chapter Quality Network ADHD Project Judy Dolins, MPH, Principal Investigator Nancy Adams, MSM, Project Manager Chapter Quality Network Where are we headed.

Today we’ll build your team’s foundational knowledge that is needed to improve how you deliver ADHD care.

Review the AAP ADHD guidelines Hear the parent perspective on ADHD Demonstrate how to use the mehealth portal Discuss how we’ll measure success Review QI basics that will help create a reliable system for

ADHD care in your practice

The First Step...

Page 27: Chapter Quality Network ADHD Project Judy Dolins, MPH, Principal Investigator Nancy Adams, MSM, Project Manager Chapter Quality Network Where are we headed.

Let’s get started!