Slide 1

Florida SIPP Quarterly Meeting

Presenter:

Jolene Rasmussen, MSHealthcare Analyst, PIP Review Team

March 23, 2011

Slide 2

Presentation Topics

• Collaborative Validation Results• Statistical Testing• Proposed PIP Topics

Slide 3

Collaborative PIP Validation Results

• Address deficiencies in next submission– Compliance with recommendations more

important than initial score – Technical assistance available

Slide 4

FY 2011 Performance Improvement Project Validation Results(N=18 PIPs)

Study Stage Activity Percentage of Applicable Elements

Met Partially Met Not Met

Design

I. Appropriate Study Topic* 85%(71/84)

2%(2/84)

13%(11/84)

II. Clearly Defined, Answerable Study Question(s) 100%(28/28)

0%(0/28)

0%(0/28)

III. Clearly Defined Study Indicator(s)* 69%(41/59)

22%(13/59)

8%(5/59)

IV. Correctly Identified Study Population* 87%(26/30)

7%(2/30)

7%(2/30)

Design Total 83%(166/201)

8%(17/201)

9%(18/201)

Implementation

V. Valid Sampling Techniques (if sampling was used) Not Applicable Not Applicable Not Applicable

VI. Accurate/Complete Data Collection 51%(73/144)

30%(43/144)

19%(28/144)

VII. Appropriate Improvement Strategies 79%(23/29)

21%(6/29)

0%(0/29)

Implementation Total* 55%(96/173)

28%49/173)

16%(28/173)

Outcomes

VIII. Sufficient Data Analysis and Interpretation* 54%(28/52)

35%(18/52)

12%(6/52)

IX. Real Improvement Achieved † † †

X. Sustained Improvement Achieved † † †

Outcomes Total* 54%(28/52)

35%(18/52)

12%(6/52)

Overall Percentage of Applicable Evaluation Elements Scored Met 68%(290/426)

*Total for activity or stage may not equal 100 percent due to rounding.† The PIP had not progressed to this point; therefore, the activity was not assessed.

Slide 5

Process for Disputing Validation Score

• The plan must submit its dispute via formal letter to HSAG and cc AHCA Contract Manager

• The letter should outline the evaluation element/comment being disputed and the plan’s rationale for why the score should be changed

• All responses should be e-mailed to ddriscoll@hsag.com no later than April 1, 2011

• The HSAG PIP Review Team will review the dispute and respond to the plan with a decision within seven (7) business days

Slide 6

Statistical Testing using GraphPad

• Refer to statistical testing document on myforidaeqro.com• http://www.graphpad.com/quickcalcs/index.cfm• Select -

o Categorical data Fisher's, Chi square, McNemar's, Sign test, CI of proportion, NNT (number needed to treat). o Press Continue

o Fisher's and chi-square. Analyze a 2x2 contingency table.o Press Continue

Slide 7

GraphPad Example

Numerator Denominator minus NumeratorBaseline 15 280Remeasurement 1 10 315

Select - o Fisher's exact test (recommended)

o Two-tailed (recommended) o Calculate

Slide 8

GraphPad Results

Numerator Denominator-Numerator Total=DenominatorBaseline 15 280 295Remeasurement 1 10 315 325Total 25 595 620

Fisher's exact test

  The two-tailed P value equals 0.2250

  The association between rows (groups) and columns (outcomes)   is considered to be not statistically significant

Slide 9

Proposed PIP Topics

Slide 10

Approved Topics

• Achieving and Maintaining a Healthy Weight in SIPP Population

Slide 11

Approved Topics with Modifications

• Decreasing Childhood Obesity While in Residential Treatment• Enhancing the Effectiveness of our Token Economy System• Increasing Family Participation in Treatment• Minimizing Weight Gain of Youth in a Residential Setting• Reducing Percentage of Overweight/Obese Patients• Reducing Physically Aggressive Behavior in Members• Reducing Risks from Aggressive Behavior• Reducing Significant Weight Change Related to Medication

Side-Effects• Staff Initiated Timeouts• Youth Satisfaction with Food During Their Stay at SIPP

Slide 12

Not Approved Topics

• Competency Based Training of Community Counselors to Carry Out the Behavioral Analysis Requested by Therapist

• Impact of Trauma Informed Care• Impact on Dietary and Nutritional Practices• Improve Standardized Method for Measuring Progress• Improving Member Satisfaction• Increasing Post-discharge Follow-up Response Rates• Increasing SIPP 60 Day Survey Completion• Nursing Recruitment and Retention• Reducing Employee Turnover• RN Satisfaction• Transition Room

Slide 13

HSAG Contacts:

For any PIP questions or to request technical assistance contact:

Christi Melendez, RN, CPHQcmelendez@hsag.com602-801-6875

Denise Driscollddriscoll@hsag.com602-801-6882

Slide 14

Questions and Answers

Slide 15

Upcoming EQR Activities

Wednesday, March 23, 2011

Presenter:

Yolanda Strozier, MBA

Associate Director, State and Corporate Services

Slide 16

Upcoming EQR activities

• The next EQR Quarterly Meetings:– Wednesday, June 8, 2011 (AHCA Offices)

One-on-one TA sessions Tuesday, June 7, 2011

– Week of September 26, 2011 (Webinar)– Wednesday, January 11, 2012 (AHCA

Offices)One-on-one TA sessions Tuesday, January 10, 2012– Week of March 19, 2012 (Webinar)

Slide 17

Upcoming EQR activities

• Finalization of PIP Validation Reports (April 2011).

• Annual PIP Summary Report and Strategic Summary Report (April–June 2011).

Slide 18

Upcoming EQR activities

Next Steps• PIPs are submitted to AHCA/DOEA— August

2011• MCOs will receive HSAG’s “Statement of

Intent” (SOI) survey on Wednesday, August 10, 2011.

• Completed SOI’s due to HSAG on Monday, August 29th.

Slide 19

External Quality Review Quarterly Meeting

THANK YOU FOR YOUR PARTICIPATION!