LA County Department of Health Services · Insecurity screening in Spring 2020 utilizing the new...
Transcript of LA County Department of Health Services · Insecurity screening in Spring 2020 utilizing the new...
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PHLNYear2ProjectAim MeasuresforSuccess
LACountyDepartmentofHealthServices
Process:PercentoftotalPhase1SitestafftrainedonFoodInsecurityPercentoftotalPhase1Sitenursing/socialworkstafftrainedonworkflowsPercentofpatientsseeninPhase1Sites(PrimaryCare)thatare:-ScreenedforFI-ScreenedpositiveforFI-Referredtoresources-FollowattemptwasmadeOutcomes:PercentofpatientswhoscreenedpositivethatwerelinkedtoresourcesPercentofpatientsscreenedandenrolledinCal-FreshPercentofpatientslinkedtoresourceswhoseneedsweremetBalance:CycletimePatientexperiencedata
FoodInsecurityAIMStatement:Wewilleffectivelyaddresshigh-prioritysocialneedsofourpatientstoimproveclinicaloutcomesbylinkingatleast25%ofpatientsseeninPhase1PrimaryCaresiteswhoscreenpositiveforfoodinsecuritytoappropriateresourcesbyDecember31,2019.
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ChangesTestedChanges
• Observations conducted of local workflows for food insecurity screening and referral at Phase 1 sites.
• A “pop-up” window was developed and tested for documenting follow-up actions for positive screens.
• We are creating a “toolkit” based on the observations and testing which will include screening/referral/linkage workflows, local food resources, scripts for clinic staff, guidelines for EMR documentation, etc.
ImplementedChanges• The Hunger Vital Sign was built in
our EMR in the nursing intake under a new “Social Needs” tab.
• Food insecurity screening initiated at all Phase 1 sites using the Hunger Vital Sign.
• A report to query number of screenings performed and number of positive screens was built.
• A registry was built that lists patients with positive screens.
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• Workflow Observation Tool:
UsingDataforImprovement
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• PDSA testing on patients who screen positive for Food Insecurity
UsingDataforImprovement
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• FI Screening Rates by Facility
UsingDataforImprovement
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• FI Prevalence Rates by Facility
UsingDataforImprovement
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ConveningleadersfromdifferentDHSfacilitiestodevelopandvetsystem-widebestpractices
Testingwithfrontlineusers
Intentionalplanningaroundthetrainingrequiredforsystem-wideimplementation
Ensuringthescreeningtools,registries,reports,etc.arebuiltandintegratedintotheEMR
StrategiesforSuccess
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HungerVitalSignsintegratedintonursingintake
KeyTools&Resources
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FoodInsecurityRegistry
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EMR“Pop-up”windowdraftedtodocumentfollowupactionsforpositiveHungerVitalSignscreens.
KeyTools&Resources
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KeyTools&Resources
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FoodInsecurityRegistry:
Listofpatientswhoscreenedpositiveforfoodinsecuritybymonth.
Includesdateofscreenandcontactinformation.
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Inconsistenttrackingandfollow-upofFIpositivescreenswhichweareaddressingthroughourefforts
NeedtocontinuetopromotesystemwideadoptionofFIscreeningatintakebynursing
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CurrentChallengesorBarriers
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NextSteps
• Phase2willgo-livewithFoodInsecurityscreeninginSpring2020utilizingthenewtoolkit.
• NewFoodInsecurityReportwillbeusedtotrackmonthlyscreeningandprevalenceratesforallDHSclinics.
• Astandardizedworkflowusingtheregistryfortrackingandfollow-uponpositivescreenswillbedeveloped.
• Identifyandhelpsupportsitesthathavelowratesofscreening.
• Furtheridentifycommunityresourcesandenhanceourabilitytolinkpatientstotheseresources..
• Celebratesuccessesandbestpractices!
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Spreading Sustaining