Demonstrating the Value of Child Life Services in a Changing Health Care Environment


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Demonstrating the Value of Child Life Services in a Changing Health Care Environment

  1. 1. Jamie Snow, MBA, CCLS Assistant Director of Child Life and Social Work Mary E. Tietjens, BS, CCLS Manager of Child Life Texas Children’s Hospital, Houston TX Texas Children’s Hospital Child Life Conference October 5, 2013
  2. 2.  Identify key components of the Patient Protection and the Affordable Care Act of 2010 (ACA)  Review how the changing healthcare environment impacts health care consumers  Gain an understanding of common healthcare terminology and how to translate child life’s value into healthcare concepts  Examine why measuring and reporting the quality and outcomes of child life interventions adds value to your program
  3. 3.  By the end of today’s workshop, participants will walk away with a high level overview of the changing healthcare market and an understanding of how to reframe the work of child life into healthcare concepts  Throughout today’s workshop, participants will begin the creation of a “Child Life Portfolio of Value” that can be utilized to demonstrate how child life services add value to their organization
  4. 4.  Discuss current changes in the healthcare system, breaking down specific components and how they relate to the world of child life  Breakout Session: Link child life value to health care concepts  Report Out: Create your Child Life Value Portfolio  Discuss the importance of measuring quality and outcomes  Breakout Session: Identify ways to measure and report child life outcomes  Report Out: Enhance Child Life Value Portfolio with measurement and reporting strategies  Questions and answer session
  5. 5. Patient Protection and the Affordable Care Act of 2010 (ACA) - Fully implemented 2014 • Quality, Affordable Heath Care for All Americans • Systematic insurance market reform – eliminate discriminatory practices • Tax credits to support affordability • Penalties if not insured • More coverage for preventative services • The Role of Public Programs • Expands eligibility for Medicaid • Enhanced federal support for Children’s Health Insurance Program (CHIP)
  6. 6. • Improving Quality and Efficiency of Health Care • Investments to improve quality and delivery of care and inform consumers about patient outcomes • Financial support linked to quality performance  Prevention of Chronic Disease and Improving Public Health • Create infrastructure for health promotion and disease prevention • Healthcare Workforce • Encourage health workforce training and retention (Loan programs for schools) • Transparency and Program Integrity • Combat fraud in public and private programs
  7. 7. • Improving Access to Innovative Medical Therapies • More affordable medications for children and underserved communities • Community Living and Assistance Services and Supports • Long term insurance program for community living assistance and support • Revenue Provisions • Excise tax on high cost employee sponsored health coverage
  8. 8.  Value Based Purchasing  Bundle Payments  Diagnosis Related Groups  Access to Care
  9. 9.  Health care reform success is contingent on consumer savviness  Health care costs are moving toward consumers: creating more consumer driven care  Healthcare transparency  Compare providers based on quality, safety and patient satisfaction  Compare insurance plans: Insurance Marketplace  Consumer sites are become prevalent: HeathGrades  Access to information on smart devices is increasing
  10. 10.  Pros  Create more efficient processes in hopes to reduce cost  New Model of Care – Good patient outcomes equal more federal support  More insured, could help the bottom line  More preventative care  Cons  Influx of new patients taxing the system as whole, creating more paperwork, more need for access in a system that is already stretched for patient access  Complex and hard to fully understand  Tracking quality metrics takes time and resources
  11. 11.  Understand your individual health care institution’s change and evolution  What quality metrics does my hospital report, or plan to report, and how are they collecting and reporting that data?  What change is taking place to embrace health care reform?  Know your hospital’s priorities and goals  Track hospital/unit statistics  Who are your consumers
  12. 12.  Embrace and market consumer driven healthcare  Create an environment that embraces patient engagement  Create value driven ideas and statements using marketing techniques  Target audience  Tell the stories that targets key components  Product, Pricing, Placement and Promotion  Provide examples  Create supply and demand
  13. 13.  Convenience and Accessibility  Strategies to enhance way finding  Community based hospitals, health centers  Medical Homes: High quality medical care for underserved communities  Child Life’s Role in Supporting Convenience and Accessibility  Share expertise: wellness programs, orientation  On-site in-services
  14. 14.  Identify Distinct Local Market Needs  Child Life Teams: Meet unique needs of hospitalized children  Marketing/Media  Child Life’s Role in Identifying Local Market Needs  “What do our patients need?” vs. “What services do we want to provide?”
  15. 15.  Proactive Patient Outreach  ACA: Health promotion/disease prevention:  Prevention and Public Health Investment Fund  “Sick care” vs. “Health care”  Supporting preventive care health initiatives  Child Life’s Role in Supporting Patient Outreach  Health and wellness fairs  Programming around wellness: cooking classes  Healthily lifestyle choices: exercise incentives
  16. 16.  Customer Service Focus  Customer satisfaction linked to reimbursement  Child life traditionally linked to satisfaction  Child Life’s Role in Customer Service  Competency driven  Highlight programs to your leadership  Performance tool objective
  17. 17.  Patient Loyalty  Consumer options focus on market differentiation  Insurance carrier  Hospital provider  Specialists  Don’t make assumptions  Child Life’s Role in Creating Patient Loyalty  Develop relationships  Demonstrate strong competencies  Clinical, work ethic and attitude
  18. 18.  I.V.  “Put to sleep”, gas, anesthesia  Dye  Urine – “you’re in”  Stool  Medicine through a small, tiny tube; I.V. = into the vein  Medicine to help you go to sleep, different than sleep at night  Medicine to help us see your picture  Pee – use child’s familiar term  Pooh, Poop – use child’s familiar term
  19. 19.  Accountable Care Organizations (ACO)  Network of hospitals and physicians  Goal to limit unnecessary spending  Primary care physician driven  Savings incentives for keeping costs down  Fee for Service  Payment model (past or current)  Quantity vs. quality  Bundled Payments  Payment model (future)  Set expected cost of clinically-defined episodes of care
  20. 20.  Marketplace/Exchange  State/federal insurance website  Comparisons/financial assistance  Opened Oct. 1 for Jan. 1, 2014 coverage  Utilization Management/Review  Assess interventions  Appropriateness, medical need, efficiency  Alignment with health benefit plan  Proactive vs. retroactive  Terms are used interchangeably
  21. 21.  Diagnosis Related Groups (DRGs)  System to classify cases into groups  Intent to identify services needed  Set reimbursement and timeframes  Encourages examination of processes and discharge barriers  Potentially Preventable Readmissions (PPR)  Analyze administrative data to identify readmissions  Factors that impact PPR  Severity of illness, age, mental health diagnosis  Assess if related to a prior admission
  22. 22.  Market Share  DRG s  Preventable Readmissions  Animal assisted therapy is a unique program within our market that enhances the emotional well- being of our patients and families.  Positive coping promotes the patient /families ability to achieve patient care goals and meet discharge criteria .  Enhanced understanding and compliance can be met through developmentally appropriate diagnosis teaching, aiding in the reduction of preventable readmissions.
  23. 23.  Patient Satisfaction  Preventive Care  The Child Life Zone is offering additional play programming, enhancing the opportunity to normalize the healthcare environment and create customer satisfaction.  As a part of our department’s wellness initiative, child life is teaming up with nutrition support to offer cooking classes for patients and families coping with a diagnosis of type 1 diabetes
  24. 24.  Break into your groups  Choose a member to scribe  Review the health care terms listed on your large Post It Note paper  Share and brainstorm your current programming components that bring value to your organization  Match programming components to a health care concept that demonstrates how child life brings value to that specific concept The desired outcome of this exercise is to begin reframing your thought process and link the value of your child life programming to your hospital’s overall health care concepts. Break Out Session
  25. 25.  Choose someone to speak for your group  Share specific child life programming ideas that demonstrate value and identify the link to a health care concept.  Challenge yourself to utilize the heath care language when reporting out to the group! The desired outcome of this exercise is to enhance your tool kit of programming ideas that demonstrate the link between child life’s value and health care concepts. Use your Start Doing and Keep Doing cards to begin the creation of your Child Life Value Portfolio Group Report Out
  26. 26.  What determines quality  Patient Satisfaction: Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS)  Hospital Policies & Procedures  Child Life Council EPB statements  Accrediting Agencies  Hospital Trends/Priorities (marketing priorities)  Community Needs Assessment  Establish goals/objectives  How do you track and measure  Use validated tool or develop tools and techniques to capture quality
  27. 27.  Determine your target audience  Include all stakeholders  Determine tools  Scorecards/Dashboards  Meetings (presentations)  Marketing
  28. 28.  Hospital Wide Implementation of Care Progression Rounds  Better daily communication on patient care  Timely discharge (increase access)  Child life’s role in a hospital wide initiative  Active and present members daily  Identify and report child life’s scope of services and barriers to discharge  Coping/Diagnosis Education/Compliance
  29. 29.  Project Scope: To build a child life specific Participant Classification System to support appropriate child life staffing for Texas Children’s Hospital (TCH).  Long Term Goal: Understand and track current staffing and plan towards a formal staffing model that would reflect child life priorities within a participant classification system. This classification system would eventually correlate with unit specific demand and child life quality measurements.
  30. 30. What Makes a Quality Intervention and How do you Measure the Outcomes of That Intervention  Indentify tools and resources needed  Time for pre-assessment  PIES  Individualized intervention  Environment  Comfort Measures
  31. 31.  Measure Outcomes  “Active coping response” vs. “inactive coping response”  Demonstrating behaviors  “non-interfering”  “potentially interfering”  “interfering”
  32. 32.  Measuring Quality  Reporting Outcomes  The child life department utilized a parent survey to assess the patient’s dietary habits pre and post implementation of the type 1 diabetes cooking class to measure changes in food choices and insulin levels.  Survey results were presented in a teaching aid summery which outlined specific learning objectives, evidence based practice references and methodology; demonstrating the link between developmentally appropriate teaching and behavior modification.
  33. 33.  Break into your groups  Choose a member to scribe  Review the child life programming concepts listed on your large Post It Note paper  Share and/or brainstorm ideas for measuring and reporting the quality and outcomes of child life programming  Match child life programming components to a health care concept that demonstrate a measurable link between child life programming and quality health care outcomes. The desired outcome of this exercise is to generate ideas for measuring and reporting the quality outcomes of child life programming concepts. Break Out Session
  34. 34.  Choose someone to speak for your group  Share specific strategies that can be utilized to measure the quality of child life programming and the outcomes that can be linked to a health care concept.  Challenge yourself to utilize the heath care language when reporting out to the group! The desired outcome of this exercise is to enhance your tool kit of quality and outcome measurement and reporting strategies that demonstrate the link between child life’s value and health care concepts. Use your Start Doing and Keep Doing cards to add reporting ideas to your Child Life Value Portfolio Group Report Out
  35. 35. Thank you for your thoughts and participation!
  36. 36. Center for Medicaid and Medicare (2013). Bundled Payments for Care Improvement (BPCI) Initiative: General Information. Retrieved from Consumer Reports (2013) Health Reform: Seven Things You Need to Know Now. Retrieved from Ellis, J & Razavi, A (2012, 6, 15). Pros and Cons of Healthcare Reform for Hospitals. Retrieved from Gamble, M. (Composer). (2013, 04 03). 5 Retail Principles for a More Effective Hospital Market Share Strategy [Web Graphic]. Retrieved from strategy.html Herman, B. (Composer). (2011, 11 29). 10 Ways for Hospitals and Health Systems to Increase Profitability in 2012 [Web Graphic]. Retrieved from 2012.html Responsible reform for the middle class. Retrieved from Skinner, J. (Composer). (2013, 4 11) How to Reform your Healthcare Marketing in 2013. Retrieved from Spoeri, B. (Composer). (2012, 6 6). 6 Trends in an Era of Consumer –Driven Healthcare. Retrieved from