Fillable Health IT-enabled Quality Improvement [eCQI] Worksheet (Ambulatory, Essential (Office of the National Coordinator)

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Health IT-enabled Quality Improvement [eCQI] Worksheet (Ambulatory, Essential (Office of the National Coordinator)

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Health IT-enabled Quality Improvement [eCQI]
Worksheet (Ambulatory, Essential Version)
This tool can help users document and analyze current approaches to specific quality
improvement targets and plan enhancements.
• It is one of the ONC eCQI Resources that provide guidance on
planning and
implementing improved care processes.
• A tutorial on using this worksheet can be found here.
• A sample worksheet with a hypertension control case study is here.
• You should select quality improvement targets based on evidence, including quality
measures results that show current performance gaps, and on practice guidelines
recognized by relevant professional societies or expert advisory panels such as the
USPSTF. Your REC, QIN-QIO
, or other QI partners can help you prioritize improvement
targets relevant to your practice. Your REC or health IT vendor can help with
implementing tools to support process changes identified by this worksheet. The
CDC/Million Hearts
Hypertension Control Change Package is an example of evidence-
based tools and guidance for supporting target-focused quality improvement efforts.
Instructions for using this worksheet
Step 1: Document the improvement target and current performance (page 2).
Step 2: Think about pertinent information flows and workflows driving performance (page 2).
Step 3: After discussion with pertinent stakeholders, document current state information flows
and workflows for the target (pages 4-6). Brainstorm potential enhancements to the current
state with the QI team, and document these in the pertinent boxes beneath the current state.
Step 4: Review all entries (pages 4-6), and summarize them in the overview table (page 3).
Step 5: Use this completed worksheet with the QI team to help prioritize and implement high-
yield enhancements to current workflows and information flows; consider beginning with those
that will yield the greatest benefits with the least effort and resources (see ONC
eCQI Process
Improvement page for further details).
Worksheet Provided By:
Jerome A. Osheroff, MD, TMIT Consulting, LLC
This tool has been refined based on experience using the eCQI worksheets in quality improvement (QI)
projects. It builds on QI tools sponsored by the Office of the National Coordinator for Health IT (ONC).
Those ONC tools were based on work of the CDS/PI Collaborative (supported by the
California Healthcare
Foundation), which builds, in turn, on the HIMSS CDS Guidebook Series. The information in this document
is not intended to serve as legal advice nor should it substitute for legal counsel. Users are encouraged to
seek additional detailed technical guidance to supplement the information contained within.
Version 2.0; May 22, 2015
2
eCQI Worksheet (Ambulatory, Essential Version)
What Are We Trying To Improve? How Are We Doing Today?
Target
Current Performance
on Target
Performance Drivers for this Target:
Reset Fields (all pages)
3
eCQI Approach Summary
1
Item
1
This table contains an overview of details documented on subsequent pages in this worksheet
Not
Visit
Related
Patient
Comes to
Daily Care
Team
Huddle
Check-in/
Waiting/
Rooming
Provider
Encounter
Encounter
Closing
After Patient
Leaves
Office
Outside
Encounters
[Population
management]
Foundational
Work
Current
Information flow
Potential Enhancements
eCQI Approach
Details
2
2
Tip: Imagine that you are a patient not meeting the target when you are populating the worksheet; i.e., consider what is and isn't
happening that's causing the suboptimal result.
Section 1: Activities that occur with specific patients (note: population management activities, e.g. Registry use, belong in Section 2)
These activities occur when the patient is not in the office (see below for after office visit)
4
Not Visit Related
Description: Not related to a patient's visit to the office/clinic or just before or after that visit.
Current
Information flow
o
Potential
Enhancements
o
Before Patient
Comes to Office
Description: After a patient has an office visit scheduled but before they arrive for that appointment.
Current
Information flow
o
Potential
Enhancements
o
These activit
ies occur when the patient is in the office
Daily Care Team
Huddle
Description: Provider team preparations for all patient visits scheduled for the day
Current
Information flow
o
Potential
Enhancements
o
5
o
o
o
Check-in/ Waiting
Rooming
Description: After patient checks in, before encounter with clinical team
Current
Information flow
o
Potential
Enhancements
o
Provider
Encounter
Description: Main encounter with Provider
Current
Information flow
Potential
Enhancements
Encounter Closing
Description: After main provider encounter, but before patient leaves the office
Current
Information flow
Potential
Enhancements
o
T
hese activities occur after a patient leaves the office
After Patient
Leaves Office
Description: The particular encounter has concluded and the patient is no longer in the office
Current
Information flow
o
Potential
Enhancements
o
6
Section
2: Activities that relate to population management
Outside
Encounters
Description: Activities focused on the entire patient panel
Current
Information flow
o
Potential
Enhancements
o
Section 3: Foundational Activities for Practice to Address Target
Foundational Work
Description: Practice activities that are foundational for planned enhancements e.g. staff training, policy
and protocol development, refining EHR and other practice tools, etc.
Current
Activities
o
Potential
Enhancements
o
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Health IT-enabled Quality Improvement eCQI Worksheet (Ambulatory, Essential (Office of the National Coordinator)

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Completed 26 January 2021

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