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Clinical Performance Improvement Network

The WSMA Foundation for Health Care Improvement has joined with the Washington Health Alliance and the Washington Academy of Family Physicians to create the Clinical Performance Improvement Network, an educational program designed to assist physician practices with quality improvement efforts.

CPIN offers opportunities for medical practices to collaborate through sharing of best practices, innovations and resources to stimulate implementation of quality improvements into practice settings.

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Upcoming CPIN webinars

There are no scheduled CPIN webinars at this time. Be sure to review our archived offerings below.

Archived CPIN Learning Sessions

Take advantage of over 30 archived educational presentations on a variety of quality improvement initiatives.

Click on the session title below for archived presentations.

Choosing Wisely - A Clinical Toolkit for Consumer Engagement

Jill A. Dudik Bross, MD, FAAP
Samaritan Healthcare Clinics

Scott Kronlund, MD, MS
Northwest Physicians Network

Kimberly Wicklund, MPH
Group Health Cooperative

Learning Objectives

  • Provide a focused framework for leveraging effective Choosing Wisely resources and strategies.
  • Describe how clinics are using the toolkit to implement Choosing Wisely in their practice setting.
  • Identify toolkit components to implement in your own clinical setting.

View Video (Originally recorded on Oct. 26, 2016) | Printable Slides

Honoring Choices Pacific Northwest: Implementing a Team-Based Advance Care Planning Program

Dianna Bleasdell; Nicala King, RN; Sarah Paik, RN; Katie Pence, PA-C; Megan Short;
Lynda Tang, DO and Hallie Williams
The Vancouver Clinic

Jessica Martinson, MS
Washington State Medical Association

Carol Wagner, RN, MBA
Washington State Hospital Association

Learning Objectives

  • Review the latest progress on implementing a team-based advance care planning program in health care organizations across the state.
  • Outline key strategies that The Vancouver Clinic (1 of 32 implementation teams in WA) has used to generate early wins and develop sustainable processes and systems that will serve as the foundation for universal adoption.
  • Discuss Honoring Choices Pacific Northwest's 5-year vision and plans and how they can help your practice.

View Video (Originally recorded on September 28, 2016) | Printable Slides

Choosing Wisely at Group Health and Swedish

Chris Dale, MD, MPH
Swedish Medical Group
Matt Handley, MD
Group Health Cooperative

Learning Objectives

  • Outline the strategies Group Health and Swedish are using to reduce antibiotic use for viral infections, annual paps and imaging for uncomplicated headaches.
  • Describe how data are collected and used to engage physicians in changing their practice to meet the Choosing Wisely goals.

View Video (Originally recorded on June 22, 2016) | Printable Slides

Value Based Purchasing - The Role of the Common Measure Set and the Campaign to Engage Consumers

Susie Dade
Washington Health Alliance
John Gallagher
Washington Health Alliance

Learning Objectives

  • Describe how the Common Measure Set is being used in value based purchasing contracts.
  • Outline how to engage patients in conversations about value.

View Video (Originally recorded on May 11, 2016) | Printable Slides

The Critical Role of the Leader: Honoring Choices Pacific Northwest

Jessica Martinson, MS
Washington State Medical Association
Carol Wagner, RN, MBA
Washington State Hospital Association

Learning Objectives

  • Review the goals and objectives of the Honoring Choices Pacific Northwest advance care planning program.
  • Outline the specific roles and responsibilities leaders can play to ensure the success of implementing an advance care planning program within your organization.

The recording of the webinar may only be accessed by staff from organizations participating in the Honoring Choices PNW advance care planning program. Please click "View Video" below to complete an attestation, after which you will be directed to the online archive of the webinar.

View Video (Originally recorded March 29, 2016)

Introducing the New Community Checkup: A look at the Washington State Common Measure Set for Health Care Quality and Cost

Chris Dale, MD, MPH
Pulmonary and Critical Care Medicine
Medical Director, Quality & Value Swedish Medical Group
Teresa Litton, MPH
Washington Health Alliance

Learning Objectives

  • Describe the purpose and background of the Washington State Common Measure Set for Health Care Quality and Cost.
  • Review the Community Checkup key findings.
  • Provide an example of how the Community Checkup can be used as a guide for improvement.

(Originally recorded December 16, 2015) | Printable Slides

Integrating Advance Care Planning Documentation into EMRs

Stephanie Anderson, MSN, RN, CHPN
Respecting Choices Faculty and Senior Consultant
Bernard (Bud) Hammes, PhD
Director, Respecting Choices
Gundersen Medical Foundataion

Learning Objectives

  • Provide a general orientation to EMR design principles and redesign possibilities to store and retrieve advance care plans, document ACP conversations and leverage the EMR for ACP data collection.
  • Outline best-practice examples of how other organizations have successfully integrated advance care planning documentation into their EMRs.

The recording of the webinar may only be accessed by staff from organizations participating in the Honoring Choices PNW advance care planning program. Please click "View Video" below to complete an attestation, after which you will be directed to the online archive of the webinar.

View Video (Originally recorded November 18, 2015)

Choosing Wisely: Strategies to Reduce Unnecessary Use of Antibiotics and Enhance Antimicrobial Stewardship

Christopher Dale, MD, MPH
Medical Director, Quality and Value
Swedish Medical Group
Marisa D'Angeli, MD, MPH
Medical Epidemiologist, Preparedness/Healthcare
Associated Infections, Washington State Department of Health
Matt Handley, MD
Chair, WA State Choosing Wisely Task Force
Medical Director of Quality, Group Health

Learning Objectives

  • Review the rate of unnecessary antibiotic prescriptions for viral infections in Washington state and the pressing need for change
  • Outline specific strategies used in local health systems to successfully reduce antibiotic prescriptions for viral infections
  • Preview Washington state's antimicrobial stewardship initiative, which officially launches in November and outline President Obama's national action plan, including potential funding opportunities

View Video (Originally recorded September 23, 2015) | Printable Slides

Honoring Choices Pacific Northwest

Joanne Roberts, MD
Chair, Honoring Choices Pacific Northwest Advisory Council 
CMO, Providence Regional Medical Center Everett 
Michelle Lott, CPC, CPMA 
Associate Director, Practice Resource Center, Washington State Medical Association
Jessica Martinson, MS
Director, Clinical Education and Professional Development, Washington State Medical Association
Carol Wagner, RN, MBA
Senior Vice President, Patient Safety, Washington State Hospital Association

Learning Objectives

  • Discuss the need to improve health care systems' ability to know, record and honor patients' choices about end of life care
  • Outline national best-practices for advance care planning programs and describe the goals and deliverables of Honoring Choices Pacific Northwest
  • Explain Medicare's new CPT codes for advance care planning conversations

View Video (Originally recorded July 29, 2015) | Printable Slides

Choosing Wisely: Changing Practice to Reduce Harm and Increase Value

Matt Handley, MD
Chair, WA State Choosing Wisely Task Force
Medical Director, Quality, Group Health Cooperative
Norris Kamo, MD
Associate Physician, General Internal Medicine, Virginia Mason
Scott Kronlund, MD
Chief Medical Officer, Northwest Physicians Network

Learning Objectives

  • Describe the need to create change across Washington state using the Choosing Wisely recommendations
  • Outline the strategies Group Health Cooperative and Virginia Mason used to reduce antibiotic use for viral infections, annual paps and imaging for uncomplicated headaches
  • Review the Choosing Wisely Action Manual, which outlines eight steps to create organizational change

View Video (Originally recorded May 27, 2015) | Printable Slides

Washington Health Alliance's Community Checkup: A tool to support health care quality improvement

Teresa Litton, MPH, Washington Health Alliance
Peter McGough, MD, UW Medicine

Learning Objectives

  • Identify two areas where Washington has room for improvement
  • Identify two areas where Washington is doing well
  • Provide one example of how the Community Checkup can be used as a quality improvement tool

View Video (Originally recorded April 22, 2015) | Printable Slides

End of Life Conversations: How ready is your organization? How ready are you?

Kate Lally, MD, VNA of Care New England
Kelly McCutcheon Agams, LICSW, Institute for Healthcare Improvement
Joanne Roberts, MD, Providence Regional Medical Center Everett
Donna Smith, MD, Virginia Mason
Lauge Sokol-Hessner, MD, Beth Israel Deaconess Medical Center

Learning Objectives

  • Discuss the critical need to improve the health care delivery system’s ability to know and honor patients’ choices during a serious or life threatening illness
  • Describe the goals and deliverables of Honoring Choices Pacific Northwest, a statewide initiative of WSHA and WSMA
  • Review the key elements of the Honoring Choices Pacific Northwest website to share with your patients
  • Outline the five principles of the Institute for Healthcare Improvement’s Conversation Ready work, and describe how organizations around the country are accomplishing the goals

View Video (Originally recorded November 19, 2014)

Choosing Wisely: Equipping Physicians to Reduce Low-Value Care

Matt Handley, MD
Chair, WA State Choosing Wisely Task Force
Medical Director, Quality, Group Health Cooperative

Learning Objectives

  • Discuss the urgency to create change across Washington state using the Choosing Wisely recommendations 
  • Share the county-by-county results from the new report, Less Waste, Less Harm: Choosing Wisely in Washington State, and identify areas for improvement 
  • Review the new Choosing Wisely Action Manual, which includes tools and resources that physician leaders can use to lead organizational change

View Video (Originally recorded September 24, 2014)

Best Practices in Patient Communication

Cynthia G. Ferrucci, MD, FACP
Internist, UW Medicine Belltown

Learning Objectives

  • Outline the core principles of effective patient communication.
  • Discuss the link of optimum communication to improved patient experience outcomes.
  • Review questions in the CAHPS Clinician and Group Surveys (CGCAHPS) and the Washington Health Alliance Patient Experience Survey

View Video (Originally recorded June 25, 2014)

Engaging Patients in Collaborative Care Plans: Self-Management Support to Increase Quality

Kerry Meyer, ARNP, PhD
Primary Care Provider
UW Neighborhood Clinic

Learning Objectives

  • Identify five attributes of Self-Management Support (SMS)
  • Outline three patient-provider interactions that work and don’t work
  • Describe how to incorporate SMS into your office visit

View Video (Originally recorded May 28, 2014)

Choosing Wisely: Frontline Strategies

Scott Kronlund, MD, MS
Francis Mercado, MD
Kimberly A. Bell, MD, SFHM, FACP

Learning Objectives

  • Review the mission and aims of the Choosing Wisely campaign
  • Outline strategies to have effective physician-to-patient conversations about the importance of and rational for the Choosing Wisely recommendations
  • Describe how to engage the medical team in educating patients, addressing concerns, distributing Consumer Reports materials and appropriately managing patient requests
  • Discuss specific strategies that are being piloted around the region to roll out the Choosing Wisely recommendations

View Video (Originally recorded April 23, 2014)

The Puget Sound Health Alliance Community Checkup Results for 2013

Susie Dade, MPA
Deputy Director
Puget Sound Health Alliance

Learning Objectives

  • Review specific quality improvement metrics and how well (or poorly) medical practices in the Puget Sound region have performed on those metrics in 2013
  • Identify common barriers to the successful prescribing and use of generic medications and how to overcome those barriers when appropriate
  • Describe specific techniques for effectively engaging prescribing physicians in considering generic medications for many initial prescriptions

View Video (Originally recorded January 22, 2014)

Using Health IT to Improve Quality

Michelle Glatt, MPH, PA-C
Qualis Health, THe Cardiac Learning And Action Network

Learning Objectives

  • Outline the characteristics of small and medium sized practices that have successfully used health IT for quality improvement.
  • Identify the barriers commonly encountered by practices who are attempting to use the report-writing capabilities of the EHR.
  • Describe methods of minimizing barriers to develop useful reports for quality improvement and population health.

View Video (Originally recorded September 25, 2013)

Better Care Practices for Patient-Centered Medical Homes

Sharon I. Eloranta, MD
Medical Director, Quality and Safety Initiatives
George W. Merck
Institute for Healthcare Improvement Fellow
Qualis Health

Learning Objectives

  • Identify why implementing Patient-Centered Medical Home (PCMH) practices such as empanelment, care coordination, and continuous team-based healing relationships are key to achieving Triple Aim results
  • Describe how PCMH practices can be created and sustained in primary-care settings
  • Identify the common barriers to successfully implementing PCMH practices and outline how to overcome these barriers in small and medium-sized practices

View Video (Originally recorded September 4, 2013)

Survey of Local Best Practices for Effective Patient Care

This webinar presents the results of a 2012 survey of over 40 medical groups in the Puget Sound region regarding their current use of specific tools and processes for effective patient care. Structural elements of best practices surveyed included adoption of electronic medical records, use of registries, strategies for improved access to care, collecting information on health outcomes, patient satisfaction, and health disparities, as well as care coordination resources and patient reminders.

Presenter:
Susie Dade, Deputy Director of the Puget Sound Health Alliance, principal author of the study.

Adoption of Processes and Tools to Advance Effective Patient Care - Medical Group Survey Results, October 2012

A Report from the Alliance Clinical Practice Improvement Network, January 30, 2013 

Intensive Care Management Services for Patients with Multiple Chronic Conditions

The Washington State Department of Health is currently launching a statewide, multi-year program to assist medical practices in their transformation to Patient Centered Medical Homes (PCMH). This includes assisting practices in developing programs to treat high-risk patients in a more cost-effective manner through targeted care management services and linking to those community-based organizations providing these same services. The webinar presents practical steps on how to create and sustain these programs in a way that significantly improve patient care outcomes by focusing intensive outpatient care on high-risk persons with multiple chronic conditions.

Presenter:
Colette Rush, RN, BSN, CCM, a public health nurse consultant in the practice improvement section of the Department of Health. Colette has an extensive background in quality improvement efforts and collaborative, including experience with the Polyclinic in Seattle and the Puget Sound Health Alliance. She is currently the lead on this new initiative to increase intensive care management for persons with multiple chronic illnesses.

View video
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Introductory slides

Colette Rush presentation

Engaging Patients:  The ABIM Foundation Choosing Wisely® Campaign

Evidence-based medicine is more than just using clinically-proven procedures; equally important is using the evidence to decide what not to do. Choosing Wisely® is part of a multi-year effort by the ABIM Foundation, along with many national specialty society partners, to help physicians become better stewards of our limited health care resources. Twenty national organizations representing medical specialists, as well as Consumer Reports, have joined with the ABIM Foundation to help physicians, patients and other health care stakeholders think and talk about the overuse of health care resources. Each specialist organization has identified five tests or procedures commonly used in their field for which the necessity should usually be questioned and discussed. The resulting lists of "Five Things Physicians and Patients Should Question" are intended to spark discussion about the need, or lack thereof, for many frequently ordered tests or treatments. This webinar presents an overview of this campaign.

Presenters:
Daniel Wolfson is Executive Vice President and COO of the ABIM Foundation, the national coordinator for the Choosing Wisely campaign. Karla Graue Pratt is Executive Vice President of the Washington Academy of Family Physicians. Susan Callahan is Director of Community Engagement for the Washington State Medical Association. John Gallagher is Director of Communications for the Puget Sound Health Alliance. All four presenters each have many years of experience in the effort to improve health care delivery, achieve better outcomes, and reduce health care costs.

Introductory slides

Daniel Wolfson presentation

John Gallagher presentation

Susan Callahan presentation

Karla Graue Pratt presentation

Medication Reconciliation Following Hospital Discharges

Repeated studies have found medication errors following hospital discharge to be a serious problem. One in eight discharged patients has an adverse drug event within three weeks of discharge. Two-thirds of all medication errors occur during patient transitions, and over 1.5 million patients have a medication error annually, at a cost of $3.5 billion. An immediate need post discharge is medication reconciliation. This webinar, originally presented on October 3, 2012, presents why and how to efficiently perform medication reconciliation in primary care settings following a hospital discharge.

Presenters
Jenny Arnold, PharmD, BCPS, is the director of pharmacy practice development for the Washington State Pharmacy Association, assistant clinical professor at the University of Washington, and chair of the Washington Patient Safety Coalitions Medication Reconciliation group. Steve Riddle, PharmD, BCPS, FASHP, is vice president of clinical affairs for Pharmacy OneSource/Wolters Kluwer Health. He is also a clinical affiliate professor at the UW School of Pharmacy, on the Washington State University College of Pharmacy Dean's Advisory Council, and the chair for the Section of Ambulatory Care Practitioners for the American Society of Health-Systems Pharmacists.

Medication Reconciliation Following Hospital Discharges introductory slides

Medication Reconciliation Following Hospital Discharges webinar presentation

Intensive Outpatient Care for Patients with Multiple Chronic Illnesses

Everyone talks about patient engagement and bending the cost curve. This webinar, originally presented on September 19, 2012, presents practical steps on how to actually achieve these goals in a way that significantly improves patient care outcomes by focusing intensive outpatient care on high-risk persons with multiple chronic conditions. While this is not a new concept, widespread adoption of these evidence-based approaches has been slow to catch on until very recently. This webinar spotlights programs underway in California, Oregon and also in Washington that have demonstrated their effectiveness in improving care and reducing costs.

Presenters
Paula Suter is Director of Clinical Care Management; Sutter Care at Home in California, co-developed the Integrated Chronic Care Model (ICCM) and was selected by CMS in their first round of Innovation Advisors. She has trained over 3,500 clinicians across the nation in chronic care management, including training in 2011 for the Home Care Association of Washington. Denise Honzel is Executive Director of the Oregon Health Leadership Council and project sponsor for their High Value Patient Centered Care pilot, a medical home pilot for highest risk patients, with 3,600 patients currently participating across 14 medical groups.

Intensive Outpatient Care for Patients with Multiple Chronic Conditions Introductory slides 

Integrated Chronic Model - A Foundation to Transform PCMH Care Delivery webinar presentation

Oregon Health Leadership Council: High Value Patient Centered Care Model webinar presentation

Using Results from Patient Experience Surveys to Improve Patient Care

This lunchtime webinar, originally presented on May 24, 2012, presents the results of the recent survey of patient experience conducted in the Puget Sound region by the Puget Sound Health Alliance, and explains how those results can be used to improve practice performance to better meet the needs of patients. Patient experience results were released on May 11, 2012 for 40 Puget Sound-area medical groups with 156 clinic locations (clinics with 3 or more primary care providers). Patient experience definitely matters to patients; it's most often how they define "quality." Patients with positive experiences return; patients with negative experiences often find a different physician. Further, positive patient experience has been shown to correlate with improved clinical outcomes.

Presenters
Susie Dade is the deputy director for the Puget Sound Health Alliance, which sponsored the recent survey of patient experience in the Puget Sound region. Larry Morrissey, MD is a pediatrician with the Stillwater Medical Group in Stillwater, Minnesota. Dr. Morrissey has worked with the CAHPS Consortium on measuring patient experience and is a frequent presenter on how to use the results of patient experience surveys to improve practice performance.

Click to view.

The Washington Patient-Centered Medical Home Collaborative - Lessons Learned

The Patient-Centered Medical Home Collaborative was a learning process for medical teams to improve primary care for their patients. From September 2009 through September 2011, 32 teams in Washington created and operated patient-centered medical homes, under a project jointly sponsored by the Washington State Department of Health and the Washington Academy of Family Physicians. In a medical home, the physician and care team build strong relationships with the patient and the patient’s family. The team coordinates care with specialists or other health providers. Patient-centered care makes the patient a partner in health care decisions. This webinar pdf presents the lessons learned from this two year collaborative.

Presenters
Patricia Justis was manager of the Washington Patient-Centered Medical Home Collaborative, in the Practice Improvement Section of the Washington State Department of Health. Kimbra Wells Metz was director of practice transformation at the Washington Academy of Family Physicians. Both were actively involved in the implementation and evaluation of the Patient-Centered Medical Home Collaborative.

Washington Patient-Centered Medical Home Collaborative webinar presentation

End of Life Conversations in Medical Care

Some of the most important, and challenging, conversations physicians can have with their patients involve planning for, and clarifying patients values about, end-of-life care decisions. The timing and structure of these conversations, and the ways to successfully engage the patient (and family members as appropriate) in what are often difficult and emotional decisions, was the subject of this webinar pdf, presented by Linda Wrede-Seaman, MD, FAAFP, FACEP, FAAHPM, a Yakima palliative medicine specialist.

Communication at End of Life  Dr. Wrede-Seaman's webinar presentation

Reducing Hospital Readmissions by Engaging Physicians

Improving effective patient handoffs back to community physicians at time of discharge has been identified as a top priority by the National Quality Foundation, Medicare and many other quality improvement organizations. This webinar presented practical tips and strategies that have been successful at local hospitals in engaging community physicians in this critically important transition.

Presenters were Larry Schecter, MD, FACS, chief medical officer at Providence Regional Medical Center in Everett, Amy Hoing, MD, a primary care physician at Evergreen Healthcare in Kirkland, and Carol Wagner, vice president for patient safety at the Washington State Hospital Association and a national leader in the effort to reduce hospital readmissions.

Rehospitalization in Washington Carol Wagner's webinar presentation

Reducing Hospital Readmissions by Engaging Physicians Dr. Schecter's webinar presentation

Clinic Perspective on Reducing Readmissions Dr. Hoing's webinar presentation

Alliance Community Check-up Results and Update

The 2011 Alliance Community Checkup is the fifth annual comprehensive report on health care performance in the Puget Sound region including medical groups, clinics and hospitals in King, Kitsap, Pierce, Snohomish and Thurston counties. This one-hour lunchtime webinar originally presented on September 29, 2011 summarized how well care is delivered at the medical group level on over twenty measures of quality and appropriateness, and was presented by Peter McGough, MD, UW associate clinical professor of family medicine and chief medical officer of the UW Medicine Neighborhood Health Centers, and Susie Dade, Deputy Director of the Puget Sound Health Alliance.

You Can't Manage What You Don't Measure Puget Sound Health Alliance webinar presentation

An Overview of Care Coordination Essentials

This webinar pdf presented an in-depth overview of the essentials for effective care coordination, giving participants a practical, four-part framework for improving how care is coordinated among clinical partners. Focused on the patient-centered medical home model of care delivery, the framework begins with taking responsibility for the care your patients receive regardless of setting and includes identifying the best practice service partners, building relationships with these partners, providing patient logistical support, and developing formal agreements and connections to improve care coordination. Ed Wagner, MD, MPH, FACP, a general internist/ epidemiologist and Director of the MacColl Institute for Healthcare Innovation at the Group Health Cooperative Center for Health Studies presented.

The Patient Centered Medical Home: Care Coordination webinar presentation

Reducing Health Disparities: Collecting Standardized Data

This webinar pdf presented a hands-on, practical approach to collecting and using standardized patient data about race, ethnicity and language to measure and reduce disparities in your practice. Although numerous focused studies have documented persistent differences in outcomes for minority patients, most medical practices are currently unable to quantify if disparities exist in health outcomes for their patients. Marcia Wilson, PhD, and Christina Rowland, MPH, of the Robert Wood Johnson Foundation’s Aligning Forces for Quality Project were co-presenters.

Reducing Disparities: The Importance of Collecting Standardized Data on Patient Race, Ethnicity and Language webinar presentation

Managing Depression in Primary Care

The second CPIN learning session was an hour-long webinar addressing the topic of managing patients with depression in primary care. The presenter was Dr. Jurgen Unutzen, chief of psychiatry, University of Washington Medical Center and director of the UW AIMS Center and the IMPACT Implementation Program.

Managing Patients with Depression in Primary Care seminar presentation

Physician Leadership in Quality Improvement; Using Registries to Improve Patient Care

The first CPIN learning session was a 90-minute in-person seminar. The session featured Ed Walker, MD, MHA, founding director of the UW Healthcare Leadership Development Alliance, speaking on the importance of physician leadership and engagement in quality improvement efforts at the practice level and Susanne Quistgaard, MD, family medicine physician at Edmonds Family Medicine Clinic, who spoke on using disease registries to improve outcomes by tracking patients with chronic conditions over time.

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