On June 6, 2014 – a beautiful late spring day – the PAFP Foundation’s Residency Program and Community Health Center Collaborative (RPC/CHCC) came together for a one-day learning session at the Lancaster County Convention Center in Lancaster. As part of a year-round interdisciplinary learning program, this face-to-face event was the second of three annual educational programs.
The teams participating in the Residency Program and Community Health Center Collaborative receive year-round education in quality and performance improvement to positively affect patient outcomes. The topics covered at the June live learning session included education for both providers and non-providers on managing patients with chronic pain, diagnosing and treating depression, and providing team-based, coordinated care.
The teams also submit monthly quality data to the PAFP Foundation on diabetes, ischemic vascular disease, smoking, depression, and body mass index screening. Asthma measures have been added and are currently a voluntary reporting measure. This new measure will be made mandatory following the eventual implementation of the ICD10 codes. The PAFP Foundation is committed to helping the practices utilize their electronic health records (EHR) systems and to obtain and submit the most accurate data. Hands-on assistance from the PAFP Foundation’s EHR and data experts will be employed to assist these collaborative practices.
The RPC/CHCC teams sent a total of 91 representatives to the learning session. This group of learners included 76 clinical and 15 non-clinical participants. Teams created plan-do-study-act (PDSA) rapid-response action plans based on the education provided at the conference; they’ll implement the PDSAs back home in their practices, involving the whole practice staff and spreading the learning to a larger audience.
Tweets and Notes
The PAFP Foundation’s effort to expand the educational reach of all live events includes encouraging faculty members, staff and attendees to actively tweet during these live sessions. Here is a sampling of their tweets and some notes from select lectures. Don't forget to follow us on Twitter!
TOPICS: Managing Chronic Pain in Primary Practice | Collaborative Care for Depression: Implementing Evidence-based Enhancements in Primary Care Practices
MANAGING CHRONIC PAIN IN PRIMARY PRACTICE
Docs often inherit chronic pain patients who were diagnosed and prescribed meds by other docs.
Chronic pain: pain as the 5th vital sign really kicked off opioid prescribing.
Chronic pain is non-cancer pain lasting beyond 3 months or beyond expected healing.
Non-cancer pain is OA, neuropathic, fibromyalgia, non-specific low back pain.
Chronic pain:topical creams can be effective but patients should be careful about touching other body parts during application.
Mindfulness stress reduction is effective in reducing emotional suffering that comes from chronic pain.
Validate the patient's chronic pain, but reassure them it's not an emergency. Chronic pain won't kill you.
Practice personnel develop biases, frustration with pain patients' demands, behaviors. We must be aware and retain compassion.
Develop chronic pain policies/guidelines for practice: documentation dx, primary complaint, urine screen, depression screens, and contract.
Chronic pain: leverage all members of the PCMH team to support patient; natural in Chronic Care Model.
Work flow is important. When patients' calls aren't promptly returned, patients' trust in relationship erodes.
Power in perspective: goal-oriented approach can focus on improvements to be achieved rather than on negative of pain.
Excellent review of dangers but also other options in truly caring for chronic pain in PCMH way. Thanks Mark! Picture
COLLABORATIVE CARE FOR DEPRESSION: IMPLEMENTING EVIDENCE-BASED ENHANCEMENTS IN PRIMARY CARE
Depression integration isn't just co-location - think collaborative care.
A good depression diagnosis assessment will help you ID patients with major depression. Everybody else only gets placebo benefit.
Depression: Don't use PHQ9 at every visit - 1st visit, annual visit, pts presenting symptoms - and do the PHQ2 first.
Depression collaborative care model includes patient, depression care manager, mental health specialist, primary care doc.
If you want to move the needle on depression care, you need a depression care manager to follow up with patients and work with the team.
Depression PHQ9 scoring in EHR - it's used for provisional diagnosis and maintenance. Check to see how your EHR scores the PHQ9.
