0000041107 00000 n . Based on national guidelines and emerging evidence and shaped by local expert opinion, this CPM provides practical strategies . This is the healthcare-specific version of what is known in lean terminology as "mass customization." 0000085699 00000 n Each visit is centred around a single theme to allow for a focused deep dive into that specialty. 0000044299 00000 n 0000008748 00000 n 0000008676 00000 n 0000003556 00000 n 0000010300 00000 n Incorporating the newly redesigned pathways into the EHR has had an immediate impact for RFL. 0000019636 00000 n 0000031239 00000 n 0000177340 00000 n startxref We recommend that child or caregiver complete the child traumatic stress screener while in the waiting room, prior to their appointment. 0000007513 00000 n Continue below to learn more about the implementing the Child Traumatic Stress Care Process Model in a pediatric primary care setting. 0000005756 00000 n 0000170251 00000 n 0000062870 00000 n 0000021559 00000 n See the Intermountain care process model Non-surgical Management of Ectopic Pregnancy DEVELOPMENT AND DESIGN OF Care Process Models Care Process Model MONTH 2015 2015 Update 0000065716 00000 n Intermountain Healthcare and Royal Free London are working toward a common goal of reduced clinical variance. The Child Traumatic Stress Care Process Model (CPM) offers an approach to be used in children's advocacy centers and pediatric primary care to identify children and families at risk of traumatic stress. E-mail. 0000073493 00000 n 0000006208 00000 n 0000050304 00000 n For children 6 18 years who report a potentially traumatic experience on the Pediatric Traumatic Stress Screening Tool (more information on this screening tool available in full CPM), the process of responding effectively to child traumatic stress involves three steps: Based on screening tool results, a brief in-office intervention targeting their most prominent symptom(s) has been shown to make a big difference for many children. 0000076267 00000 n 0000079372 00000 n This CPM includes two processes to address child traumatic stress across the pediatric lifespan. 0000004033 00000 n Andrew D. Auerbach, M.D., M.P.H., C. Seth Landefeld, M.D., and Kaveh G. Shojanie, M.D. 0000059703 00000 n 0000000016 00000 n Copyright 2023, Intermountain Healthcare, All rights reserved. 0000019314 00000 n Users are prohibited from doing any of the The clinical leadership for the digitisation programme is divided into RFLs four clinical divisions: Medicine, Surgery, Specialist Services, and Womens, Childrens and Diagnostics. 0000064797 00000 n 0000005795 00000 n Working with Intermountain and redesigning their methods of care represents a considerable shift for RFL and leaders have been deliberate about how these changes are introduced to doctors, nurses and others who provide care. 0000076040 00000 n 0000009151 00000 n 0000028737 00000 n 0000054116 00000 n Important features included creating meaningful alignment around value, building teams to drive the transition and implementing supportive workflows and technological innovations. 0000009144 00000 n 0000023018 00000 n 0000058232 00000 n 0000226180 00000 n 0000051827 00000 n 0000072602 00000 n Do I need to be a therapist to administer the screener or provide in-office interventions? CPM020 - 01/21 3 COPD CPM JANUARY 2021 TABLES TABLE 1. 0000034579 00000 n Prnom. 0000000016 00000 n 0000002947 00000 n %PDF-1.7 % 0000023593 00000 n Children in the severe and moderate traumatic stress symptom range will typically benefit from an intervention based on their symptoms, but clinicians may also choose to use a brief \H6Hl7% K{X0(%p* *\y~b!o^%CIe%'jR$b $zoE)fPBgf+"jf6yy/i>>XmHm!$ 0000086396 00000 n 268 0 obj <>stream 0000039661 00000 n For many children, belly breathing or mindfulness training (teens) will be able to slow down a racing heart or mind at bedtime to fall asleep easier or reduce the intensity of anxious / fearful or angry feelings. 0000087649 00000 n This is not like an IQ test or psychological testing where the results could be skewed. 0000054196 00000 n 0000050145 00000 n The multidisciplinary team is tasked with asking how they can improve the care processes within the programme. 0000005541 00000 n 0000179100 00000 n Its purpose is to summarize and promote evidence-based approaches to lifestyle and weight management, and to facilitate implementation in routine primary care. Helping people live the healthiest lives possible, Intermountain is widely recognized as a leader in clinical quality improvement and efficient healthcare delivery. Intermountain Healthcare is a Utah-based, not-for-profit system of 33 hospitals (includes "virtual" hospital), a Medical Group with more than 3,800 physicians and advanced practice clinicians at about 385 clinics, a health plans division called SelectHealth, and other health services. 0000065867 00000 n | Dr Chris Wood 0000177088 00000 n Because of its unique size and scope, Royal Free London was concerned with reducing variation across its venues of care while increasing quality and decreasing costs. 0000063674 00000 n 0000020531 00000 n 0000050331 00000 n 0000031441 00000 n 0000015893 00000 n 0000079310 00000 n 0000002990 00000 n endstream endobj 1718 0 obj <>/Filter/FlateDecode/Index[179 1481]/Length 57/Size 1660/Type/XRef/W[1 1 1]>>stream <<3AE4BE8F4CF5524D9372135619CC8848>]/Prev 518892>> 0000017396 00000 n 0000066540 00000 n 0000003093 00000 n 0000005140 00000 n 0000075636 00000 n 0000011817 00000 n 0000008067 00000 n 0000038525 00000 n RFL provides specialist services in liver and kidney transplantation, rare cancers, haemophilia, HIV, infectious diseases, plastic surgery, immunology, neurology, Parkinsons disease, vascular surgery, cardiology, amyloidosis and scleroderma. 0000066508 00000 n 2:1b``AY0 tbg(8/C3n0=~ They then work to continually refine and improve each care process. Intermountain monitors use of the Information Systems resources. 0000007049 00000 n 0000032530 00000 n 0000004712 00000 n 0000008244 00000 n Two of the first clinical programmes developed were cardiovascular, and women and newborns. 0000007949 00000 n 0000004263 00000 n The partnership with Intermountain has allowed us to learn the positive things, and the things theyve found difficult, the pitfalls and bear traps theyve discovered, and thats made it easier to be open to the perspective of people that have walked the journey before us.. Provides patient education as directed (content reflects specific MA training, guidelines, care process models, protocols). 0000079895 00000 n 0000089548 00000 n Published February 21, 2008, Harming Through Protection. 0000225797 00000 n 0000005294 00000 n 0000084852 00000 n Intermountain Healthcare is a Utah-based, not-for-profit system of 22 hospitals, a Medical Group with more than 1,600 physicians and advanced practice clinicians at about 180 clinics, a health plans division called SelectHealth, and other health services. %PDF-1.7 % Addressing unwarranted variance in care protocols and embedding those processes in the electronic health record (EHR) can be an effective way for healthcare leaders to impact both quality outcomes and their bottom lines. 0000015820 00000 n P , s &v. 0000176436 00000 n It has three main hospitals the Royal Free Hospital (founded in 1828 with the direct mission of providing free, quality care to patients with little or no means), Barnet Hospital and Chase Farm Hospital. 0000005448 00000 n Additional assistance with risk assessment: iCentra order algorithm, Score Line 801-50-SCORE ( providers only ), and Connect Care 801-442-4457. 0000165412 00000 n 0000013265 00000 n 0000026552 00000 n 0000021074 00000 n 0000024509 00000 n 0000005742 00000 n 0000008686 00000 n Click for details. 0000036974 00000 n Published February 21, 2008. 0000008500 00000 n 0000165722 00000 n 1425 82 0000009527 00000 n 1425 0 obj <> endobj 0000006529 00000 n Of all the approaches leaders can leverage to address these issues, reducing unwarranted clinical variance is receiving increased attention. 0000004619 00000 n 0000056318 00000 n >iDTPTTqbZ]w;$zm3{! 0000225756 00000 n Deming was also an advocate of considering systems as a whole, not as disparate smaller component parts that could be changed without influencing an entire operation. Providers and caregivers around the country are using the model to measure and improve key diabetic metrics, including A1C results, blood pressure control, and kidney . 0000004309 00000 n 0000002325 00000 n Choose a skill that you are comfortable teaching and share your knowledge with the families you see in clinic. Together, these components have allowed Intermountain to create integrated CPMs to manage practice guidelines and digital workflows that actively guide doctors toward the clinical decisions that will improve outcomes for patients. Published on 8 March 2019. 0000128388 00000 n "I`IvWdZ>B.nJ.o}LVL:}T{&!Qd4l;( q& Q/b2N$5%/wTg?8YSneUE+ When should the child or caregiver complete the traumatic stress screener? This care process model (CPM) is maintained by Intermountain Healthcare's Lower Respiratory Tract Infection Team, . Dr Streather noted that seeking out partnerships to improve is an essential part of growth, but that it is not always easy. If the child is younger than 10 or has developmental limitations, then the parent/caregiver can complete the screener for them. How old does a child need to be to complete the traumatic stress screener? 0000022000 00000 n Its good to see that even after 18 months of introducing a complex programme, we see the general enthusiasm growing daily.. 0000226638 00000 n 0000035552 00000 n The programme has evolved over the years, but the core philosophy is still the same the science of process management and change leadership is applied to healthcare leading to better quality, safety, cost and services outcomes. We are segmenting clinicians into clinical themes and having them evaluate pathways of care and look at the data that informs those pathways to determine how we can improve them in a systematic way. 0000076190 00000 n The way Royal Free reaches out to the community, thats a big push for Intermountain right now. Each pathway is redesigned in a series of at least two workshops and then iterated upon using Plan, Do, Study, Act (PDSA) cycles and Institute for Healthcare Improvement (IHI)-based Quality Improvement methodology. SEEK is an effective model for prevention of abuse / neglect in early childhood. 0000010567 00000 n The Intermountain Care Process Model recently developed the Pediatric Traumatic Stress Screening Tool to assess traumatic stress in children in the primary care setting and to help identify diagnostic criteria for PTSD. 0000177828 00000 n Box 581289 Salt Lake City, Utah 84158, A Short History of the Medical Home Portal, Pediatric Patient Summary-Medical Home Portal Project, Nevada Pediatric Mental Health Care Access Program (PMHCAP), Rhode Island Pediatric Psychiatry Resource Network (PediPRN), University of Utah Pediatric Resident Writing Elective, University of Utah Writing & Career Development Group, Utah Children's Care Coordination Network, Anxiety Disorders & Attention Deficit Hyperactivity Disorder (ADHD), Attention-Deficit/Hyperactivity Disorder (ADHD) & Disruptive Each of the eight stages of change has a corresponding pitfall. 0000048189 00000 n I think one of the problems in health systems is that good practice happens in a lot of places, but were not very good at learning from excellence in other places, said Dr Streather. :x-)KYYY"3%C_hS! 0000005681 00000 n 0000226944 00000 n 0000132101 00000 n 0000006881 00000 n 0000035663 00000 n 0000072122 00000 n 0000014692 00000 n 0000008863 00000 n Intermountain Healthcare: Towards an integrated, value-based model Intermountain (US) UH Bristol (UK) TTSH (Singapore) VCHI (US) Show sources Briefing paper Tackling waste is a difficult but. 0000005695 00000 n 0000017626 00000 n 0000009463 00000 n 0000041187 00000 n 0000070665 00000 n 0000010514 00000 n This care process model (CPM) and accompanying patient education were developed by a multidisciplinary team including primary . It takes humility to recognise that you dont have all the answers and seek out people who are leaders in their field, he said. 0000226561 00000 n 1660 60 hUiPG~=";.^qv12%&e-Kg.^OPxx7(w~X]"`~g The EHR data from every patient treated by CPMs offer further points to improve the next application of the CPM through a nearly real-time feedback loop. 0000004046 00000 n Copyright 2003-2020. If you will still be using Intermountain's network, systems or data, information about your use may be reviewed, 0000012129 00000 n 0000005441 00000 n The Services Directory has information about Nationwide providers. 0000006687 00000 n 0000084783 00000 n 0000176282 00000 n 0000038456 00000 n 0000017688 00000 n 0000032127 00000 n 0000031920 00000 n 0000012208 00000 n Intermountain will use a regional deployment strategy to bring all acute care facilities, ambulatory . Franklin G. Miller, Ph.D., and Ezekiel J. Emanuel, M.D., Ph.D. 0000023004 00000 n 0000022254 00000 n 0000087726 00000 n 0000008676 00000 n 0000118904 00000 n CPMs are meant to provide an evidence-based and standardised way to address the core clinical processes that matter most to their patients and clinicians. 0000078906 00000 n 0000044721 00000 n by Treesa Carter | James Hitter following: (1) modifying Intermountain data on any of Intermountain information systems; 0000007424 00000 n 0000005534 00000 n 0000070999 00000 n 0000025653 00000 n 5-Step Model for Creating a Virtuous Medical and Financing System to Enhance the Health and Well being of Future Generations. 0000170459 00000 n 6346 95 0000007488 00000 n 0000088537 00000 n 0000010857 00000 n Through our advanced training programme in clinical process improvement, we train senior leaders, middle management and front-line health professionals in the theory and application of cost and quality control. Failing to address variations can negatively impact the ability to provide quality, consistent, safe and cost-effective care. 0000013288 00000 n 0000079777 00000 n 0000006077 00000 n by Cerner UK 0000012415 00000 n Send us an email or give us a call if you have questions. Part of the partnership has been learning that it is not a one-to-one process of dropping in methodology from Intermountain to RFL, and that the Trust has adapted the ideas to their own circumstances. This care process model (CPM), produced by Intermountain Healthcare's Antibiotic Stewardship team, Community-Based Care, and Intermountain Pediatrics, is based on the American Academy of Pediatrics (AAP) Clinical Practice Guidelines. He brought with him a background in medical research, having previously held positions at the National Cancer Institute and the Harvard School of Public Health, as well as an interest in the theory and methods of W. Edwards Deming. Ping Identity Corporation. Care Process Model AUGUST 2016 The inside pages of this tool provide an algorithm and associated notes and can be folded open and posted in your office or clinic. 0000006220 00000 n height, weight, OFC, care process model data, etc.). This work was funded through federal grant monies allocated by the National Child Traumatic Stress Initiative (NCTSI), which is part of the Substance Abuse and Mental Health Services Administration (SAMHSA). 0000198367 00000 n Then make 3 key decisions. 0000015431 00000 n There can be reticence to learn from others and there can sometimes be the resistance to adopting something that was someone elses idea. 0000018163 00000 n startxref 0000010273 00000 n 0000007186 00000 n If this is an emergency please go to the nearest emergency room or call 911. By integrating our care process models into the EHR, we make sure that not only is the information where clinicians need it, when they need it, but its also baked into the soul of the organisation, Dr Allen said. 0000005907 00000 n WARNING: Intermountain Healthcare's Information Systems resources are for Intermountain approved purposes only. Behaviors, Attention-Deficit/Hyperactivity Disorder (ADHD) & Mood Disorders, Fetal Alcohol Spectrum Disorder Distinguished from Autism, Mucopolysaccharidosis Type I & Motor Development, Mucopolysaccharidosis Type I (MPS 1) Genetics, Mucopolysaccharidosis Type I (MPS 1) Hematopoietic Stem Cell Transplantation & endstream endobj 1661 0 obj <>/Metadata 177 0 R/Names 1662 0 R/Outlines 155 0 R/PageLayout/SinglePage/Pages 176 0 R/StructTreeRoot 179 0 R/Type/Catalog/ViewerPreferences<>>> endobj 1662 0 obj <> endobj 1663 0 obj >/PageWidthList<0 612.0>>>>>>/Resources<>/ExtGState<>/Font<>/ProcSet[/PDF/Text]/XObject<>>>/Rotate 0/StructParents 0/Thumb 171 0 R/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>> endobj 1664 0 obj [1665 0 R 1666 0 R 1667 0 R 1668 0 R] endobj 1665 0 obj <>/Border[0 0 0]/H/N/Rect[131.157 415.338 170.914 404.138]/StructParent 17/Subtype/Link/Type/Annot>> endobj 1666 0 obj <>/Border[0 0 0]/H/N/Rect[460.652 162.428 475.529 151.48]/StructParent 1/Subtype/Link/Type/Annot>> endobj 1667 0 obj <>/Border[0 0 0]/H/N/Rect[509.976 162.428 537.031 151.48]/StructParent 2/Subtype/Link/Type/Annot>> endobj 1668 0 obj <>/Border[0 0 0]/H/N/Rect[187.84 256.725 212.127 244.468]/StructParent 18/Subtype/Link/Type/Annot>> endobj 1669 0 obj <> endobj 1670 0 obj <> endobj 1671 0 obj <> endobj 1672 0 obj <> endobj 1673 0 obj <> endobj 1674 0 obj <>stream 0000065951 00000 n 0000006553 00000 n 0000007337 00000 n %%EOF Screen for child traumatic stress. 0000193542 00000 n 0000018223 00000 n 0000019018 00000 n 0000176512 00000 n 0000168976 00000 n 0000000016 00000 n 0000005093 00000 n 0000002281 00000 n 0000014401 00000 n Care Process Model JUNE 2013 This care process model (CPM) was created by a multidisciplinary team of physicians and other healthcare providers at Intermountain Healthcare. It turns out that clinical process management and improvement is our core business strategy.. 0000005250 00000 n All rights reserved. Mild range scores (0 10) protective approach, Moderate range (11 20) resilient approach, Severe range (21 or higher) restorative approach. 0000006843 00000 n 0000005286 00000 n 0000008313 00000 n 0000008541 00000 n CPM uses several different tools to look for trauma exposure (recent and remote events), suicidality and self-harm, and traumatic stress symptoms. 0000060731 00000 n 0000010474 00000 n 0000017260 00000 n ALL RIGHTS RESERVED. Acronym: CPM Targeted Populations: Ages 6-18; both males and females; for children who have experienced a wide range of traumas. 0000021696 00000 n Within a health system, unwarranted clinical variance is understood as the difference in clinical practices and services that do not derive from unique patient needs and that may involve the overuse, underuse or misuse of medical services. hb``0f``d`e` l,x70y7Yc[%Lq|cO 'rX)!2[HQ(WVE 0khhDGG; J@(}=bw&5_R 0000071295 00000 n 1 Resources for Parents and Caregivers 0 0000006937 00000 n 0000063196 00000 n 0000066307 00000 n Members of each clinical programme regularly review the core care processes within it using evidence from literature and data from Intermountains own EHR. 0000002797 00000 n 0000177263 00000 n 0000011770 00000 n 0000026052 00000 n 0000058433 00000 n The formalised nature of the partnership agreement has also allowed for knowledge sharing on a granular and practical level that might not have been possible if RFL had passively observed Intermountains processes one or two times. 0000066109 00000 n Special attention is also paid to who attends each visit to ensure all stakeholders are involved. 0000002388 00000 n Treatments, Prader-Willi Syndrome & Cognitive & Psychiatric Issues, Prader-Willi Syndrome and Complications from Obesity, Premature Infant and Retinopathy of Prematurity, Attention-Deficit/Hyperactivity Disorder (ADHD), Charcot-Marie-Tooth Disease (Hereditary Motor Sensory Neuropathy), Intellectual Disability & Global Developmental Delay, Postural Orthostatic Tachycardia Syndrome (POTS), Duchenne & Becker Muscular Dystrophy: Cardiomyopathy, MCADD (Medium-Chain Acyl-CoA Dehydrogenase), Somatic Symptom Disorder & Functional Neurologic Disorders, Carnitine Palmitoyltransferase 1A (CPT 1) Deficiency, Citrullinemia Type II & Citrin Deficiency, Guanidinoacetate Methyltransferase (GAMT) Deficiency, Holocarboxylase/Multiple Carboxylase Deficiency, Medium-Chain Acyl-CoA Dehydrogenase Deficiency (MCADD), Short/Branched Chain Acyl-CoA Dehydrogenase (SBCAD) Deficiency, Short-Chain Acyl-CoA Dehydrogenase Deficiency (SCADD), Very Long-Chain Acyl-CoA Dehydrogenase Deficiency (VLCADD), Screening Tests and the Diagnostic Process, After a Diagnosis or Problem is Identified, A New (or Old) Diagnosis - "You Are Not Alone", Building New Hopes and Dreams After a Diagnosis, Caring for Children with Special Health Care Needs, Complementary and Alternative Medicine (CAM), Foster Care of Children with Special Needs, Hospital Admissions, Inpatient Stay, and Discharge, Management and Prevention of Constipation in Children, Safety Precautions for Children with Seizures, Transportation and Travel for People with Disabilities, Choosing a Complementary and Alternative Medicine (CAM) Provider, From Preschool to Kindergarten/Elementary School, Tips for Single Parents of Children with Special Needs, When Parents of Children with Disabilities Divorce, Attention Deficit Hyperactivity Disorder (ADHD) (FAQ), Duchenne & Becker Muscular Dystrophy (FAQ), Intellectual Disability and Global Developmental Delay (FAQ), Mucopolysaccharidosis Type I (MPS I) (FAQ), Neonatal Opioid Withdrawal Syndrome (NOWS) (FAQ), Postural Orthostatic Tachycardia Syndrome (POTS) (FAQ), Transgender and Gender-Diverse Youth (FAQ), Everyday Strategies to Help Improve Wellness, Thoughts From a Single Parent of a Great Kid, A Parent Perspective on Dealing With Ignorance, Services for the Uninsured or Under-Insured, Understanding the Affordable Care Act (ACA) and the Health Insurance Marketplace, Causes of Hearing Loss, with ICD-10 codes, Coding for Developmental & Mental Health Screening, About Children & Youth with Special Health Care Needs (CYSHCN), Questions & Answers about Care Coordination, Children with Short Stature Born Small for Gestational Age, Drooling in Children with Special Health Care Needs, Mild Traumatic Brain Injury (TBI) & Post-concussive Syndrome, Neonatal Opioid Withdrawal Syndrome (NOWS), Pain in Children with Special Health Care Needs, CBD for Neurologic Conditions in Children, Childhood Epilepsy with Centrotemporal Spikes (CECTS), Evaluation & Treatment of a First Unprovoked Seizure, Medical Conditions Affecting Sleep in Children, Sleep Disorders & Parasomnias in Children, Toilet Training Children with Complex Medical Conditions, Attention-Deficit/Hyperactivity Disorder (ADHD) for Educators, Boosting Calories for Babies, Toddlers, and Older Children, Feeding & Swallowing Problems in Children, Feeding Tubes & Gastrostomies in Children, Nutrition & Growth in Children with Complex Conditions, Bilirubin Screening & Testing in Newborns, Clinical Guidelines for Care of Children with Medical Complexity, Evaluation for Suspected Ehlers-Danlos Syndrome, Newborn Differences of Sex Development (DSD) Admission Checklist, Congenital Cytomegalovirus (CMV) Related Hearing Loss, Folic Acid Supplementation & Neural Tube Defects, Infant & Early Childhood Social-Emotional Screening, Mental Health Screening for Children & Teens, https://www.medicalhomeportal.org/clinical-practice/guidelines-and-algorithms, Utah Department of Health & Human Services, Nevada Division of Public and Behavioral Health, Centers for Medicare and Medicaid Services (CMS), Ohio Department of Health, Bureau of Maternal, Child & Family Health, Childrens Medical Services/Children with Special Needs, New Mexico Department of Health, Rhode Island Title V/Maternal and Child Health Program, Check the URL you entered to make sure it is correct.