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Onsite Quarterly Meeting SIPP PIPs. Presenter: Christy Hormann, LMSW , CPHQ Project Leader-PIP Team. June 13, 2012. Overview of Presentation. Progression of SIPP PIPs SFY 2012 validation results Areas for improvement. SFY 2011 SIPP PIPs. First year SIPPs completed the PIP process - PowerPoint PPT Presentation
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Onsite Quarterly MeetingSIPP PIPs
June 13, 2012
Presenter:
Christy Hormann, LMSW, CPHQProject Leader-PIP Team
Overview of Presentation
Progression of SIPP PIPs
SFY 2012 validation results
Areas for improvement
SFY 2011 SIPP PIPs
First year SIPPs completed the PIP process
Each SIPP required to submit one PIP
Total of 14 PIPs were submitted
SFY 2011 SIPP PIPs cont.
One was completed through Activity VI
13 were completed through VIII
Initial scores were lower due to lack of the proper documentation
SFY 2012 SIPP PIPs For SFY 2012, the SIPPs were required to
submit the collaborative PIP and a PIP topic of their choosing
Some of the individual SIPP topics were increasing family participation in treatment, minimizing weight gain during treatment, and reducing readmissions
SFY 2012 SIPP PIPs cont.
There were a total of 27 PIPs submitted for validation
Six PIPs were assessed through Activity VI Four PIPs were assessed through Activity
VII Five PIPs were assessed through Activity
VIII
SFY 2012 SIPP PIPs cont. Twelve PIPs were assessed through Activity
IX None of the PIPs were assessed for Activity
X-Sustained Improvement
PIP Stages
III. OUTCOMES
II. IMPLEMENTATION
I. DESIGN
Study Design Stage Establishes methodological framework for
the PIP Includes development of study topic,
question, indicators, and population (Activities I through IV)
A strong study design is necessary for the successful progression of a PIP
Study Design Stage Evaluation Elements
Activity I: Study Topic Reflects high-volume or high-risk
conditions Is selected following collection and analysis
of data
Study Design StageEvaluation Elements
Activity I: Study Topic Addresses a broad spectrum of care and
services Includes all eligible populations that meet
the study criteria Does not exclude members with special
health care needs Has the potential to affect member health,
functional status, or satisfaction
Study Design StageEvaluation Elements
Activity II: Study Question States the problem to be studied in simple
terms Is answerable
Study Design StageEvaluation Elements
Activity III: Study Indicators Are well-defined, objective, and measurable Are based on current, evidence-based
practice guidelines, pertinent peer-reviewed literature, or consensus expert panels
Allow for the study question to be answered
Study Design StageEvaluation Elements
Activity III: Study Indicators Measure changes (outcomes) in health or
functional status, member satisfaction, or valid process alternatives
Have available data that can be collected on each indicator
Study Design StageEvaluation Elements
Activity III: Study Indicators Are nationally recognized measures, such
as HEDIS technical specifications, when appropriate
Includes the basis on which indicator(s) was adopted, if internally developed
Study Design StageEvaluation Elements
Activity IV: Study Population Is accurately and completely defined Includes requirements for the length of a
member’s enrollment in the MCO Captures all members to whom the study
question applies
SIPP Design Stage ResultsStudy Stage Activity Met Partially
MetNot Met
Design
I. Appropriate Study Topic* 87%(139/160)
3%(4/160)
11%(17/160)
II. Clearly Defined, Answerable Study Question(s) 74%
(40/54)11%
(6/54)15%(8/54)
III. Clearly Defined Study Indicator(s)* 68%
(86/127)9%
(11/127)24%
(30/127)
IV. Correctly Identified Study Population
75%(48/64)
14%(9/64)
11%(7/64)
Design Total*
77%(313/405)
7%(30/405)
15%(62/405)
* The activity or stage total may not equal 100 percent due to rounding.
Study Implementation Stage Includes sampling, data collection, and
interventions (Activities V through VII) During this stage, MCOs collect data,
evaluate and identify barriers to performance, and development interventions targeted to improve outcomes
The implementation of effective improvement strategies is necessary to improve PIP outcomes
Study Implementation StageEvaluation Elements
Activity V: Sampling Consider and specify the true or estimated
frequency of occurrence Identify the sample size Specify the confidence level Specify the acceptable margin of error
Study Implementation StageEvaluation Elements
Activity V: Sampling Ensure a representative sample of the
eligible population Are in accordance with generally accepted
principles of research design and statistical analysis
Study Implementation Stage Evaluation Elements
Activity VI: Data Collection The identification of data elements to be
collected The identification of specified sources of
data A defined and systematic process for
collecting baseline and remeasurement data A timeline for the collection of baseline and
remeasurement data
Study Implementation Stage Evaluation Elements
Activity VI: Data Collection Qualified staff and personnel to abstract
manual data A manual data collection tool that ensures
consistent and accurate collection of data according to indicator specifications
A manual data collection tool that supports interrater reliability
Study Implementation Stage Evaluation Elements
Activity VI: Data Collection Clear and concise written instructions for
completing the manual data collection tool An overview of the study in written
instructions
Study Implementation Stage Evaluation Elements
Activity VI: Data Collection Administrative data collection algorithms/
flow charts that show activities in the production of indicators
An estimated degree of administrative data completeness
Study Implementation Stage Evaluation Elements
Activity VII: Interventions Related to causes/barriers identified through
data analysis and quality improvement processes
System changes that are likely to induce permanent change
Revised if the original interventions are not successful
Standardized and monitored if interventions are successful
SIPP Implementation Stage Results
Study Stage Activity MetPartially
Met Not Met
Implementation
V. Valid Sampling Techniques (if sampling was used) 86%
(6/7)0%(0/7)
14%(1/7)
VI. Accurate/Complete Data Collection* 58%
(159/272)13%
(36/272)28%
(77/272)
VII. Appropriate Improvement Strategies 70%
(45/64)11%
(7/64)19%
(12/64)
Implementation Total61%
(210/343)13%
(43/343)26%
(90/343)
* The activity or stage total may not equal 100 percent due to rounding.
Outcomes Stage The final stage of the PIP process
(Activities VIII through X) Involves data analysis and the evaluation of
improvement based on the reported results and statistical testing
Sustained improvement is achieved when outcomes exhibit improvement over multiple measurements
Outcomes Stage Evaluation Elements
Activity VIII: Data Analysis Are conducted according to the data
analysis plan in the study design Allow for the generalization of results to the
study population if a sample was selected Identify factors that threaten the internal or
external validity of findings Include an interpretation of findings
Outcomes Stage Evaluation Elements
Activity VIII: Data Analysis Are presented in a way that provides
accurate, clear, and easily understood information
Identify the initial measurement and the remeasurement of the study indicators
Identify statistical differences between the initial measurement and the remeasurement
Outcomes Stage Evaluation Elements
Activity VIII: Data Analysis Identify factors that affect the ability to
compare the initial measurement with the remeasurement
Include an interpretation of the extent to which the study was successful
Outcomes Stage Evaluation Elements
Activity IX: Real Improvement The remeasurement methodology is the
same as the baseline methodology There is documented improvement in
processes or outcomes of care The improvement appears to be the result of
planned intervention(s) There is statistical evidence that observed
improvement is true improvement
Outcomes Stage Evaluation Elements
Activity X: Sustained Improvement Repeated measurements over comparable
time periods demonstrate sustained improvement or that a decline in improvement is not statistically significant
SIPPs Outcomes Stage ResultsStudy Stage Activity
MetPartially
Met Not Met
Outcomes
VIII. Sufficient Data Analysis and Interpretation*
54%(63/116)
17%(20/116)
28%(33/116)
IX. Real Improvement Achieved54%
(26/48)21%
(10/48)25%
(12/48)
X. Sustained Improvement Achieved ‡ ‡ ‡
Outcomes Total*
54%(89/164)
18%(30/164)
27%(45/164)
* The activity or stage total may not equal 100 percent due to rounding.‡ The PIPs did not progress to this phase during the review period and could not be assessed for real or sustained improvement.
SIPP Indicator Results There were a total of 44 study indicators 22 were not assessed for improvement 15 demonstrated improvement Of those that demonstrated improvement,
11 demonstrated statistically significant improvement
SIPP Indicator ResultsSFY 2012 Performance Improvement Project Outcomes
for the SIPPs (N=27 PIPs)
SIPPs Total Number of Study Indicators
Comparison to Study Indicator Results from Prior Measurement Period
Sustained Improvement
1Declined
Statistically Significant
DeclineImproved
Statistically Significant
ImprovementNot
Assessed
Plan A 3 0 0 0 2 1 ‡
Plan B 3 0 0 0 0 3 ‡
Plan C 3 0 1 0 1 1 ‡
Plan D 3 0 0 2 0 1 ‡
Plan E 3 1 1 0 0 1 ‡
Plan F 2 0 0 0 0 2 ‡
Plan G 3 0 0 0 2 1 ‡
Plan H 3 0 0 0 0 3 ‡
Plan I 3 0 0 0 2 1 ‡
Plan J 3 0 1 0 1 1 ‡
Plan K 3 0 0 1 1 1 ‡
Plan L 3 1 0 1 0 1 ‡
Plan M 4 0 2 0 0 2 ‡
Plan N 5 0 0 0 2 3 ‡
Overall Totals 44 2 5 4 11 22 ‡
1 One or more study indicators demonstrated sustained improvement.‡ The PIP(s) did not progress to this phase during the review period and/or required an additional measurement period; therefore, sustained improvement could not be assessed.
Common Areas for Improvement
Activity I: Study Topic No historical plan-specific data provided to
support the selection of the study topic (Evaluation Element #2)
Common Areas for Improvement
Activity IV: Study Population Length of enrollment required not specified
(Evaluation Element #2)
Common Areas for Improvement
Activity VI: Data Collection Timeline for data collection not provided
(Evaluation Element #4) Not all information regarding manual data
collection was provided (Evaluation Elements #5-9)
Common Areas for Improvement
Activity VIII: Data Analysis Baseline data and data analysis not reported
in this year’s submission (Evaluation Elements #1-5)
Recommendations Use the PIP Summary Form Completion
Instructions when documenting the PIP Summary Form
If you have questions, contact HSAG for technical assistance
HSAG ContactsFor any PIP questions or to request PIP technical assistance contact:
Christy [email protected]
Jenny [email protected]
Questions