Are you in "Compliance"?

It is important to be truthful about culturally competency efforts, it is not enough to have signage in different languages or have bilingual staff. What is the true meaning and purpose of cultural competence? Can we explain it? Don't tell me the rehearsed definition, tell me what you feel is the right explanation. 

Helen Dao, MHA

"Care Coordination Model: Better Care at Lower Cost for People with Multiple Health and Social Needs"

This is a great paper to read, it illustrates a model that embraces all the different needs of patients such as medical, psychological, and social.  This model is already being used by different States (CMS) in the structure of the Health Home, which primary goal is to provide comprehensive care coordination to people with multiple chronic conditions, high hospital utilizations (not having an assigned medical home provider) mental health needs, drug and substance abuse, plus social determinants of health such as housing, access to food, employment, etc.  Care coordination is a necessary, not just the right thing to do, unfortunately reimbursement is not yet being taking into account by CMS, which hinders practices to provide comprehensive care coordination services to those that are most needed. However, we know that there are some new initiatives around care coordination with some payment incentives, the Health Home being on of them, which still in the infancy stages, but some progress is being made.



Care Coordination Model: Better Care at Lower Cost for People with Multiple Health and Social Needs

Connecting Health Care Providers with Patients/Families

For most part, patients feel comfortable with their health care provider. They often keep all the medical appointments, call in for refills, and sometimes will keep an specialist appointment.  However, the gap of communication continues to exist, and patients may not identify their health care provider as the person to go to for all their medical needs. Here is where we talk about care coordinator, they are key individuals to serve as the "go to" person,  a liaison, an advocate, in some cases cultural brokers and mediators. Care coordinators serve the role as medical/mental health services connectors, they link patients with the appropriate health care providers. They also serve the role as community navigators, identifying and connecting patients with resources and services. 

Care coordinators are a vital component of the medical home, they are the glue to an continum expanding model and are the fibers that link all medical, mental health, social services, natural support systems, structural systems, community resources, and the health care system. 

Below is a links for the Health Care Research and Science that has a complete definition and resources for care coordination services. 

www.ahrq.gov/...care/.../coordination/

Care coordination

About the Author 

Helen Dao, MHA

A Public Health Consultant 

www.daoconsultingservices.com

Dao Management Consulting Services, Inc.: PATIENT’S/FAMILY’S CULTURAL AND LINGUISTIC ASSESSM...

Dao Management Consulting Services, Inc.: PATIENT’S/FAMILY’S CULTURAL AND LINGUISTIC ASSESSM...: Here is a great tool that we have developed for health care providers and care managers to use with patients and families during a visit or ...

PATIENT’S/FAMILY’S CULTURAL AND LINGUISTIC ASSESSMENT CARD®

Here is a great tool that we have developed for health care providers and care managers to use with patients and families during a visit or an intake.  We beleive that it important to learn as much as we can about patients/families cultural and linguistic background in order to access and provide effective care and services.

It can be difficult to know and understand the diverse needs of patients and families when cultural and linguistic needs are unknown or misunderstood.  Having insight into the patients’ cultural, ethnic, and linguistic background can help avoid miscommunication and the potential for misdiagnosis or poor adherence to treatment and appointments follow-up.

This tool was designed, as a vehicle to collect pertinent information about the patient/family cultural and linguistic needs.  The tool should be implemented in two stages:

1. The first section is for the patient/family to answer during the intake process.
2. The second session is for the health care provider/care manager to complete post-visit based on his/her observations during visit.

By completing this tool, we hope that the practice will identify its strength and vulnerable areas such as lack of appropriate language services, low level of staff training on cultural and linguistic appropriate services, the need for a cultural broker, and creating a practice environment where there is a two way communication between the provider and patient/family.

Here is the link to our tool, hope you find it useful.

DAO_patientfamilyculturalandlinguisticassessmentcard

About the Author:

Helen Dao, MHA

A Public Health Consultant

www.daoconsultingservices.com

201-448-2046

Dao Management Consulting Services, Inc.: Patient/Family-Centered Medical Home and Care Coor...

Dao Management Consulting Services, Inc.: Patient/Family-Centered Medical Home and Care Coor...: Care coordination is the centered-piece of the patient/family centered medical home model.   On a daily basis primary care...

Patient/Family-Centered Medical Home and Care Coordination

Care coordination is the centered-piece of the patient/family centered medical home model.  On a daily basis primary care providers work hand and hand with care managers to ensure patients have access to appropriate preventive care services, community resources, education, and information about their treatment plan, and to behavioral health services.  Care coordination has become an essential component and a necessary of a practice daily operation, clinical outcomes goals, and organization’s policies changes.  A well-positioned organization will ensure that care coordination is a vehicle of change and a model that can be incorporated at every level of the organization and engages every member.

Below are some key components that we help practices focus on:

• Evaluate strengths and areas for improvement in implementation of care coordination within the medical home model
• Develop are coordination team action plan to improve collaboration and teamwork in the practice
• Focus on proactive, longitudinal care within the patient/family-centered medical home
• Identify and use tools to integrate patient and family input throughout the course of care
• Improve communication and accountability among providers within the medical home model
• Recognize the role of care coordinators working collaboratively to improve patient’s goals
• Explore the nature and dynamics of “care coordination partnerships”
• Identify, understand, and address barriers related to cultural diversity and appropriate language access
• Understand the social and economic determinants of health impacting patients
• Recognize barriers to assessing health-related social service needs
• Develop strategies to address health-related social service needs in the patient/family-centered medical home
• Recognize socio-economic factors impacting development and treatment of disease

h    About the Author:

      Helen Dao, MHA

      Public Health Consultant

      helen@daoconsultingservices.com

"Culturally Tailored Chronic Disease Education Program Improves African American Patients' Self-Management Behaviors -AHRQ Innovations Exchange"

This is a very interesting article, very similar to the work we are doing with care navigators. We track diabetes composite and compare the pe-QI project data to progress data every 3 months. Great article to read.



Culturally Tailored Chronic Disease Education Program Improves African American Patients' Self-Management Behaviors, Blood Pressure and Blood Glucose Control, and Quality of Life | AHRQ Innovations Exchange



Helen Dao, MHA

www.daoconsultingservices.com

Dao Management Consulting Services, Inc.: Teaching Health Care Quality to Care Managers

Dao Management Consulting Services, Inc.: Teaching Health Care Quality to Care Managers: It is important for care managers to know and understand how their daily work is linked to health care quality.  Everyday, care managers hel...

Teaching Health Care Quality to Care Managers

It is important for care managers to know and understand how their daily work is linked to health care quality.  Everyday, care managers help patients to access health care services and social services in order to help them meet their goals in life.  Health care quality is not only related to clinical measures, it also relates to non-clinical goals and to patient's safety.  knowing and understanding for care managers about the work they do and how is directly connected to the patient's health care and safety is crucial.

If you are a care manager or are responsible for a care coordination program, how do you train your care managers to identify clinical measures and safety measures associated with the daily services they provide to their patients?  Do you spend time doing in-service about health care quality, or do you use existing opportunities in your practice such as HEDIS measures? What I have experienced in my work with care managers that do not have clinical background, is that we must remember to teach and test their knowledge and understanding in how to structure the patient's clinical and non-clinical goad with health care quality.  The reality is that not all practices have the financial resources to hire RNs or other clinicians to perform the work as a care manager.  This is  a challenge that many practice phase and it is only to the patient best interest that we train non-clinician care managers to know the basics and build confidence around health care quality.

Here are some suggested activities:

• Select a QI project, for example hospital readmission, diabetes A1c control or last full eye exam.
• Meet with the care managers and explain the project from A to Z.
• Develop a QI data collection tool.
• Explain how they will go about collecting data for a baseline and what the sample size means.
• Do not assume all care managers may know bout QI projects processes
• Stay true to your periodic data review and provide feedback to the care managers on what the data tells you.
• Identify a champion in the team that will remind care managers to monitor patients progress and document data.
• Assist care managers to partner with patient's primary provider on the QI project to monitor the clinical interventions and the non-clinical interventions that help patients meet their goals.

Of course, this is an ongoing education and training task for the care managers, but it is very important.

I welcome you to share your own experiences with QI project and getting care managers involve!

Helen Dao, MHA

helen@daoconsultingservices.com

www.daoconsultingservices.com

Care Coordination Connects

Care managers are charged with the responsibility of connecting patients and families to community resources. At the same time they have the responsibility to identify appropriate community services where agencies can make that connection with patients needs. It is essential to understand that the connection between patients and community organizations is a two-way street, such as referring patients for services as well community organizations becoming aware of care management agencies and referring their consumers to such services. 

Care Coordination - A Way to Improving Clinical Quality Measures

Care Coordination, a way to improving clinical quality measures. We are working with a group of care coordinators in tracking and measuring clinical and non-clinical interventions with patients with diabetes type 1 and type 2. This QI project involves 70 patients, Hispanic, African Americans, and caucasians. 

This project tracks the patient's HbA1c control level, Lipid, full eye exam, foot examination, blood pressure. We should have the first set of data by the end of August, stay tuned, we will share our progress with all of you!



Helen Dao, MHA
helen@daoconsultingservices.com
www.daoconsultingservices.com

HHS announces the availability of $100 million in Affordable Care Act funding to expand access to primary care through new community health centers

HHS announces the availability of $100 million in Affordable Care Act funding to expand access to primary care through new community health centers

Integrating Day to Day Cultural Competency Knowledge Into Community-Based Program

I am getting ready to do a workshop on cultural competence integration in community-based programs. This is a great opportunity to translate theory into practice. One of my passions is to use transparency to integrate day to day cultural awareness and practices into programs integrated into the community. The best part of it is to see it developed, how staff and patients interact without them knowing that they are using cultural competence skills to have a clear and respectful communication despite of cultural diversity.

Helen Dao, MHA
helen@daoconsultingservices.com
www.daoconsultingservices.com

Building a team of care coordinators

Building a team of care coordinators: One of the things that we have learned during the process of working with clients in building effective and productive teams of care coordination is integration of patient direct service delivery and practice systems impact.

Helen Dao, MHA
helen@daoconsultingservices.com

Thinking Recognition...

If you are a practice getting ready to apply for NCQA PCMH recognition, there are a few things you should keep in mind before getting started:

* Identify an application facilitator, this person will be responsible for overseeing all your application activities and doing the final review of all documentation.

* Once you are ready to get started try focusing on the "Must Pass" elements and the "Critical Factors" because if you do not pass any of the "Must Pass" elements, your application is done  The same attention should be given to the "Critical Factors", standards will required that in addition to passing the factors you need to pass the standards, it is also required to pass the "Critical Factors".

* Make sure that you organize all your documents by standards and factors, it can get a bit confusing if good organization skills are not invested.

*Cross reference your documents with each standard and factor prior and during uploading to the ISS NCQA website.

*One you upload all your documents to reach of the elements, do another cross reference and do NOT forget to link each of the documents 

We hope you find these tips useful, let us know if you have any questions and will answer them as they come.

Good luck!

Helen Dao

helen@daoconsultingservices.com

"The Art and Science of Person- and Family-Centered Care"

I watched this video and thought about using it for staff/clinician training on patient-and family centered care approach.  I believe this clip can be used as an ongoing reinforcement of the reasoning behind the Medical Home and how to continuously motivate staff.



Check it out...



The Art and Science of Person- and Family-Centered Care



Helen Dao, MHA

Healthcare Consultant

Dao Management Consulting Services, Inc.

www.daoconsultingservices.com

Achieving Higher Standards of Excellence

Congratulations to Union Community Health Center, Bronx NY for getting recognized by NCQA as a level 3 Patient-Centered Medical Home. Helen Dao was the lead facilitator for the NCQA PCMH application!

This is one part of the work that many hospitals and Practices are taking on to reach the goal of achieving higher standards of excellence.  During this process, we learned a lot, we realized that every single staff, service, IT component are so vital to the understanding the workflow and operations of a single healthcare system or multiple systems. 

Helen Dao, MHA
Healthcare Consultant
Dao Management Consulting Services, Inc.
www.daoconsultingservices.com

Dao Management Consulting Services, Inc.: New and Exciting Program for Primary Care Health C...

Dao Management Consulting Services, Inc.: New and Exciting Program for Primary Care Health C...: Cultural and Linguistic Appropriate Services for Multicultural Communities A Program Primary Care Health Centers The purpose of this...

New and Exciting Program for Primary Care Health Centers

Cultural and Linguistic Appropriate Services for Multicultural Communities

A Program Primary Care Health Centers

The purpose of this program is to gain an understanding of a high- level performing primary practice through the integration of cultural & linguistic appropriate services.   The goal is to ultimately provide tools and enhance the skills and knowledge of primary care providers in delivering comprehensive health care and education to multicultural populations.  The need and rationale to integrate cultural competence into organizational policy are numerous. The National Center for Cultural Competence six compelling reason: Respond to current and projected demographic changes in the United States, eliminate longstanding disparities in the health status of people of diverse racial, ethnic and cultural background, improve the quality of service and health outcome, meet legislative, regulatory and accreditation mandates, gain a competitive edge in the market place, and decrease the likelihood of liability/ malpractice claims. 

In a multicultural society such as ours, health professionals are more likely than ever to encounter cultural differences challenges based on people backgrounds, cultures, and socioeconomic levels. Nearly one in five Americans (19%) will be an immigrant in 2050 (Pew Hispanic Center, 2008).

Training Course Description (One full day training and available as a series of webinars)

This training is a case-based approach to promote discussion about cultural and linguistic appropriate services in primary care practices.  It will provide participants with important facts, concepts and principles concerning the major ethnic groups and sub-groups residing in their region or State.  Participants will gain an understanding of strategies to address cultural and linguistic barriers, cultural diversity and linking quality measures to cultural awareness, promoting positive attitudes, and enhancing communication.  The goal is to ultimately enhance the skills, knowledge, and understanding in delivering comprehensive health care services for multicultural communities.  This is an evidence-based curriculum, adapted from the National Center for Cultural Competence Curricula Enhancement Module Series.

This training is designed on field experiences and case studies, it is important to understand that a community is made out of a collective group of individuals. It consists of multiple cultures, ethnicities, and races. Because every community is different, it is essential to understand its needs such as social issues, health care, and mental health.

Participatory Nature of Curriculum

• Participants will learn from one another through open, facilitated discussion.
• Participants will benefit from the curriculum in different ways.
• Mastery of ideal cultural and linguistic appropriate services is an evolving and experiential process.

Curriculum Matrix

Session I          Concepts and Framework of Cultural & Linguistic Competency

Session II         Linking Quality Measures to Cultural Awareness

Session III        Rationale for the Critical Importance of Cultural Self-Assessment  

Session IV        Process of Inquiry - Communicating in a Multicultural Environment

For more information contact us at Helen@daoconsultingservices.com

Phone: 201-448-2046 or 201-686-7152

www.daoconsultingservices.com