Projects

Chronic Disease Management

Compliance with State and CDC Opioid Prescribing Guidelines

  • Revision of prescribing standard

  • Revision of visit standard including pre-visit work, documentation, problem list management, visit summary

  • Development of patient-facing documents (medication agreement, notice to patients)

  • Opioid Standard Compliance Audit development and analysis

  • Revisions of Medication-Assisted Treatment Protocol for Opioid Use Disorder Treatment using suboxone

  • Lead for Opioid Prescription Case Review Committee

  • Crafted a separate standard for benzodiazepine/z-drug prescribing

COVID-19 Telehealth Visit Protocol

  • RN-based triage system for those qualifying for antivirals

  • Standardized documentation

  • Piloted virtual health platform and workflow development

Anticoagulation Program

  • Major overhaul of outpatient policy and RN-led visit standard

  • EMR workflow optimization

  • Development of adverse event tracking system and case review

  • Supported implementation of the University of Washington-based Collaborative Care model for mental health treatment with a behavioral health specialist, psychiatric specialist, and primary care

Integrated Behavioral Health Model

Preventive Care

  • Collaborated effort with pediatrics department to create standard of well child care within organization

  • Standardized visit content, documentation, offered screenings

Well Child Checks

  • Developed pre-visit worksheet, explanatory letter of visit to patient

  • Designed RN-led visit, devised training, and implemented new visit workflow

Medicare Wellness Visits

Practice Management

Case Study: Consolidating Primary Care Clinic Sites

A rural, hospital-owned primary care practice with a large Medicare population delivered care at three locations. Disparate distribution of resources led to accessibility, coverage, and reimbursement issues.

Consolidating two of the clinic sites facilitated sharing of staff and resources, a more unified culture, as well as recouped lost income from the CMS site-neutral policy.

Read the entire case study here.

  • Analyzed and provided ongoing optimization of panel sizes based on multiple practice variables

  • Developed department-level practice panel management

  • Managed internal PCP transfer requests to avoid over/under empanelment

Primary Care Panel Management

EMR Inbasket Project

  • Standardized routing to team-members integrated with EMR workflows

  • Created training module for RNs on triage of patient portal messages

  • Standardized refill request documentation

  • Mapped flow and documentation of physical paperwork

  • Increased established patient access by 20% through template change, reducing wait times for chronic disease management while improving continuity

  • Created reliable and consistent access for new patients to the practice

  • Expedited access for new patients with an urgent medical condition

Template Standardization

Advanced Practice Clinician (APC) Integration

  • Revised practice model for APCs, including clarification of roles and supervision

  • Supervised early-career APCs in medical knowledge and practice management through regular oversight and implementation of a practice development checklist

  • Developed standardized chart review tool and performed regular cadence of chart reviews

Team Documentation (MAs as scribes)

  • Created knowledge-based and experiential training module with EMR involving clinicians and MAs learning together for team documentation

  • Scheduled staff to balance continuity between scribe and clinicians and staffing needs

Locums Management

  • Hired locums tenens and defined roles

  • Created orientation tools

  • Onboarded/offboarded inbasket work

  • Managed patient expectations

Clinician Evaluations

  • Created rubric for objective job performance evaluation to reduce bias

  • Created individualized job performance improvement plans based on evaluations

RN Medication Administration Work Standards (e.g. Prolia, DepoProvera, IM Naltrexone)