Story by PO1 Brannon Deugan on 04/08/2019A four member team from Naval Branch Health Clinic (NBHC) Gulfport recently won first place out of 47 entries in the quality category at the 2019 National Capital Region Quality Symposium on March 27.
The team, led by Hospital Corpsman 2nd Class Carolanne Hardy, implemented a process improvement plan focusing on the Healthcare Effectiveness Data Information Set (HEDIS) measurements of the Pediatric Clinic's well-child visits. HEDIS is a healthcare performance improvement tool used throughout Navy Medicine.
"It makes me feel good to help others and the Improve HEDIS Well-Child Visits' project made a tremendous difference for our patients." said Hardy, who is from Lakes Wales, Florida. "I am very proud of the team and what we were able to accomplish. The feeling is indescribable."
Hardy previously attended the Lean Six Sigma (LSS) Green Belt training course and had to complete two projects. The HEDIS well-child project was her second project, which allowed her to earn her LSS Green Belt Certification in November 2018.
"Working in the clinic, it made sense to work with projects that would affect patient care," said Hardy. "I wanted to take on something that could really make a difference not only for our HEDIS measures, but to help our patients as well. I didn't know the difference this project would make for our clinic and patients."
Well-child visits involve a complete physical examination of a child with the healthcare provider checking the child's growth and development. In December 2015, the clinic's HEDIS for well-child visits was at 57 percent. Since the clinic implemented changes developed by Hardy's LSS project, the clinic now averages approximately 90 percent for HEDIS. Improved HEDIS measures will also help improve overall family health and allow the active duty service members assigned to Naval Construction Battalion Center Gulfport to focus on their readiness.
"We looked into what would cause the HEDIS score to be so low and what events were affecting that measure," said Hardy. "We looked at that data and figured out what we were capable of changing. The main change was including the well-child visits with acute care visits."
Once the team identified areas for improvement, changes were implemented immediately. Dr. Elisabeth Haller, pediatrician at NBHC Gulfport, explained that Christina Schelp, health systems specialist, was proactive in contacting patients to schedule well-child visits. If a child was being seen for an illness and was due for a well-child visit, Haller would see them for both at the same appointment.
"Many of our [patients] have two or three children, so it is difficult for them to get in for a sick appointment and a well-child visit," said Haller. "We try to combine those in the instances when it is possible."
Along with scheduling and combining appointments when possible, the team further examined the HEDIS measurements for clarity on the criteria being measured.
"The matrix requires six well-child visits before the age of 15 months," said Mary Greer, clinic manager at NBHC Gulfport. "Previously, we thought that that sixth visit was in the 15th month, but that is not the case. That appointment has to be prior to the day the child turns 15 months old. So this is an example of how we had to readjust our thinking to clearly understand the metric."
Hardy explained that the project was focused on improving patient care and she had no intentions of seeking recognition at the NCR Quality Symposium. However, she was honored to have the opportunity to attend the event in Silver Springs, Maryland.
"Being surrounded by ranks much higher than I am from all branches of services and being able to represent the clinic and the hospital was an honor," said Hardy. "It is very hard to explain, because we did this for the patients. I never saw this going as far as to win an award. It is nice for our team to be recognized and it was a great experience. I felt pretty accomplished being there."