Minimum Documentation: Documentation of process and workflow including responsible resources at each stage of the workflow; Written training materials; List of training dates along with number of staff trained Milestone #9: M. D’Urso/ S. Choudhury Project Deliverable DY2 Q4 Milestone #9: Ensure that all staff involved in measuring and recording blood pressure are using correct measurement techniques and equipment. Metric# 9.1: PPS has protocols in place to ensure blood pressure measurements are taken correctly with the correct equipment. Minimum Documentation: Policies and procedures; List of training dates along with number of staff trained, if applicable Send Policies and procedures from partners as well as trainings to PMO. Milestone # 11: M. D’Urso/ S. Choudhury Project Deliverable DY2 Q4 Milestone #11: Prescribe once-daily regimens or fixed-dose combination pills when appropriate. Metric# 11.1: PPS has protocols in place for determining preferential drugs based on ease of medication adherence where there are no other significant non-differentiating factors. Minimum Documentation: Policies and procedures Send Policies and procedures from partners as well as trainings to PMO. Milestone #14 : M. D’Urso/ S. Choudhury Project Deliverable DY2 Q4 Milestone #14: Develop and implement protocols for home blood pressure monitoring with follow up support. Metric# 14.1: PPS has developed and implemented protocols for home blood pressure monitoring. Minimum Documentation: Policies and procedures ------------------------------------------------------------------ Metric 14.2: PPS provides follow up to support to patients with ongoing blood pressure monitoring, including equipment evaluation and follow-up if blood pressure results are abnormal. Minimum Documentation: Policies and procedures; Baseline home blood pressure monitoring and periodic updates exhibiting an increase of monitoring; Documentation of process and workflow including Home Care partner please submit protocols for home blood pressure monitoring. Submit policies and procedures for BP monitoring and follow up with training sheets.
responsible resources at each stage of the workflow; Periodic self-audit reports and recommendations ------------------------------------------------------------------ Metric 14.3: PPS provides periodic training to staff on warm referral and follow-up process. Minimum Documentation: List of training dates along with number of staff trained; Written training m Milestone # 15: M. D’Urso/ S. Choudhury Project Deliverable DY2 Q4 Milestone #15: Generate lists of patients with hypertension who have not had a recent visit and schedule a follow up visit. Metric 15.1: PPS has implemented an automated scheduling system to facilitate scheduling of targeted hypertension patients. Minimum Documentation: Vendor System Documentation; Other Sources demonstrating implementation of the system; Roster of identified patients Pull roster of identified patient and redact the PHI and send a screenshot to the PMO. Milestone # 16 : M. D’Urso, RN/ S.Choudhury Project Deliverable DY2 Q4 Milestone #16 Facilitate referrals to NYS Smoker's Quitline. Metric 16.1: PPS has developed referral and follow-up process and adheres to process. Minimum Documentation: Policies and procedures of referral process including warm transfer protocols Submit Policy and procedure for referrals to NYS Smoker’s Quite line and training sheets to PMO. Milestone # 18: M. D’Urso, RN/ S.Choudhury Project Deliverable DY2 Q4 Milestone# 18: Adopt Strategies from the Million Hearts Campaign Metric# 18.1, 18.2, 18.3: Provider can demonstrate implementation of policies and procedures which reflect principles and initiatives of Million Hearts Campaign. (includes PCP, Specialists, BH) Minimum Documentation: Policies and Procedures; Baseline home blood pressure monitoring and periodic updates exhibiting an increase of monitoring; Documentation of process and workflow including responsible resources at each stage of the workflow; Written training materials Submit Policy and procedure for Million Hearts Campaign and training sheets to PMO. PMO will laminate policy and procedures for partners.