Evidence Based Health Care Quality Help: Sample Delfini Educational Program

Kaiser Permanente Hawaii Evidence-based Medicine Conference:
The Essentials

"Talk Story, Talk Evidence" ™
Featuring Delfini Group &
Kaiser Permanente Hawaii Guideline Team Representatives

Wailea Marriott Resort
Maui, Hawaii
November 6 - 9, 2006

Conference Report:
The conference was a huge success! Over seventy people participated in the 3rd Annual Kaiser Permanente Hawaii EBM Conference with many expressing huge thanks for the opportunity and all the help they received. Many have described it as the best Delfini conference yet! Topics included critical appraisal training to evaluate the medical literature, searching tips, clinical practice guideline development, KP HI Chronic Kidney Disease guideline showcase, tips for EBM working groups with a special focus on pharmacy & therapeutics committees and measurement, including performance measurement training and pay-for-performance. Conference information is below.

Why Everyone Working in Health Care Should Attend this Conference

Everyone working in health care is an information specialist. How do you know that the clinical information you are using is trustable and not misleading? Is it helping — and not harming — patients? Is it useful? Or is it further contributing to health care waste?

You need to know easy strategies to avoid being misled by poor quality medical information.
You need efficiencies for dealing with the sheer volume of information you face.
You need effective tips for how to efficiently and effectively read the journals and other information that come across your desk.
You need to know how to effectively improve health care quality, measure performance and run effective EBM committees.

This conference is designed to provide health care professionals with important concepts, methods and tools to successfully accomplish evidence-based quality improvement work. The conference offers education and training directed at leaders, clinicians, clinical teams and QI support staff in key aspects of evidence-based medicine, guideline development, performance measurement and EBM committee work such as that performed by Pharmacy and Therapeutics and Technology Assessment Committees.

A proven evidence-based approach for finding, reviewing, grading and synthesizing the literature into an evidence-based clinical guideline will be presented.

Teaching/learning methods include lectures, demonstrations, exercises, discussions, case presentations, tool reviews, and QA sessions.

Come enjoy several days with us on the beautiful island of Maui to learn some of the most simplified concepts and yet most effective methods of evidence- and value-based medicine being practiced today.

Wala'au
"Talk Story"
Island-speak for taking time-out to share with others such things as stories, ideas, opinions, visions and each other.

Much of medicine is practiced through Talk Story. We have created this conference to both Talk Story and Talk Evidence.

Did you know?
• Institute of Medicine (IOM), the Center for the Evaluative Clinical Sciences at Dartmouth, Centers for Medicare and Medicaid Services (CMS), and The Rand Corporation have reported estimates that 20% to 50% of all prescriptions, visits, procedures and hospitalizations in the U.S. may be inappropriate which translates into potential for patient harms and waste of an estimated 400 billion dollars annually

• Misleading medical science is a large part of the problem as is lack of skills of researchers and of users in being able to differentiate valid and useful science from invalid science or medical science which will not lead to meaningful clinical benefit

• Over 80% of research studies reviewed by Delfini are potentially unusable for informing clinical decision-making because of flaws in the research or its reporting

• One study found that 18-68% of information in abstracts – in the top 6 medical journals – couldn’t be verified in the body of the text

• Many resources touting themselves as “evidence-based” do not use a rigorous or consistent EBM process and contain potentially misleading – and potentially harmful – information

• Busy physicians and other professionals engaged in health care decision-making can effectively and quickly learn principles of evidence-based practice in just a few hours with the right training approach and tools

"Talk Story, Talk Evidence" ™
Program at a Glance

November 6th: Special Session 1

For Leaders & Interested Others: Momi «» Pearls
Pearls on Performance Measurement & Pay-for-Performance

November 7 & 8th: Main Event — Conference Days 1 & 2

For Everyone: Moku «» Islands
November 7: Islands of Information -
Simplified Techniques for Finding and Evaluating Useful Medical Information

For Everyone: Lokahi «» Unity & Harmony
November 8: Topics in the Tropics -
Evidence-based QI Improvement Project Strategies and Examples

November 9th: Special Session 2

For EBM Committee Leaders, Members and Staffers:
Laulima «» Many Hands Working Together
Treasure Trove of Tips for EBM Committees (Focus on Pharmacy & Therapeutics Committees and Medical Technology Assessment Committees)

Objectives
At the end of the conference, attendees will be able to —

Easily perform a useful search of the medical literature applying tips and a helpful searching tool and utilizing the best clinical information sources
Apply easy-to-understand concepts to evaluate the believability and usefulness of published medical articles
Summarize medical evidence for a clinical question and create evidence-based clinical recommendations — including messaging for patients
Evaluate, select and adapt clinical guidelines
Describe the evidence- and value-based guideline development process
Create information, action and decision support for various target groups
More effectively participate in evidence-based committees such as Pharmacy & Therapeutics and and Technology Assessment Committees

E komo mai... «» Please join us for some of the best training in evidence- and value-based medicine you will ever receive…

More Information

Agenda l Faculty l Accreditation l Testimonials
Cost l Registration l Location

EBM Conference Location

Audience
The conference is designed to serve many interests with special training options:
• Medical leaders, pharmacy leaders, administrators
• Physicians, clinical pharmacists and other health care professionals such as nurses, nutritionists, EBM committee participants, content developers such as health educators and more
• Quality leaders and staff
• EBM working group leaders, members and staff such as Pharmacy & Therapeutics and Medical Technology Assessment staff and committee members

Agenda

Kaiser Permanente Hawaii
Evidence-based Medicine Conference:
The Essentials

"Talk Story, Talk Evidence" ™
Featuring Delfini Group &
Kaiser Permanente Hawaii Guideline Team Representatives

Wailea Marriott Resort
Maui, Hawaii
November 6 - 9, 2006

November 6th — Special Session 1

Momi «» Pearls
Enhancing Quality through Performance Measurement & Pay-for-Performance: The Pearls
8:00 AM - 8:15 AM Introduction to the Conference
8:15 AM - 8:45 AM Introduction to Evidence-based Medicine & the Evidence-based Organization
8:45 AM - 9:50 AM Pearls on Performance Measurement: Essentials
9:50 AM - 10:20 AM Skill-building Exercises: Mini-exercises on Measure Validity
10:20 AM - 10:30 AM -- break --
10:30 AM - 11:00 AM Exercise: Creating a Performance Measure
11:00 AM - 11:30 AM Finding Seed Measures
11:30 AM - 11:35 AM -- stretch --
11:35 AM - 12:20 PM Money in the Palm or Trouble in Paradise: Pay-for-Performance Essentials
12:20 PM - 1:00 PM Avoiding Pitfalls & Directing Attention to Quality: Or How Not to Get Torched by Your Docs and Actually Improve Care
1:00 PM - 1:30 PM Group Consult

November 7th — Conference Day 1

Moku «» Islands
Islands of Information - Simplified Techniques for Finding and Evaluating Useful Clinical Information
8:00 AM - 8:15 AM Introduction to the Conference
8:15 AM - 8:30 AM Introduction to Evidence-based Medicine: A Port in the Storm
8:30 AM - 10:00 AM Tips for Rapidly Appraising Information for Truth and Believability
10:00 AM - 10:10 AM -- break --
10:10 AM - 10:30 AM Tips for Rapidly Appraising Information for Usefulness
10:30 AM - 11:30 AM Exercises in Critical Appraisal
11:30 AM - 11:35 AM -- stretch --
11:35 AM - 12:05 PM Systematic Reviews & Secondary Sources
12:05 PM - 12:30 PM Illustrations & Case Studies
12:30 PM - 1:15 PM Information Overload and Islands of Sanity: Searching Strategies & Quality Sources for Information
1:15 PM - 1:30 PM Group Consult

November 8th — Conference Day 2

Lokahi «» Unity & Harmony
Topics in the Tropics: Evidence-based QI Improvement Project Strategies and Examples
8:00 AM - 8:15 AM Introduction to the Day
8:15 AM - 9:15 AM How to Choose or Adapt Clinical Practice Guidelines
9:15 AM - 10:00 AM Showcase: The KP Nephrology EBM Guideline Project -- Processes
(Read more about the project here.)
10:00 AM - 10:10 AM -- break --
10:10 AM - 10:55 AM Showcase: The KP Nephrology EBM Guideline Project -- Outcomes
10:55 AM - 11:55 AM Synthesizing Evidence & Creating Clinical Recommendations
11:55 AM - 12:00 PM -- stretch --
12:00 PM - 1:00 PM Implementation Strategies
1:00 PM - 1:30 PM Group Consult

November 9th — Special Session 2

Laulima «» Many Hands Working Together
Treasure Trove of Tips for EBM Committees (Focus Pharmacy & Therapeutics Committees and Medical Technology Assessment Committees)
8:00 AM - 8:15 AM Introduction to the Day
8:15 AM - 9:00 AM Committee Basics
9:00 AM - 10:00 AM Pitfalls EBM Committees Commonly Fall Into and How to Avoid Them
10:00 AM - 10:10 AM -- break --
10:10 AM - 10:55 AM Treasures for Committee Members: How to prepare and package information for EBM meetings and make your members happy
10:55 AM - 11:40 AM Treasures for Committee Staffers: Prepping and pre-work advice for happier meeting
11:40 AM - 11:45 AM -- stretch --
11:45 AM - 12:30 PM Treasures for Committee Leaders: How to optimize committee functioning and lead to successful outcomes
12:30 PM - 1:00 PM Evidence versus judgment: how to apply both correctly in achieving value
1:00 PM - 1:30 PM Group Consult

'Imi ola «» To seek life in its highest possible form…
This is our makana «» gift to you; E pili kakou «» we invite you to come join us to
"Talk Evidence, Talk Story."

Come wala'au!

Accreditation	CME and CE accreditation
CME	The Kaiser Foundation Hospital is accredited by the Hawaii Medical Association to provide continuing medical education for physicians. The Kaiser Foundation Hospital designates this educational activity for a maximum of 20 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity. It is the policy of the Kaiser Foundation Hospital to ensure balance, independence, objectivity, and scientific rigor in all educational activities. Individuals who may influence content must disclose all relevant financial relationships with any commercial interest. Should it be determined that a conflict of interest exists as a result of a financial relationship disclosed, the conflict of interest must be resolved prior to the activity.
CE	The Hawaii Pharmacists Association is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. Participants will be able to obtain up to 1.950CEUs (19.50contact hours) of continuing pharmacy education for UPN 168-999-06-010-L04. Statements of credit will be issued based on proof of attendance and completion of program evaluation form and forwarded to participants within 30-45 days of receipt of completed documentation.
Cost	Choose whichever days you like. Special discounts for 3 and 4 conference day selections. "Early Dolphin" discount if you register before October 23, 2006. For more details, download the brochure.
Location For reservations, call the Marriott directly: 1-888-797-1913	Wailea Marriott Resort 3700 Wailea Ala Nui Wailea, Hawaii 96753 On the Island of Maui

E komo mai... «» Enter, come in...come swim with the dolphins...

Registration

Past event: sample program only

Faculty

Delfini Group™, LLC

Michael E. Stuart MD

        Michael Stuart, MD
        President
        mstuart (at) delfini.org

Sheri Strite
        Sheri Ann Strite
        Principal &
        Managing Partner
        sstrite (at) delfini.org

Representing Kaiser Permanente Hawaii Nephrology Guideline Team

Karen I. Ching, MD
Brian Lee, MD
Grant Okawa, MD

About Delfini Group
Delfini is one of the foremost practitioners of evidence- and value-based medicine in operation today.

Michael Stuart MD and Sheri Ann Strite combine academic experience with over sixty years of practical experience in health care, clinical quality health systems improvements, leadership, research and teaching.

Their work is dedicated to helping individuals and organizations learn the concepts, methods and skills of evidence-based clinical improvement to achieve improved outcomes and value in clinical care.
They have received accolades for their work, which focuses on simplified methods, confidence-building simulations and practical tools.
They have received numerous testimonials from health care leaders, physicians, pharmacists, students and others on the successes and effectiveness of their approach. Their training evaluation scores average 4.8 out of 5.0.
Their website has been praised as a useful source for evidence- and value-based clinical improvement information.
They are praised for their work in clinical content development including monograph preparation. They also perform effective health care quality system assessments and facilitate quality improvement initiatives.

DELFINI TESTIMONIALS
" ...as the Chief Quality Officer of a bigger organization, I have a chance to talk with healthcare improvement thought-leaders from around the country. I am even more convinced today that you can find no one better in the US to teach this complex material in a way that physicians and others will "get". By "get", I mean learn in a way that can be applied, and isn't that the objective?"
W. David Holloway, MD
Senior Vice President, Chief Quality Officer
Parkview Health System
Fort Wayne IN

ON GUIDELINE PROGRAM
“Not only did we get a theoretical basis, but also several practical tools that will allow us to effectively evaluate both individual articles and guidelines. We're confident that these tools will help our docs provide care that is more evidence-based, and therefore more likely to improve patient outcomes...”
Tim Young, MD
Medical Director
OMNI Medical Group
Tulsa OK

ON PERFORMANCE MEASUREMENT PROGRAM
“... This program exceeded our high expectations! The family physicians who attended were interested and engaged throughout the two and one-half day program and I am sure the tools you shared will find good use in the near future for many of them..."
Bruce Bagley, M.D.
Medical Director for Quality Improvement
American Academy of Family Physicians"

ON EBM COMMITTEE HELP
"Our P & T presentation format and discussions have become more efficient, and we have standardized decision algorithms that help during crossroad discussions for an individual therapy. ..."
Nicole O'Kane, PharmD
InterHospital Physicians Association
Portland OR

“By the end of the day we had: 1) created the structure and function of the new committee, 2) general agreement of how we would use EBM in decision-making, and 3) a good understanding of the resources/functions needed from pharmacy to support the new committee. In addition, we introduced this core group of clinical leaders to the concepts and methods of EBM. This 'deep awareness' has helped many times in other areas, such as better clinical pathway development. This EBM training was a big 'ah ha' needed toward critical mass...."
W. David Holloway, MD
Sr VP, Chief Quality Officer, Parkview Health

After Two Days Following A Delfini Training Retreat...
"For myself, I think I've been to more than six of your programs and I continue to be inspired and stretched each time. We are already incorporating the information you provided, as wells as your tools into our processes."
Helen Sherman, R.Ph., Pharm.D.
Senior Director - Chief Pharmacy Officer Pharmacy Services
The Regence Group
Portland, OR

More Delfini Testimonials

Ho'ohala manawa pili Nai’a «» Pass the time with the Dolphins
Inoa po: name received in a vision

Dolphins «» Delfini
As dolphins are reputed as helping shipwrecked sailors, Delfini’s mission is to help others navigate out of the chaos we find ourselves in due to problems with our current health care system.

“Best one-day educational program I’ve experienced in 25 years!”
Intermountain Health Care attendee
Salt Lake City UT

QUOTES FROM EVALUATIONS FROM PRACTICING DOCS

"Best EBM stuff I’ve seen!..."

"The course was simply stated 'fantastic' — a real eye-opener, and I appreciated the zest with which it was presented."

"I was amazed at how simple and easy to understand you made this subject! I picked up so many pointers and short cuts, that I am now using everyday."

TESTIMONIALS FROM MEDICAL DIRECTORS

"I always measure the value of programs by the number of 'take home' actionables. It was great! Thanks much."
Peter J. Keim, MD
Vice President & Chief Medical Officer
Gateway Health Plan
Pittsburgh PA

"...It's been exciting to see some of the "conversions" of doctors as they really start seeing a whole new way of thinking about evidence-based diagnosis and treatment... that is creating noticeable change in certain boards and committees in our tertiary medical center.…"
J. Robert Gray, MD
Medical Director, OMNI Medical Group

"The course was "hands-on" and practical, highly relevant to a clinician or pharmacist. Sheri wasted no time in demonstrating to us how easily we can be misled by seemingly convincing, but incomplete or biased data. This material should be required for all who study the health sciences."
Wayne M. Flicker, MD, PhD
Chair, Pharmacy and Therapeutics Committee
HealthCare Partners Medical Group
Los Angeles CA