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TRIPLE AIM IMMERSION PROJECT
Table of Contents
1. PILOT - 4 Hour Workshop2. 12th Street HWC Audiology3. Annual Martin Luther King Jr. Event4. Building Trust with LGBTQ Patients5. Culinary Medicine6. Cystic Fibrosis7. Decreasing ED Visits in Texarkana8. Healthy Active Arkansas - Access to Healthy Foods9. Healthy Active Arkansas - Healthy Worksites10. Healthy Active Arkansas - Marketing Programs11. Human Trafficking12. Integrated Behavioral Health13. Medication Reconciliation14. Mental Health Awareness15. Opioid Education for High School Students16. Oral health Education17. Patients Over Paperwork18. Payer Provider Partnership19. Professional Wellness20. Stop the Bleed21. Stress Reduction Through Mindfulness
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TRIPLE AIM IMMERSION PROJECT PILOT PROGRAM - FOUR HOUR TRIPLE AIM PROJECT PROPOSAL WORKSHOP
This is a PILOT PROGRAM that will count as completing the IPE Immersion Phase Triple Aim Project (TAP) by attending a four (4) hour single day workshop.
DATE: Friday, February 8th from 1 - 5 pm in the Library, ALC
WORKSHOP FORMAT INCLUDES:• Interprofessional kick off meeting• Triple aim project development• Project presentation with immediate faculty feedback
A bank of project proposal ideas will be provided at the beginning of the workshop or teams may define their own focus topic. Teams will work collaboratively to develop, refine, and present their project proposal at the end of the workshop period.
Following completion of the four hour workshop, the team will complete a three page written summary which must be uploaded into the IPE Immersion Triple Aim Project 2018-19 under MyCommunities and an on-line event survey and peer evaluation (link will be provided at the end of the event).
Any student completing this Triple Aim Project pilot program is excused from presenting a TAP project during Student Research Day (March 12, 2019). HOWEVER, please ensure you have signed up to complete the Competence Phase #5 Competence Workshop on Student Research Day, if you are scheduled to complete this IPE event this semester. (Click here to register for Competence Workshop)
Triple Aim Goal(s) Addressed: Patient outcomes/experience of care, Population health improvement, Healthcare cost reduction, Professional wellness/Provider satisfaction
Facilitator: Dr. Kathryn Neill ([email protected])
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TRIPLE AIM IMMERSION PROJECT 12th ST. HWC AUDIOLOGY SERVICES EXPANSION
Problem/Goal: The 12 St HWC has an audiology booth and has presence in the clinic from the department of audiology students and faculty. The clinic would like to increase use of these audiology services. Project ideas are needed to identify opportunities to use these resources to better meet the needs of the community.
Triple Aim Goal(s) Addressed: Patient care/experience improvement, Population health improvement
Maximum Number of Teams: 2
Contact Person: Dr. Melissa Clark ([email protected])
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TRIPLE AIM IMMERSION PROJECT Annual Dr. Martin Luther King, Jr. Event
Background: The Dr. Martin Luther King, Jr. event is a campus-wide event sponsored by the Chancellor’s Diversity and Inclusion Committee and the Center for Diversity Affairs. The Chancellor’s Diversity and Inclusion Committee consists of students, staff and faculty from around our campus. Its goals are to 1) recognize and cultivate diversity and inclusion by implementing cultural awareness and education, and 2) promote practical interactive pluralism that advances the well-being and success of each participant in our multicultural community. The Dr. Martin Luther King Jr., event is a part of the committee’s annual activities aimed to increase and to celebrate cultural awareness.
Problem/Goal: Dr. Martin Luther King Jr. once said that "life's most persistent and urgent question is what are you doing for others?" Each year the committee seeks to develop a campus-wide program/initiative that allows members to honor Dr. King’s legacy of service. We would like for the IPE teams to:
1. Brainstorm about ideas for MLK 20192. Meet with committee members to present ideas for MLK 20193. Develop the necessary tools, including logistics to implement approved plan4. Assist in developing, supporting, and facilitating MLK 2019
Objective: To increase campus awareness and participation in annual MLK event.
Triple Aim Goal(s) Addressed: Cultural Competency/Diversity/Community
Service Maximum Number of Teams: 2
Contact Person: Odette Woods ([email protected])
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Building Trust for LGBTQ Patients in Healthcare
Background Information: This year, UAMS scored 90 out of 100 points achieving the status of “Top Performer” among health care providers recognized by the Human Rights Campaign (HRC) Foundation, the educational arm of the country’s largest LGBTQ civil rights organization. The honor is given to organizations that meet LGBTQ-‐�-‐inclusive benchmarks that are part of the HRC Foundation’s Healthcare Equality Index (HEI), a unique national benchmarking survey that encourages equal care for LGBTQ Americans by evaluating inclusive policies and practices related to LGBTQ patients, guests, and employees.
The role of effective communication and patient-‐centeredness in providing safe and high-‐quality health care to diverse patient populations is well accepted. Effective patient–provider communication has been linked to an increase in patient satisfaction, better adherence to treatment recommendations, and improved health outcomes. Patient-‐centered care “encompasses qualities of compassion, empathy, and responsiveness to the needs, values, and expressed preferences of the individual patient. Combining the elements of effective communication and patient-‐centeredness into care delivery has been shown to improve patients’ health and health care. Like many other populations identified as at-‐risk or disadvantaged, research has demonstrated that LGBTQ individuals experience disparities not only in the prevalence of certain physical and mental health concerns, but also in care due to a variety of factors, including experiences of stigma, lack of awareness, and insensitivity to their unique needs.
Problem/Goal: LGBTQ people face many barriers within health care, including discrimination, ignorance, and fear. The lack of informed care, sensitive language, research, and data prevents access to competent routine care and screening. LGBTQ health is emerging as a national concern due to the growing body of evidence indicating significant health care disparities experienced by the LGBTQ community. Many LGBTQ people, especially transgender, avoid seeking both preventative care and care for urgent or life-‐threatening conditions. In the health care setting—an environment that is already a source of considerable fear, stress, and anxiety—LGBTQ patients today too often bear the additional burdens of discrimination and feeling unwelcome, vulnerable, and invisible. Fortunately, there are practices and strategies that health care providers and hospitals can implement to begin building trust and making the health care environment more welcoming, inclusive, and safe for LGBTQ patients and their families.
After researching best practices: • Identify organizational protocols to advance cultural competence, improve communication, and support
equitable and more patient-‐centered care for the LGBTQ community.• Identify institutional priorities that clearly delineate responsibilities and expectations of clinical employees,
their supervisors, colleagues and staff.These recommendations can be in the form of an informal or formal document that would be available to leadership and managers as a resource to consistently and appropriately address challenging situations.
Triple Aim Goal(s) Addressed: Patient care/experience improvement
Maximum Number of Teams: 1
Facilitators: Dr. Masil George ([email protected])
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CULINARY MEDICINE - THE INTERSECTION OF FOOD AND HEALTH
Background: Culinary medicine is a field that blends medical science and the art of cooking and food. This is a growing field of practice with evidence base. Culinary medicine is intended to help people with accessing and eating meals that help prevent and treat a variety of disease processes and improve overall well-being. Different clinical status or condition requires varying meals, foods, and beverage selections. The way that food works in the body and the sociocultural and pleasure aspects of cooking and eating are included in this work.
Problem/Goal: UAMS is exploring how culinary medicine content would be available to students across UAMS programs in curricular coursework and/or IPE curriculum activities. Ideas may include didactic and experiential components, consideration of an elective course, certificate program, etc. Teams are invited to submit proposals for integration of culinary medicine into professional training programs.
Triple Aim Goal(s) Addressed: Improve population health, Improve patient experience of care, Improve professional wellness
Maximum Number of Teams: 2
Facilitators: Dr. Joshua Phelps ([email protected])
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TRIPLE AIM IMMERSION PROJECT CYSTIC FIBROSIS AWARENESS EVENT
Problem/Goal: In an attempt to increase awareness for cystic fibrosis (CF) in our community, we would like to host an interprofessional health screening/education event in coordination with the Cystic Fibrosis Foundation of Arkansas. The event supports the importance of teamwork and collaboration among an interprofessional team, patient and family-‐-‐ -‐ centered care, and an overall improved patient care/experience. Additionally, this activity would support a relationship between UAMS and cystic fibrosis patients and caregivers prior to the time period when these patients transition from care at Arkansas Children’s Hospital to the adult CF clinic at UAMS.
Triple Aim Goal(s) Addressed: Patient care/experience improvement
Maximum Number of Teams: 2
Facilitators: Mr. Larry Taylor ([email protected])
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TRIPLE AIM IMMERSION PROJECT DECREASING THE NUMBER OF ED VISITS IN TEXARKANA
Problem/Goal: UAMS Southwest seeks a student team to identify solutions to the growing problem of inappropriate ED visits:
• The overuse of U.S. emergency departments (EDs) is responsible for $38 billion in wastefulspending each year.
• ED overuse is on the rise across all patient populations, irrespective of age or insurance coverage.
• Drivers of ED overuse include lack of access to timely primary care services, referral to the ED byprimary care physicians themselves, and financial and legal obligations by hospitals to treat allpatients who arrive in the ED.
• Strategies to curb ED overuse include redesigning primary care to improve access and scheduling;providing alternative sites for non-urgent primary care; improving the case management ofchronic disease patients, and using financial incentives and disincentives for visits to the ED.
Triple Aim Goal(s) Addressed: Population health improvement, Healthcare cost reduction
Maximum Number of Teams: 1
Facilitator: Jami Duran ([email protected])
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TRIPLE AIM IMMERSION PROJECT HEALTHY ACTIVE ARKANSAS - ACCESS TO HEALTHY FOODS
Problem/Goal: State and local governments and other stakeholders will promote education public policies and access to affordable healthy foods for all Arkansans. Goals of Healthy Active Arkansas - Access to Healthy Foods are to:
• Work to eliminate food deserts.• Expand local garden projects, small farms, farmers' markets, and gleaning programs.• Increase participation in nutrition assistance programs.• Utilize evidence-based nutrition education programs.• Educate health care professional and cross-functional hospital teams in nutrition education and
about access to healthy food.• Expand current public policies to assure inclusion of healthy foods, such as by increasing state
food-purchasing program to include fresh fruits and vegetables for distribution to low-incomeArkansans.
In an attempt to educate health care professionals and the community about access to healthy foods, students are invited to develop proposals that address Healthy Active Arkansas goals.
Triple Aim Goal(s) Addressed: Population health improvement / healthcare cost reduction
Maximum Number of Teams: 1
Facilitators: Stephen Attebery ([email protected])
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TRIPLE AIM IMMERSION PROJECT HEALTHY ACTIVE ARKANSAS - HEALTHY WORKSITES
Problem/Goal: Worksites will establish healthy environments that promote good health through prevention, reduce healthcare costs associated with chronic illness and disability, and improve employee productivity. Goals of Healthy Active Arkansas - Healthy Worksites are to:
• Help employers establish effective wellness programs for their worksites.• Help employers reduce the healthcare costs of obesity-related chronic conditions.• Create a more effective worksite by educating employers about the business case for worksite
wellness.• Increase the number of worksite wellness programs and employee participation in those programs.
In an attempt to educate health care professionals and the community about healthy worksites, students are invited to develop proposals that address Healthy Active Arkansas goals.
Triple Aim Goal(s) Addressed: Population health improvement / healthcare cost reduction
Maximum Number of Teams: 1
Facilitators: Amber Teigen ([email protected])
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TRIPLE AIM IMMERSION PROJECT HEALTHY ACTIVE ARKANSAS - MARKETING PROGRAM
Problem/Goal: Develop and implement a robust, sustained, and culturally appropriate targeted communications and marketing program aimed at changing norms and behaviors with respect to physical activity and nutrition. Goals of Healthy Active Arkansas - Marketing Program are to:
• Create a community culture of fitness and good nutrition through an evidence-based marketingstrategy.
• Implement appropriate communications strategies and engage various media to reach the greatestnumber of people.
• Engage local champions that can influence the "culture of health."
In an attempt to educate health care professionals and the community about marketing programs, students are invited to develop proposals that address Healthy Active Arkansas goals.
Triple Aim Goal(s) Addressed: Population health improvement
Maximum Number of Teams: 2
Facilitators: Wendy K. McCloud, IPE Manager ([email protected])
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TRIPLE AIM IMMERSION PROJECT Human Trafficking
What is human trafficking?According to the Department of Homeland Security, human trafficking is “modern-day slavery and involves the use of force, fraud, or coercion to obtain some type of labor or commercial sex act.” Human trafficking is not the same as human smuggling, which involves illegal transportation of a person across a border.
The different kinds of human trafficking include sex trafficking, forced labor, and domestic servitude. Sex trafficking victims may be forced, threatened, or manipulated by promises of love or affection to engage in sex acts for money. Any person under the age of 18 involved in a commercial sex act is considered a victim of human trafficking.
Victims of human trafficking are of all genders, ages, races, countries, socioeconomic statuses, etc. People who are already in vulnerable situations – such as people experiencing homelessness – may be more likely to be targeted.
Problem/Goal: Students are invited to develop proposals that target increasing awareness of human trafficking issues in our community and supporting identification of and help for victims. Projects may focus on the UAMS student population, clinicians in practice, or community members.
Triple Aim Goal(s) Addressed: Patient experience improvement, Population health improvement
Maximum Number of Teams: 2
Facilitators: Dr. Glenn Ballard ([email protected])
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Integrated Behavioral Health
Problem/Goal: Behavioral health needs in both primary, subspecialty, and inpatient care environments are high. Patients and their families have a variety of issues—stressful events, depression, anxiety, oppositional behavior, substance abuse, etc.
Students are invited to develop projects that target UAMS patients and their families that address the need for integrating behavioral health screening, assessment, access to care options, provision of educational information, and/or intervention opportunities.
Triple Aim Goal(s) Addressed: Patient experience improvement, Population health improvement
Maximum Number of Teams: 1
Facilitators: Ms. Kathy Emans ([email protected])
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TRIPLE AIM IMMERSION PROJECT Medication Reconciliation – Aligning the Medication Use Process Across Spectrum's of Care
Problem: Need for improved Provider Information, Cross-Provider Communication, and Patient Education and Satisfaction in Medication Therapy and Adherence across the spectrum of care – Admission, Transitions in Care, Discharge. Home Medication therapy is a complex process impacted by coordination of multiple prescribers, multiple pharmacy sources, changes in baseline medical status, and pharmacy benefit programs (i.e. insurance). Changes in medications, medication doses, formulary vs non-formulary products, and polypharmacy can make the medication reconciliation process complex in acute and chronic/stable patient environments.
The primary objectives for this project include but are not limited to: improved patient engagement regarding medication use to inform providers upon admission and discharge planning and improved education and satisfaction for patients and families regarding medication therapy when returning to home following discharge.
Key items to consider:Research the current medication reconciliation process for a unit upon admissionResearch the current medication reconciliation/education process for a unit for dischargeResearch the outcomes related to Patient Engagement/Experience regarding understanding of medication therapy upon discharge. Research the readmission rate for medication-related problems for a unit
Triple Aim Goals: Population Health/Patient Experience/ Reducing cost of careQuadruple Aim: Joy in work as individuals see their contribution to the improving care. Maximize scope of practice work for team members.
Maximum number of teams: 1
Facilitator(s): Dr. Christi Smith ([email protected])
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Mental Health Awareness
Problem/Goal: In an attempt to increase awareness of mental health issues in our community, students are invited to develop proposals that target increasing awareness and reducing stigma associated with mental health diagnoses/issues such as depression, anxiety, grief, relationship conflicts, academic difficulties or other issues that interfere with an individual’s maximal functioning. Projects will focus on the UAMS student population.
Triple Aim Goal(s) Addressed: Patient experience improvement, Population health improvement
Maximum Number of Teams: 3
Facilitators: Dr. Purushottam Thapa ([email protected])
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TRIPLE AIM IMMERSION PROJECT OPIOID EDUCATION FOR HIGH SCHOOL STUDENTS
Problem/Goal: Age-appropriate opioid education materials and/or activities are needed for the M*A*S*H program, a health careers exposure program for Arkansas high school students.
• Opioids are natural or synthetic chemicals that reduce feelings of pain.• Opioids are a class of drugs that include pain relievers available legally by prescription such as
oxycodone, hydrocodone (Vicodin), codeine and morphine, as well as heroin and syntheticopioids such as fentanyl.
• Anyone who takes prescription opioids can become addicted to them or develop tolerance ofphysical dependence.
• In 2016, more Americans died due to opioid overdoses than car crashes. From cities and suburbsto rural America, opioid addiction and overdose is "the crisis next door".
Triple Aim Goal(s) Addressed: Population health improvement
Maximum Number of Teams: 1
Facilitators: Amber Marshall ([email protected])
**Federal Grant Funds Available**
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ORAL HEALTH EDUCATION/SERVICES EXPANSION
Problem/Goal: Dental Health needs in Arkansas are paramount. This is reflected from initiatives supported by Delta Dental of Arkansas, the Arkansas Oral Health Coalition, and the Arkansas Center for Health Improvement (ACHI) Oral Health Policy section. ACHI purports the following health information for Arkansas (the most comprehensive data on children and adults in Arkansas was collected in 2010 by the Arkansas Department of Health):
Among children and adolescents:o 64% had evidence of current or past cavities (caries experience)o 29% had untreated cavitieso 27% were in need of routine careo 4% were in need of urgent care.
Among older adults:o a significant proportion of older adults were missing five or more teetho females are more likely to have all their natural teeth missing compared to maleso 23.3% of adults 65+ in AR reported they had no permanent teeth, vs 16.9% in US
Additionally, payment models are changing rapidly from fee-for-service to value-based outcomes. This reflects an enhanced reliance on all members of the care team that interact with patients at different points in the spectrum of care as well as increased recognition that outcomes for patients are often dependent on concerted and collaborative initiatives that focus on the “whole” patient and his/her exposure to daily influences and decisions that affect their health outcomes outside of a single patient-provider interaction.
Project ideas are needed to identify opportunities to educate providers and the community regarding oral health for young children and adults and maximize screening opportunities and resources to better meet the needs of the community.
Triple Aim Goal(s) Addressed: Patient care/experience improvement
Maximum Number of Teams: 4
Facilitators: Ms. Jennifer Stane ([email protected]) and Ms. Claire Tucker ([email protected])
** Grant funds are available to fund projects for implementation for this call. Sponsored by Delta Dental Foundation of Arkansas.***
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TRIPLE AIM IMMERSION PROJECT Patients over Paperwork
Problem/Goal: The need for accurate, timely, comprehensive documentation is an important trend as EHRs provide the opportunity for better communication and coordination of care. Furthermore, agencies like Medicare/Medicaid require additional paperwork including authorizations, forms, etc. CMS Administrator Seema Verma launched the “Patients over Paperwork” initiative, which established an internal process to evaluate and streamline regulations with a goal to reduce unnecessary burden, to increase efficiencies, and to improve the patient experience. In carrying out this internal process, CMS is moving the needle and removing regulatory obstacles that get in the way of providers spending time with patients. However, providers can add to this initiative by improving efficiencies, streamlining EHR documentation, and maintaining a focus on the patient experience. For instance, In the clinical care environment, the economic pressures to see more patients has led to a clash between time for documentation and time with patients. Some providers stay late or fill out notes, reports, forms, treatment plans, and other paperwork at home in the evening which can relate to increased stress and burnout. Others document in the room with the patient. There is evidence-based best practices for how to do that which minimizes impact on patient centered care but not everyone is trained or proficient at those practices. Project ideas are needed to identify opportunities to maintain a high level of patient-centered care and a positive patient experience while meeting documentation requirements and minimizing stress in the existing workforce.
Triple Aim Goal(s) Addressed: Patient care/experience improvement, Provider experience
Maximum Number of Teams: 1
Contact Person: Alicia Berkemeyer ([email protected])
**This project is sponsored by Arkansas Blue Cross Blue Shield*
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TRIPLE AIM IMMERSION PROJECT Payer Provider Partnership
Problem/Goal: To examine how providers and payers can achieve financial success by providing high quality, efficient care to patients within a defined budget limit. Students will learn about concepts like a Medicaid block grant and other alternative funding initiatives, helping them understand the concept of a limited total pool of resources to serve a defined population of patients. The goal is to understand how providers could operate successfully under that scenario, and what would need to be expected of providers and payers in an integrated approach to serve the needs of these populations.
Triple Aim Goal(s) Addressed: Reducing the per capita cost of health care
Maximum Number of Teams: 1
Contact Person: Steven A. Spaulding ([email protected])
*This project is sponsored by Arkansas Blue Cross Blue Shield*
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Professional Wellness
Problem/Goal: Health care professionals need skills in managing the stress of taking care of acute and chronic illnesses and injuries all in the context of a rapidly changing health care system. Across primary, subspecialty, and inpatient care stress levels can be high. Providers who are resilient in the face of stress have better patient outcomes, better patient satisfaction scores, fewer medical errors, fewer days missed from work, higher professional fulfillment/satisfaction, lower burnout, and higher retention rates.
Students are invited to develop projects that target professional wellness in health care professional trainees, clinical staff, or faculty.
Quadruple Aim Goal(s) Addressed: Patient experience improvement, Provider satisfaction/fulfillment improvement, Reduction of burnout
Maximum Number of Teams: 2
Contact Person: Dr. Wendy Ward ([email protected])
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TRIPLE AIM IMMERSION PROJECT STOP THE BLEED
Problem/Goal: Bleeding is the leading cause of death in the US and Arkansas for individuals aged 1-44 years old.
• Motivated by multiple tragedies that have occurred in the US in recent years, what has becomeknown as the Hartford Consensus was convened to bring together leaders from law enforcement,the federal government, and the medical community to improve survivability from events thatcause severe bleeding which, if left unattended, can result in death. The participants of theHartford Consensus concluded that by providing first responders (law enforcement) and civilianbystanders the skills and basic tools to stop uncontrolled bleeding in an emergency situation, liveswould be saved. The first responder program has received very good response and is widely beingused across the country. The next step is to focus on needs of civilian bystanders. Civilians needbasic training in Bleeding Control principles so they are able to provide immediate, front line aiduntil first responders are able to take over care of an injured person. Due to many situations, theremay be a delay between the time of injury and the time a first responder is on the scene. Withoutcivilian intervention in these circumstances, preventable deaths will occur. The American College ofSurgeons Committee on Trauma is leading the effort to save lives by teaching the civilianpopulation to provide vital initial response to stop uncontrolled bleeding in emergency situations.This will be accomplished by the development of a comprehensive and sustainable bleedingcontrol education and information program targeted to civilians that will inform, educate andempower the 300+ million citizens of the United States.
Stop the Bleed is a course that includes didactic and hands on training to teach civilians how to control severe bleeding until first responders arrive. This includes teaching how to apply pressure, place tourniquets, and pack wounds for hemorrhage control.
Triple Aim Goal(s) Addressed: Population health improvement, improve patient experience, reduce costs
Maximum Number of Teams: 2
Facilitator: Kelly Urban, MEd, BSN, RN, CCRN-K, TCRN ([email protected])
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TRIPLE AIM IMMERSION PROJECT Stress Reduction Through Mindfulness
Problem/Goal: Chronic levels of stress negatively effect the health and wellness of patients and healthcare providers alike. Mindfulness is an evidence-based technique used to reduce stress; however, mindfulness may be either unfamiliar or unconventional to many. There may also be many preconceived notions or misconceptions about the practice of mindfulness. This project would raise awareness to the practice of mindfulness and its value in stress reduction in both patient and provider populations.
Triple Aim Goals Addressed: Patient care/experience improvement, population health improvement, Professional Wellness (#4 of the Quadruple Aim)
Maximum Number of Teams: 1
Contact Person: Amber Teigen ([email protected])
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