Projects

KPMG_logoKPMG

New York State Medicaid Delivery System Reform Incentive Payment – May 2015 – Present

The New York State government has set a goal to reduce avoidable hospital use by 25% over 5 years for the Medicaid population, which it will achieve through an innovative program called the Delivery System Reform Incentive Payment. Apix Performance will be working as an expert advisor to KPMG during this $8 billion healthcare transformation in New York state.

Apix Performance is assisting KPMG to design and develop a rapid-cycle clinical improvement program to support healthcare providers across the state improve the care that they provide, and to qualify for funding based on achievement of performance targets. The Medicaid Accelerated eXchange (MAX) Series will focus on improving care for high-risk patient populations and increasing efficiency for integrated networks of care providers.

Twenty-five Performing Provider Systems (integrated organizations of hospitals, primary care, community services and other regional care providers) have been set up across New York State. Teams of interdisciplinary care providers from each of the Performing Provider Systems are expected to participate in the MAX Series, representing more than 200 clinical professionals. The focus has been to improve care for ‘super-utilizer’ patients through better coordination of community and medical services.

More information about the Delivery System Reform Incentive Payment can be found here…


NLMA_logoNewfoundland and Labrador Medical Association

Psychiatry Performance Program in Western Health – May-Sept 2016

Apix Performance is facilitating a Performance Program to improve the coordination of Mental Health services and reduce wait times in Western Health, Newfoundland. All members of the inter-disciplinary clinical team, including a patient representative, psychiatry and community mental health will be working together to design and implement improvements that will increase access to palliative care services in the region. A focus has been on improving care pathways for patients presenting with Depression and Anxiety, and a specialized inter-disciplinary clinic has been set up for these patients.

The program is sponsored by the Newfoundland and Labrador Medical Association and the Department of Health and Community Services.


NLMA_logoNewfoundland and Labrador Medical Association

Inpatient Care Review – Eastern and Central Health, Newfoundland – Sept 2015-May 2016

Apix Performance collaborated with Hospital Consulting Solutions to complete a review and recommendations to improve inpatient care services at two hospitals in Newfoundland. There is a need to better engage primary care physicians in providing inpatient care in the province, and to ensure that staffing is sufficient to manage increasing inpatient workload. The project involved an extensive stakeholder engagement strategy, on-site reviews and workload analysis. Recommendations have been made regarding changes to help ensure high quality and sustainability for inpatient care programs.

The program was sponsored by the Newfoundland and Labrador Medical Association and the Department of Health and Community Services.


NLMA_logoNewfoundland and Labrador Medical Association

Palliative Care Performance Program in Eastern Health – March-June 2015

Apix Performance facilitated a Performance Program to improve the palliative care consult service in Eastern Health, Newfoundland. All members of the inter-disciplinary clinical team, including a patient representative, worked together to design and implement improvements that have increased access to palliative care services in the region.

The program was sponsored by the Newfoundland and Labrador Medical Association and the Department of Health and Community Services.


TOHThe Ottawa Hospital

Quality Based Procedure Implementation Review – January-March 2015

Apix Performance is reviewing the implementation of Quality Based Procedures at The Ottawa Hospital. Apix will conduct a gaps analysis to better understand how the existing QBP approach meets the needs of patients, clinical working groups, external partners and TOH. Based on this, recommendations will be made to improve quality and efficiency of Quality Based Procedures.

The Ottawa Hospital is the largest hospital in Canada and a leading performer in safety and quality in North America. Apix Performance will be under contract to the Chief Quality and Performance Officer for this project.


NLMA_logoNewfoundland and Labrador Medical Association

Stroke Rehabilitation Performance Program at Eastern Health/Memorial University – May-November 2014

Apix Performance facilitated a Performance Clinic for clinical teams providing post-stroke rehabilitation services. Care pathways were streamlined to provide earlier access to outpatient stroke rehabilitation using existing clinical resources.

The clinical team saved over 600 hours of staff time during the initial 4-months of the program, and have been able to increase their patient care capacity.

The program was sponsored by the Newfoundland and Labrador Medical Association and accredited for Royal College of Physicians and Surgeons continuing professional development credits by Memorial University.

Program summary:
Participant experiences:

NLMA_logoNewfoundland and Labrador Medical Association

GI Endoscopy Performance Program at Eastern Health/Memorial University – January-May 2014

Apix Performance facilitated a Performance Clinic for gastroenterology and surgical teams providing GI endoscopy services. Over a 3-month period a pooled surveillance colonoscopy clinic was implemented providing earlier access to endoscopy for high-risk patients. This was the first shared endoscopy clinic involving both surgeons and gastroenterologists, and the first pooled endoscopy service providing centralized management of wait lists and scheduling.

The program was sponsored by the Newfoundland and Labrador Medical Association and accredited for Royal College of Physicians and Surgeons continuing professional development credits by Memorial University.

Program summary:
Participant experiences:

toq_logoThe Taming of the Queue Conference

Poster Presentation – A Process Improvement Program at a Movement Disorder Clinic Improves Patient Access – April 2014

Dr. Douglas Woodhouse presented a poster at the annual Taming of the Queue conference in Ottawa, Canada. The poster described the results from a Performance Program that achieved the following results:

  • Shorter access time: Access time decreased to 20 days, compared to 133 days at the beginning of the project
  • Better utilization of the multi-disciplinary care team: The percentage of patients with a movement disorder rose to 88%, from a baseline of 27%
  • More new consults: New patients now account for 23% of appointments, from 8.4%
  • Improved attendance: Attendance has risen to 93%, from 81%
  • Greater efficiency: The carousel appointment and multi-disciplinary clinic form save an estimated 150 hours of physician time and 320 hours of administrative time per year.

int_forum_logoInternational Forum on Quality and Safety in Healthcare

Poster Presentation – A Process Improvement Program at a Movement Disorder Clinic Improves Patient Access – April 2014

Dr. Douglas Woodhouse presented a poster at the annual International Forum on Quality and Safety in Healthcare conference in Paris, France. The conference is co-sponsored by the BMJ and the Institute for Healthcare Improvement. The forum was attended by over 3,000 healthcare leaders and practitioners worldwide and provides a setting for them to meet, learn, share local knowledge and recognise accomplishments in improving quality and safety for patients and communities across the world.


nosm_logoNorthern Ontario School of Medicine

Distributed Tutorial Session – High quality patient care and financial sustainability, a process oriented approach to health care – March 2014

Dr. Douglas Woodhouse hosted a distributed tutorial session for the Northern Ontario School of Medicine. The video-conferenced training session was provided to remotely located medical students across northern Ontario. The tutorial session helps to prepare medical students to play a leadership role in optimizing healthcare processes. Process improvement tools are discussed and the positive impact of efficient processes on cost and quality are reviewed.


pfizer
Pfizer Netherlands

Rheumatology Performance Clinic – November 2013

Apix Performance facilitated a 2-day Performance Clinic on behalf of Pfizer Netherlands. A multi-disciplinary clinical team from Jeroen Bosch hospital in the Netherlands participated in process improvement activities and developed implementation plans for improvement. The team receives support for their improvement activities over 3 months following the workshop. The workshop was delivered in Dutch, in partnership with Van Der Putten Medical.


ZorgDomein
ZorgDomein Netherlands

Advice on Translation and Internationalization of Website and ZorgDomein Products – October-November 2013

Apix Performance provided advice and translation services related to internationalization of ZorgDomein products for English-speaking markets and health-systems.

ZorgDomein is a provider of e-referral and tele-consultation solutions. They are the leading provider of referral software solutions in the Netherlands, in use in the majority of Dutch hospitals and by over three-quarters of General Practitioners.


opha_logoOntario Public Health Association

Keynote Presentation at the Annual Fall Forum – October 2013

Dr. Douglas Woodhouse was the keynote speaker at the annual Fall Forum of the Ontario Public Health Association, and moderated several interactive sessions.

“Can we continuously improve public health? This thought-provoking and provocative presentation will examine the evolution of quality improvement systems using examples from manufacturing, healthcare and public health, highlighting the need for widespread adoption of quality improvement systems in Ontario’s public health sector.”


NLMA_logoNewfoundland and Labrador Medical Association

Neurology Performance Program at Eastern Health/Memorial University – May 2012-April 2013

The Division of Neurology at Memorial University participated in a Performance Program facilitated by Apix Performance. Two clinical teams, providing care for patients with Multiple Sclerosis and Parkinson’s disease, streamlined their care processes. During the program, both teams achieved impressive reductions in access time and increased efficiency.

Over a six-month period access time for initial appointment for patients with suspected movement disorders decreased from 133 to 20 days. A ‘carousel’ multi-disciplinary appointment and a standardised clinic form improved the flow of patients saving an estimated 150 hours of physician time and 320 hours of administrative time per year.

The results have been published in the BMJ Quality Improvement Reports journal, available here…

The program was sponsored by the Newfoundland and Labrador Medical Association and accredited for Royal College of Physicians and Surgeons continuing professional development credits by Memorial University.

Program summary:
Participant experiences:

pfizer
Pfizer Netherlands

Rheumatology Performance Clinic – April 2013

Apix Performance facilitated a 2-day Performance Clinic on behalf of Pfizer Netherlands. A multi-disciplinary clinical team from Maastad hospital in the Netherlands participated in process improvement activities and developed implementation plans for improvement. The team receives support for their improvement activities over 3 months following the workshop. The workshop was delivered in Dutch, in partnership with Van Der Putten Medical.


TOHThe Ottawa Hospital

Strategic Review – February-March 2013

The Ottawa Hospital is a leading institution in data-driven clinical process improvement and the integration of mobile technology to support improved clinical workflows. Apix Performance advised on a number of strategic issues under contract to the Senior Vice President of Strategy and Transformation at The Ottawa Hospital. Opportunities to improve transfers of patient care during referral processes and the potential for e-Referral solutions, particularly in cancer care, were analyzed. Apix Performance also worked with the Transformation Team to advise on the engagement of clinical teams during process improvement projects.


nosm_logoNorthern Ontario School of Medicine

Distributed Tutorial Session – High quality patient care and financial sustainability, a process oriented approach to health care – March 2013

Dr. Douglas Woodhouse hosted a distributed tutorial session for the Northern Ontario School of Medicine. The video-conferenced training session was provided to remotely located medical students across northern Ontario. The tutorial session helps to prepare medical students to play a leadership role in optimizing healthcare processes. Process improvement tools are discussed and the positive impact of efficient processes on cost and quality are reviewed.


pfizer

Pfizer Netherlands

Dermatology Performance Clinic – February 2013

Apix Performance has completed Performance Clinics for Dutch Dermatology teams on behalf of Pfizer Netherlands. Two multi-disciplinary teams from Dutch Dermatology clinics have participated in process improvement activities and developed implementation plans for improvement. The teams receive support for their improvement activities over 3 months following the workshop. The workshops were delivered in Dutch, in partnership with Van Der Putten Medical.


bmjBritish Medical Journal

Cycle Time: The New Wait Time – A Practical Approach to Process Improvement – January 2013

Dr. Douglas Woodhouse was a guest presenter for a BMJ Quality webinar in January 2013. He presented a practical approach to process improvement based on his article “Cycle Time: The New Wait Time” published on the BMJ Quality Blog.


CAMHCentre for Addiction and Mental Health

Clinical Change and Process Improvement Webinar Series – Smoking Cessation Program Implementation – November 2012

A series of 3 webinars has been commissioned by the Centre for Addiction and Mental Health, Canada. The webinars will review a practical approach to clinical change and process improvement, with a focus on implementing smoking cessation programs in clinical practice. This program is a follow-up from the TEACH webinar (Training Enhancement in Applied Cessation and Health) that Dr. Woodhouse delivered in partnership with CAMH.


cqcoCancer Quality Council of Ontario

Conference presenter at Align, Bridge, Collaborate: Strengthening primary and specialist care links for seamless patient care – November 2012

Dr. Douglas Woodhouse presented a rapid round during the CQCO conference as an invited speaker. He spoke about how referral systems in the Netherlands have been designed and implemented.


CAMHCentre for Addiction and Mental Health

Performance Clinics – Process Improvement Workshops for Smoking Cessation Programs – March 2012

Dr. Douglas Woodhouse hosted a continuing medical education webinar for health care professionals on behalf of CAMH Canada. He discussed key success factors for process change and implementing smoking cessation programs into clinical practice. The webinar was part of the TEACH (Training Enhancement in Applied Cessation and Health) series of smoking cessation webinars for health professionals.


NLMA_logoNewfoundland and Labrador Medical Association

Streamlining the Medical Referral and Specialty Consultation Process – January-April 2012

Apix Performance is working with the Newfoundland and Labrador Medical Association in Canada to improve access to specialty services. Reducing access times for referrals to specialty care has been identified as a priority issue. We are working together with specialist and primary care teams in the Eastern Health region (St. John’s) to improve referral processes and to identify and resolve bottlenecks in patient flow.


CMACanadian Medical Association

Joint GP and Specialist Forum – February 2012

Dr. Douglas Woodhouse was an invited presenter at the Canadian Medical Association Joint GP and Specialist Forum. Dr Woodhouse discussed a strategy for change management related to the implementation of a clinical referral system in the Netherlands. His presentation was delivered remotely for the audience in Ottawa, Canada by videoconference from Amsterdam, Netherlands.


CMA
Canadian Medical Association

Multi-stakeholder Summit: The Referral and Consultation Process – December 2011

Dr. Douglas Woodhouse was an invited participant at the Canadian Medical Association Multi-stakeholder Summit: The Referral and Consultation Process in Ottawa, Canada. The conference provided a forum for participants who been involved with improving referral processes in different jurisdictions to share ideas and experiences.


pfizer
Pfizer Netherlands

Rheumatology Performance Clinic – November 2011

Apix Performance facilitated a 2-day Performance Clinic on behalf of Pfizer Netherlands. Two multi-disciplinary teams from Dutch Rheumatology clinics participated in process improvement activities and developed implementation plans for improvement. The teams receive support for their improvement activities over 3 months following the workshop. The workshop was delivered in Dutch, in partnership with Van Der Putten Medical


Medtronic
Medtronic Canada

Symposium of Paediatric Diabetic Professionals – November 2011

Dr. Douglas Woodhouse presented “Engaging Clinicians in Process Improvement” during a plenary session at the Symposium des Professionnels en Diabétologie Pédiatrique (Symposium of Paediatric Diabetic Professionals), organized by the Fondation Pour Enfants Diabétiques (The Diabetic Children’s Foundation). The symposium took place in Montreal, Canada. Dr. Woodhouse’s presentation was sponsored by Medtronic of Canada.


pfizer
Pfizer Netherlands

Pain Treatment Performance Clinic – November 2011

Apix Performance facilitated two, 2-day Performance Clinics on behalf of Pfizer Netherlands. Four multi-disciplinary teams from Dutch Pain Treatment clinics participated in process improvement activities and developed implementation plans for improvement. The teams receive support for their improvement activities over 3 months following the workshop. The workshop was delivered in Dutch, in partnership with Van Der Putten Medical.


CMA
Canadian Medical Association

Health Policy and Negotiations Conference – October 2011

Dr. Douglas Woodhouse was an invited speaker at the Canadian Medical Association Health Policy and Negotiations Conference, held in Ottawa, Canada. He presented Streamlining Referrals from Primary to Specialty Care. Dr. Woodhouse discussed current challenges with referral systems, identified needed improvements and described a Dutch referral solution.


ZorgDomein
ZorgDomein Netherlands – April-May 2011

Apix Performance completed a review of referral improvement projects in the United Kingdom and in Canada. We reviewed health systems, current trends and provided a comparative analysis of several e-referral solutions.

ZorgDomein is a provider of e-referral and tele-consultation solutions. They are the leading provider of referral software solutions in the Netherlands, in use in the majority of Dutch hospitals and by over three-quarters of General Practitioners.


patientsafety_logo
The Patient Safety Company – April-June 2011

Apix Performance worked with The Patient Safety Company to assess a foreign market for error-reporting and clinical improvement software. We analyzed current trends in the health system, reviewed the competitive landscape and developed a business plan. Apix Performance also provided advice on product development and business strategy.

The Patient Safety Company provides adverse-event reporting and clinical improvement software. The Patient Safety Company is located in Alkmaar, Netherlands and provides software services to international clients.