FHC NH Partnership for Patients

Our charge is clear: reduce preventable harm by 40% and reduce preventable

readmissions by 20% by 2013.

Partnership for Patients

• Launched in April 2011• Initiative from the Centers for Medicare &

Medicaid Services Innovation Center• Established by the Affordable Care Act to

identify and develop promising new models of care delivery to reduce costs and increase quality.

• $500 million funding

Keep patients from getting injured or sicker.

• By the end of 2013, preventable hospital-acquired conditions would decrease by 40 percent compared to 2010.

• Achieving this goal would mean approximately 1.8 million fewer injuries to patients, with more than 60,000 lives saved over the next three years.

Help patients heal without complication.

• By the end of 2013, preventable complications during a transition from one care setting to another would be decreased so that hospital readmissions would be reduced by 20 percent compared to 2010.

• Achieving this goal would mean more than 1.6 million patients will recover from illness without suffering a preventable complication requiring re-hospitalization within 30 days of discharge.

Hospital Engagement Networks

• 26 State, regional and national hospital system organizations – help identify solutions already working to reduce healthcare

acquired conditions– work to spread them to other hospitals and health care

providers– develop learning collaboratives for hospitals – rapidly improve patient safety in hospitals

• Two “HENs” in NH – NH FHC Partnership for Patients – Intermountain Healthcare

NH Hospitals:100% Engagement

Partnership for Patients: Core Areas of Focus

• Adverse drug events (ADE) • Central line-associated

blood stream infections (CLABSI)

• Pressure ulcers • Surgical site infections• Injuries from falls and

immobility

• Catheter-associated urinary tract infections (CAUTI)

• Obstetrical adverse events • Venous thromboembolism

(VTE) • Ventilator-associated

pneumonia (VAP) • Preventable readmissions

Building upon platform ofNH Partnership to ELIMINATE HARM by 2015

Venous thromboembolism (VTE)

• 1st Focus as part of NH Eliminate Harm by 2015

• “VTE Prevention-Live Clot Free” in NH toolkit distributed July 2011 to all hospitals

• Data collection began Q4 2011: VTE prophylaxis and DVT/PE Incidence

• Varying degrees of implementation, some driven by Meaningful Use & SCIP

Live Clot Free in New Hampshire

• Toolkit sent to all hospitals in July– Measurement definitions– Reporting forms– Sample protocols– VTE discharge education sheet– FAQ

Summary of VTE Data

• Audit period: October 1 – December 31,2011 discharges

• 22 Hospitals submitted VTE Data• Range of Eligible Patients audited per hospital

was from 5 – 3230 patients– 1 less than 30– 14 Hospitals provided requested sample size of 30– 7 more than 30

Hospitals Reporting VTE DataAlice Peck Day Memorial HospitalAndroscoggin Valley HospitalCatholic Medical CenterCheshire Medical CenterConcord HospitalDartmouth Hitchcock Medical CenterElliot HospitalExeter HospitalFranklin Regional HospitalFrisbie Memorial HospitalHuggins HospitalLakes Region General HospitalLittleton Regional HospitalMonadnock Community HospitalNew London HospitalParkland Medical CenterPortsmouth Regional HospitalSouthern NH Medical CenterSpeare Memorial HospitalValley Regional HospitalWeeks Medical CenterWentworth Douglass Hospital

% of eligible patients who received VTE prophylaxis or have documentation why no VTE prophylaxis was given

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 220%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

37%

63% 64%

77%

82%

86%90% 90%

92%95%

97%100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100%

Series1

8

14

# of Hospitals w/Confirmed VTETotal # of Hospitals Data provided

# of Hospitals with patients with confirmed VTE out of Twenty Two Hospitals who submitted data

Summary of # of Patients with confirmed VTEand # of those Patients who received no VTE prophylaxis

# of Pts dev during hospitalization Patients who recv'd VTE prophylaxis # of Pts PRIOR no VTE prophylaxis0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%100.00%

82.50%

17.50%

Series1

40

33

7

HARM

Questions for Discussion

• In Search of Data Collection Methods– What are the barriers / challenges?– Lessons learned?

• In Search of Better Processes– What did you learn as you were doing reviews?– Did you develop tools to enhance VTE

prophylaxis?– Did you identify any templates of best practices?

FHC NH Partnership for Patients2013 VISION

“Live Free of Medical Error, and Don’t Die!”