healthcare call to action 2007
DESCRIPTION
Presented at the National Academy for State Health Policy's 20th Annual State Health Policy Conference in Denver, Colorado. Author: Tom EvansTRANSCRIPT
Healthcare Call to Action Healthcare Call to Action 20072007
Tom Evans, M.D.Tom Evans, M.D.
A New Era…A New Era…
A new era of transparency and A new era of transparency and accountability…accountability…
Development of evidence-based medicineDevelopment of evidence-based medicineDefine and standardize clinical performance Define and standardize clinical performance metricsmetricsConvergence around new measuresConvergence around new measuresAwareness of effectivenessAwareness of effectiveness
Industry shifts in practiceIndustry shifts in practiceChanges in reimbursement Changes in reimbursement Value Driven Health CareValue Driven Health Care
Value-Driven Health SystemValue-Driven Health System
Connecting the SystemConnecting the System– Standards to connect all health information systemsStandards to connect all health information systems
Measure and Publish QualityMeasure and Publish Quality– Every case, every procedureEvery case, every procedure
Measure and Publish PriceMeasure and Publish Price– Standardize identical services and episodes of careStandardize identical services and episodes of care
Create Positive IncentivesCreate Positive Incentives– Reward those who offer and those who purchase high Reward those who offer and those who purchase high
quality, competitively priced healthcarequality, competitively priced healthcare
Iowa HealthcareIowa Healthcare CollaborativeCollaborative
– 2003 Task Force of providers, payers, 2003 Task Force of providers, payers, purchasers and consumerspurchasers and consumers
““How will this era of transparency and How will this era of transparency and accountability effect Iowa Healthcare with it’s accountability effect Iowa Healthcare with it’s unique challenges?”unique challenges?”
From joint IHA/IMS Task Force … From joint IHA/IMS Task Force … ……to provider-led statewide quality to provider-led statewide quality
improvement initiativeimprovement initiative
Iowa Healthcare CollaborativeIowa Healthcare Collaborative
Align & Equip Health Care Providers on Quality and Value
Responsible Public ReportingResponsible Public Reporting
Engage the CommunityEngage the Community for Clinical for Clinical ImprovementImprovement
Raise the Standard of Care in IowaRaise the Standard of Care in Iowa
IHC Organizational StructureIHC Organizational Structure
IHC Board
IHC Advisory Council
Data Committee
Clinical Initiative Work Groups
EducationCommittee
IHC 2007 Work Plan
Iowa Healthcare CollaborativeIowa Healthcare Collaborative2007 Work Plan2007 Work Plan
EducationEducation
Public ReportingPublic Reporting
Patient SafetyPatient Safety
Clinical InitiativesClinical Initiatives
IHC 2007 Work PlanEducation
ConferencesPatient Safety SummitPhysician’s ForumLEAN in Health Care ConferenceAnnual IHC Conference
Website- www.ihconline.orgToolkits
Anticoagulation, Medication Reconciliation, Health Literacy, Healthcare-associated Infection, Lean in Health Care, Safe Culture Physician Practice Toolkit
IHC 2007 Work PlanIHC 2007 Work PlanPublic ReportingPublic Reporting
Driven by Driven by “Responsible Public Reporting”“Responsible Public Reporting”
IHC SourcesIHC SourcesBoth clinical and administrative dataBoth clinical and administrative dataPublicly available and voluntary reported information sourcesPublicly available and voluntary reported information sources
Data suitable for comparative purposes Data suitable for comparative purposes CMS Hospital CompareCMS Hospital CompareAHRQ Administrative data setAHRQ Administrative data set
Subjective data, not suitable for comparative purposesSubjective data, not suitable for comparative purposesNQF 30 Safe Practices informationNQF 30 Safe Practices informationHealthcare Associated Infection (HAI) measuresHealthcare Associated Infection (HAI) measuresSpread Measures Spread Measures
Public ReportingPublic Reporting
The Iowa ReportThe Iowa Report
– 2005 Report2005 ReportCMS Measures- Hospitals CMS Measures- Hospitals AHRQ Data- Statewide aggregateAHRQ Data- Statewide aggregateSurvey on NQF Safe PracticesSurvey on NQF Safe Practices
– 2006 Iowa Report2006 Iowa ReportCMS Measures- Hospital specificCMS Measures- Hospital specificAHRQ Data- Hospital specific and some statewide aggregateAHRQ Data- Hospital specific and some statewide aggregateHealthcare Associated Infection (HAI) measure section Healthcare Associated Infection (HAI) measure section
Public ReportingPublic ReportingThe 2007 Iowa ReportThe 2007 Iowa Report– Impact storiesImpact stories
– 5 Million Lives Campaign5 Million Lives Campaign– Healthcare-associated InfectionHealthcare-associated Infection– Rapid Response ProcessesRapid Response Processes– Lean in HealthcareLean in Healthcare– Medication ReconciliationMedication Reconciliation
– CMS measuresCMS measures– Expanded AHRQ measures, both hospital specific Expanded AHRQ measures, both hospital specific
and statewide aggregateand statewide aggregate– Expanded HAI Reporting- six new measuresExpanded HAI Reporting- six new measures– Spread of 5M InitiativesSpread of 5M Initiatives
IHC 2007 Work PlanIHC 2007 Work PlanPatient SafetyPatient Safety
Promote NQF 30 Safe PracticesPromote NQF 30 Safe Practices
Medication SafetyMedication Safety– Anticoagulation Anticoagulation – Medication ReconciliationMedication Reconciliation– High Alert MedicationsHigh Alert Medications
Safe CultureSafe Culture
Health LiteracyHealth Literacy
Explore PSO designation Explore PSO designation
IHC 2007 Work PlanIHC 2007 Work PlanClinical InitiativesClinical Initiatives
Lean in Health CareLean in Health Care
IHI 5 Million Lives CampaignIHI 5 Million Lives Campaign
Healthcare-Associated InfectionHealthcare-Associated Infection
Lean in HealthcareLean in Healthcare
Annual Lean Conference Annual Lean Conference – Promote and endorsePromote and endorse– Share Iowa experiencesShare Iowa experiences
““Active” User GroupActive” User Group
Lean CollaborativeLean Collaborative– 21 hospitals…21 hospitals…
5 Million Lives Campaign5 Million Lives Campaign
Strategy:Strategy:– All 12 initiatives, all 117 Iowa hospitalsAll 12 initiatives, all 117 Iowa hospitals– Clustered and aligned with existing IHC workClustered and aligned with existing IHC work– Project Coordinator, goalsProject Coordinator, goals– Convene, share, track progressConvene, share, track progress
Breakthrough series modelBreakthrough series model– Learning sessions (9/11/07, 3/3/08, 9/9/08)Learning sessions (9/11/07, 3/3/08, 9/9/08)– Action periods between with calls and Action periods between with calls and
contactscontacts
Campaign InitiativesCampaign Initiatives
Acute Myocardial Acute Myocardial InfarctionInfarction
Adverse Drug EventsAdverse Drug Events
Surgical Site Infection Surgical Site Infection
Ventilator Assoc. Ventilator Assoc. PnuemoniaPnuemonia
Central Line InfectionCentral Line Infection
Rapid Response Rapid Response TeamsTeams
Congestive Heart Congestive Heart FailureFailure
High Hazard High Hazard MedicationsMedications
Surgical Care Surgical Care Improvement ProjectImprovement Project
Pressure UlcersPressure Ulcers
Methicillin Resistant Methicillin Resistant Staph AureusStaph Aureus
Boards on BoardBoards on Board
Healthcare Associated InfectionHealthcare Associated Infection
Alignment with NQF Safe Practices and the Alignment with NQF Safe Practices and the 5M Campaign5M Campaign
Engagement of ICP CommunityEngagement of ICP Community
Statewide Influenza HCW Vac. GoalStatewide Influenza HCW Vac. Goal
Introduced voluntary reporting of six Introduced voluntary reporting of six statewide measuresstatewide measures
Influenza Vaccination of Healthcare Workers Influenza Vaccination of Healthcare Workers
Central Line Infection- ICUCentral Line Infection- ICU
Surgical site infection rates for Hip, Colon, CABG Surgical site infection rates for Hip, Colon, CABG and Hysterectomyand Hysterectomy
Our Response… Our Response…
Providers Need to Lead
Brightest, most powerful component of the health care equation… Excuses:– “I don’t have time.”– “This isn’t my problem.” – “When the hospital gives me a cut of the action…”– “I don’t have a prescribing pen…no real influence…”
Training and Mindset:– See one, do one, teach one. – We’re trained to not innovate
LeadershipLeadership
To lead, we need to develop… To lead, we need to develop… – A spirit of innovation A spirit of innovation – A sense of ownership A sense of ownership – A focus on ‘nimbleness’A focus on ‘nimbleness’– A commitment to collaboration A commitment to collaboration
Redefining Professionalism
The New Era of Transparency and Accountability based on a Value-Driven Healthcare System…– Evidence-based process measures & metrics– Define and standardize clinical performance metrics– Data used to improve quality and value– Reliable information publicly available on quality and
cost– Rapid spread of best practice– Engagement of patients as partners
Cornerstones for the future…
Align & Equip Health Care Providers on Quality and Value
Responsible Public Reporting
Engage the Community for Clinical Improvement
Raise the Standard of Care