hospitals, quality and hit: important issues and intersections · of stroke patients reduction in...

Copyright © 2006 Siemens Medical Solutions USA, Inc. All rights reserved.

Hospitals, Quality and HIT: Important Issues and Intersections

Gail E. Latimer, MSN, RN, VP, Chief Nursing OfficerSiemens Medical Solutions


Inform ClinicalPractice

PersonalizeCare

ImprovePopulationHealth

InterconnectStakeholders

By using health IT togive consumers moreaccess to and involvementin health decisions.

PersonalizeCare

By expanding themonitoring of publichealth and bringingresearch advancesmore quickly tomedical practice.

ImprovePopulationHealth

By building an interoperablehealth information system sorecords follow patients.

InterconnectStakeholders

By bringing IT tools, including EHRand content, to doctors and hospitals.Inform

ClinicalPractice

The Value of Health Information Technology

ElectronicHealthRecord


Clinical Performance Drivers

Targeted Performance Areas – The Nation is Monitoring

Length of stayPatient fallsUrinary tract infectionPressure ulcersHospital-acquiredpneumoniaShock or cardiac arrestUpper gastrointestinal bleeding

SepsisDeep vein thrombosisCentral nervous system complicationsIn-hospital deathWound infectionPulmonary failureMetabolic derangement

Acute MIHeart failurePneumoniaSurgical infection prevention


Transparency in Hospital Public Reporting -Clinical Process Measures


EHR

Emergency DepartmentScheduling

Medical UnitRadiology

Pharmacy Health Info Mgmt

Laboratory

Patient's HomeEnvironmental Services

Business Office

Dietary

Physician's Office


Incorporating Evidence Within Clinical Practice

Accelerating role in today’s healthcare Provides improved quality and reduction in variationServes as the basis for many quality management and performance initiativesInformation technology will drive the use of knowledge with the EHR


Increase Accuracy and Efficiency of Clinical ProcessesComputerized Physician Order Entry


Incorporating the Capture of Core MeasuresClinical Documentation


Knowledge-driven EHR


Knowledge Drives the Patient Plan of Care

Smoking Cessation slide


Knowledge Drives the Patient Plan of Care


Acute Myocardial Infarction Workflow -


Workflow Engine –Listening, Monitoring, and Escalating…….


Workflow Engine –The Right Information, To the Right Person, at the Right Time……


Leveraging Technology to Measure Quality and Cost

Technology provides real-time access to cost and quality

Technology generates new knowledge to advance healthcare

Technology deployment supports the care delivery process while measuring outcomes

Technology can capture clinical practice, improve processes and quantify the impact on patient outcomes


AMI

Aspirin at ArrivalGoal 100%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Οχτ2003=52

Νοϖ2003=50

∆εχ2003=63

ϑαν2004=56

Φεβ2004=42

Μαρ2004=54

Απρ2004=50

Μαψ2004=57

ϑυνε2004=39

ϑυλψ2004=46

Αυγ2004=36

Σεπτ2004=47

Οχτ2004=60

Νοϖ2004=63

∆εχ2004=56

ϑαν2005=52

Φεβ2005=70

Μαρ2005=55

Απρ2005=52

Μαψ2005=53

ϑυνε2005=60

ϑυλψ2005=63

MRMC HQI Top Decile

Aspirin Prescribed at Discharge Goal 100%

0%

10%

20%30%

40%

50%

60%70%

80%

90%100%

Οχτ2003=52

Νοϖ2003=50

∆εχ2003=63

ϑαν2004=56

Φεβ2004=42

Μαρ2004=54

Απρ2004=50

Μαψ2004=57

ϑυνε2004=39

ϑυλψ2004=46

Αυγ2004=36

Σεπτ2004=47

Οχτ2004=60

Νοϖ2004=63

∆εχ2004=56

ϑαν2005=52

Φεβ2005=70

Μαρ2005=55

Απρ2005=52

Μαψ2005=53

ϑυνε2005=60

ϑυλψ2005=63

MRMC HQI Top Decile


AMI

ACE Inhibitor / ARB for LVSD Goal 100%

6/8 7/9

15/15 8/8 9/9

6/8

13/14

8/11

13/14 12/14

10/10

9/11

9/14

15/1613/13

13/14

11/11

9/10

13/13

0%

20%

40%

60%

80%

100%

Οχτ2003=52

Νοϖ2003=50

∆εχ2003=63

ϑαν2004=56

Φεβ2004=42

Μαρ2004=54

Απρ2004=50

Μαψ2004=57

ϑυνε2004=39

ϑυλψ2004=46

Αυγ2004=36

Σεπτ2004=47

Οχτ2004=60

Νοϖ2004=63

∆εχ2004=56

ϑαν2005=52

Φεβ2005=70

Μαρ2005=55

Απρ2005=52

Μαψ2005=53

ϑυνε2005=60

ϑυλψ2005=63

MRMC HQI Top Decile

Smoking Cessation Advice/CounselingGoal 100%

0%10%20%30%40%50%60%70%80%90%

100%

Οχτ2003=52

Νοϖ2003=50

∆εχ2003=63

ϑαν2004=56

Φεβ2004=42

Μαρ2004=54

Απρ2004=50

Μαψ2004=57

ϑυνε2004=39

ϑυλψ2004=46

Αυγ2004=36

Σεπτ2004=47

Οχτ2004=60

Νοϖ2004=63

∆εχ2004=56

ϑαν2005=52

Φεβ2005=70

Μαρ2005=55

Απρ2005=52

Μαψ2005=53

ϑυνε2005=60

ϑυλψ2005=63

MRMC HQI Top Deciledenominator may change due to inclusion/exclusion criteria


AMIBeta Blocker at Arrival

Goal 100%

0%10%20%30%40%50%60%70%80%90%

100%

Οχτ

2003=52

Νοϖ

2003=50

∆εχ

2003=63

ϑαν

2004=56

Φεβ

2004=42

Μαρ

2004=54

Απρ

2004=50

Μαψ

2004=57

ϑυνε

2004=39

ϑυλψ

2004=46

Αυγ

2004=36

Σεπτ

2004=47

Οχτ

2004=60

Νοϖ

2004=63

∆εχ

2004=56

ϑαν

2005=52

Φεβ

2005=70

Μαρ

2005=55

Απρ

2005=52

Μαψ

2005=53

ϑυνε

2005=60

ϑυλψ

2005=63

MRMC HQI Top Decile

Thrombolytic received within 30 Minutes of Hospital Arrival (Avg. Time in Minutes)

0102030405060708090

100

Οχτ

2003=52

Νοϖ

2003=50

∆εχ

2003=63

ϑαν

2004=56

Φεβ

2004=42

Μαρ

2004=54

Απρ

2004=50

Μαψ

2004=57

ϑυνε

2004=39

ϑυλψ

2004=46

Αυγ

2004=36

Σεπτ

2004=47

Οχτ

2004=60

Νοϖ

2004=63

∆εχ

2004=56

ϑαν

2005=52

Φεβ

2005=70

Μαρ

2005=55

Απρ

2005=52

Μαψ

2005=53

ϑυνε

2005=60

ϑυλψ

2005=63


Nursing Dashboard - 5 East

Unit: 5 East

Director:

Unit Description # of Beds 36

StaffingAverage Bed Census 32.47 3.91%Vacancy Rate 4% (Combined RN/LPN) 0.36%Retention Rate* 87%% Float Usage 0.20% Patient Satisfaction Average Daily Acuity 2.28 -Overall Satisfaction with

Nursing Care (Norm) 87.6-Key Driver #1 87.3

Adverse Drug Events Reported 15D 1:5.17 -Drug Events w/ Harm Reported 0

E (3-7) 1:4.92 -Drug Events Prevented 9.1 per 1000 dosesE (7-11) 1:5.33 -Hospital Wide Rate of Harm .14 per 1000 doses

N 1:5.36 CE Results-Pneumonia Vaccine Assessment no data

Fall Rate % Restrained/Patient Day

Avg. - N & P Ratio (Includes PCS)

NURSING DASHBORD REPORTMedical/Surgical

Calendar / QTR: 1st Quarter, FY 2005October - December 2005Kelley Prevatte

Type of Patient: Medical/Surgical Observation

Quality/Patient Safety Outcomes


Monitoring Clinical Outcomes


The Value of Health Information Technology -Monitoring Quality and Cost


Achieved more than 90% compliance with regulatory standards for discharge education of stroke patients

Reduction in prescriber errors by 71%

Reduction in medication to pharmacy review time from up to 24 hours to within 1 hour

Decreased harmful events to a six month average of 0.33 per 1,000 doses (compared to a national average of 2-8 harmful events per 1,000 doses)

The Value of Information Technologyfor Clinical Practice

hospitals, quality and hit: important issues and intersections · of stroke patients reduction in...

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